MDNews - Eastern Pennsylvania/Northwest New Jersey

November/December 2013

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Larger Lungs ++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++ +++++++++++ +++++++++++ +++++++++++ +++++++++++ +++++++++++ ++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++++++ ÍÍÍ THAT'SNEWS Mean Better Transplants N EW RESEARCH FROM Johns Hopkins University has found that lung donor recipients who receive lungs slightly larger than a perfect match have an increased chance of survival after lung transplant surgery. Before a lung transplant, the predicted total lung capacity (pTLC) of both the recipient and the donor are calculated based on height, age and gender. The lungs of the donor and the recipient are matched based on the pTLC ratio, calculated by dividing the donor's pTLC by the recipient's pTLC. Prior to this study, it was thought that the closer the pTLC ratio was to 1.0 (a perfect match), the better the patient outcome. However, an analysis of more than 6,000 single and double lung transplants found that a ratio of 1.3, indicating the donor lungs have a significantly larger pTLC, increases the chances of survival by 30 percent in double lung transplants. Additionally, among single lung transplants, each 0.1 increase in the predicted lung capacity ratio resulted in a 6 percent increase in the chances of survival after one year. I —Melissa Moore Safe Split-Liver Donations Can Save More Lives New Corneal Transplant Procedure A NEW METHOD OF corneal transplant may help shorten recovery time, reduce the risk of tissue rejection and enhance postoperative vision recovery. For some patients, a corneal transplant is required due to a malfunctioning Descemet's membrane, a thin layer of tissue in the rear of the cornea. In a traditional corneal transplant, the entire outer surface of the eye would be transplanted. However, a Descemet's membrane endothelial keratoplasty (DMEK) allows physicians to only transplant the Descemet's membrane in patients who qualify for the procedure. After a traditional corneal transplant, most patients only regain corrected vision of 20/30 or 20/40. Because a DMEK does not change the outside structure of the eye, vision recovery after a DMEK is typically 20/20 or 20/25. Recovery time is also shortened, and the chances of tissue rejection are lowered because the transplant involves a much smaller amount of tissue than a typical corneal transplant. I —Melissa Moore B ECAUSE THE LIVER is regenerative, a whole donated liver can be split into one larger graft and one smaller graft, with the smaller donated to a child and the larger donated to an adult. Previous research demonstrated that splitting the liver diminished the chances of survival in adults who received the split liver. New research published in the Journal of the American College of Surgeons analyzed the outcomes of more than 62,000 adults receiving their first transplanted liver. Researchers concluded that a partial liver transplant has become significantly less risky over time, with adults who received a split-liver graft between 2006–2010 having similar outcomes to those who received whole-liver transplants. Because split-liver donations account for less than 1 percent of pediatric liver donations, researchers hope the study will lead to more split grafts being used and more children receiving a much-needed liver. I —Melissa Moore A DV E R T I S E R I N D E X Knopf Automotive ................................................................................18 MDNEWS.COM I MD NEWS Eastern Pennsylvania/NW New Jersey | 19

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