Patients receive 1,000th and 1,001st transplants in same day

Reprinted with permission of BJC Today, Feb. 9, 2009

By Kathryn Holleman

Washington University lung transplant surgeons reached a milestone and quickly passed it Jan. 21 when they performed the 1,000th adult lung transplant at Barnes-Jewish Hospital and 1,001st transplant just a few hours later. BJH completes 55-65 lung transplants annually.

With almost 400 additional lung transplants performed at St. Louis Children’s Hospital, the Washington University Medical Center is the busiest lung transplant center in the United States.

Although the transplant milestone is significant, the transplant staff isn’t spending too much time celebrating. “We just paused to take a breath at 1,000, and a few hours later, we were in the operating room next door doing 1,001,” says Bryan Meyers, M.D., lung transplant surgeon and head of thoracic surgery at BJH.

“This is a good opportunity to focus on the achievements of a marvelous team — nursing, pulmonary medicine, thoracic surgery, anesthesia — helping a group of very ill but committed patients,” says G. Alexander Patterson, M.D., chief of cardiothoracic surgery and head of the lung transplant program.

Working at BJH during the first transplant in 1988 and continuing to work for the hospital as perioperative services patient care director is Colleen Becker, RN. She says though the patients’ acuity is similar, they don’t have the same types of complications as they did 20 years ago.

“I worked in the ICU back then, and got to treat that first patient,” Becker says. “I remember going to classes to be trained how to shift the first transplant patients out of the OR and into the ICU. Their care has really changed over the years. The surgical technique and the medications are so much improved. It’s great to see them up and walking around so soon.”

The BJH lung transplant program was started in 1988 by a team of physicians and nurses, led by physicians who had performed the first successful human lung transplant in 1983 at the University of Toronto.

The team continued to innovate and develop surgical techniques and medical regimens that are acknowledged as the gold standard in lung transplant and thoracic surgery.

One of those innovations is the bilateral, sequential lung transplant in which both lungs are transplanted separately, rather than in a single block. This technique significantly boosted the use of lung transplant to treat cystic fibrosis.

The transplant program is headed by Dr. Patterson, Evarts A. Graham Professor of Surgery and chief of cardiothoracic surgery. Dr. Patterson has performed more of the 1,000 transplants than any other surgeon on the team.

Bert Trulock, M.D., the Rosemary and I. Jerome Flance Professor of Pulmonary Medicine and medical director of lung transplantation, served as a transplant team pulmonologist from the BJH program’s beginning.

Michael Pasque, M.D., has been involved as a surgeon in the program since the very start in 1988. He has vivid recollections of the early days of transplant activity, and remains central to the program today.

The program is renowned for its excellent patient outcomes, which equal or surpass national standards. Factors contributing to these outcomes include selection of the most appropriate transplant candidates; world-renowned medical and surgical transplant specialists, many of whom have worked together since the program began; extensive experience in caring for end-stage lung disease and lung transplant patients; and aggressive pursuit of leading-edge therapies and promising new drugs, according to Dr. Patterson.