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NEW YORK, Mar 08 (Reuters Health) - Patients who depend on a machine to help them breathe can survive a lung transplant almost as well as those who did not need mechanical assistance to breathe before the surgery, new study results suggest.
Lung transplants have been used to treat people suffering from a number of conditions including cystic fibrosis and emphysema. About 3% of people in the United States awaiting lung transplants depend on mechanical ventilation.
Past studies have shown that these patients are three times as likely to die in the first year after a lung transplant, as compared with those who were able to breathe on their own.
But now, results of a small study of patients on mechanical ventilation before receiving a lung transplant suggest that this does not have to be the case.
Researchers from the University of Florida, Gainesville, and Duke University in Durham, North Carolina, followed nine patients who had been on ventilators for periods of time ranging from 13 days to 5 years before having lung transplants. Most had been on ventilators for about 6 months. These patients were compared with a group of 65 lung transplant patients who had not needed mechanical ventilation ("controls").
Seven ventilator-dependent patients survived for one year after transplant, for a survival rate of 78%, compared with 83% of the non-ventilator-dependent patients.
The main difference between the two groups, according to lead author Dr. Maher A. Baz of the University of Florida, was that the patients who had been on ventilators had to spend a longer time after transplant on mechanical ventilation. On average, they spent 41 days on a ventilator, compared with 9 days for the control group.
This does not mean every patient on a ventilator can survive a lung transplant, Baz and his colleagues note. The patients in the study were relatively healthy despite their lung problems and were undergoing exercise therapy before the surgery. Also, they were not infected with drug-resistant bacteria, a problem that affects many people on long-term ventilatory support.
SOURCE: Chest 2001;119:224-227.
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