Baylor Scott & White Annette C. and Harold C. Simmons Transplant Institute is a leader in the field of transplant in numerous areas. Today, they are responsible for one more: Baylor Scott & White Health has the largest team of female abdominal transplant surgeons in the United States.
Cystic fibrosis (CF) and pulmonary hypertension (PH) were once common categories for referral to lung transplant. However, advances in medical therapies have allowed many patients with these diseases to avoid transplant. Today, at most transplant centers throughout the world, lung transplants are being performed on increasingly older patients, primarily with interstitial lung disease (ILD) followed by chronic obstructive pulmonary disease (COPD). Unlike CF and PH, few treatments with the ability to extend survival currently exist for ILD, specifically idiopathic pulmonary fibrosis (IPF), and COPD. When these patients continue to decline despite maximized medical therapy, surgical options may be indicated.
The understanding of pulmonary hypertension (PH) continues to evolve. The threshold to diagnose PH was lowered to mPAP ≥ 20 mmHg in the 6th World Symposium on PH in 2018. The therapeutic approach has also changed over time, favoring aggressive use of multiple pulmonary vasodilators in combination upfront and escalation of therapy based frequent assessment of disease progression. The changes to diagnostic criteria and management underscore the need to identify the disease early and to treat it aggressively.
Editorial by Todd Grazia, MD, Chief of Transplant Pulmonology, Baylor University Medical Center
When SARS Co-V2 arrived on U.S. shores in early 2020, physicians in all specialties faced an enormous learning curve. As many have said, we didn’t know what we didn’t know about the coronavirus. Some patients seemed to skate through the infection, while others were laid up with flu-like symptoms for a few weeks, and yet others developed severe respiratory failure from ARDS and died. Pulmonologists and intensivists were tasked with caring for and trying to treat a critical patient population whose lungs seemed to be systematically attacked, and often, permanently damaged by the virus. As the pandemic continued to rage and upend lives, transplant pulmonologists faced a daunting ethical dilemma: Should we or should we not consider lung transplantation for patients with irreversible lung damage from COVID-19?
Findings of a clinical study demonstrated that the use of an antibiotic-eluting envelope placed around a cardiac implantable electronic device (CIED) during implantation reduced the incidence of major infections by 40 percent compared implantation without the antibacterial envelop. The study, called the Worldwide Randomized Antibiotic Envelope Infection Prevention Trial (WRAP-IT; NCT02277990), evaluated the safety and efficacy of the Medtronic TYRXTM Absorbable Antibacterial Envelope in adult patients at 181 centers in 25 countries with 776 implanting physicians.
