DOCTORS SEEK NEW TECHNIQUES TO REPLACE LUNG-TRANSPLANT SURGERY.

Byline: Mary Jean Pramik Medical Tribune News Service

More than 2,000 Americans are waiting for a call from the United Network for Organ Sharing (UNOS) telling them that a donor lung is available.

And many of these people will die waiting, said a Missouri lung transplant specialist who spoke at the annual meeting of the American College of Chest Physicians in San Francisco last week.

Dr. Cesar A. Keller, director of the lung transplant program at St. Louis University, and other experts are testing possible alternatives to alleviate the shortage.

Currently, patients can expect a 1-1/2- to two-year wait for new lungs. The wait time for lung transplants skyrocketed between 1990 and 1994, he said. Until 1990, patients may have experienced a delay of about 200 days between the recommendation for lung transplant surgery and the day of operation. In 1994, the median wait time rose to 555 days.

The rapid development of lung transplant technologies and the adoption of the surgery as treatment for more disorders has resulted in a serious shortage of donors, he said.

The number of patients registered for lung transplantation in 1988 was 125. This number increased to 2,169 by September 1996. Of the 125 patients registered in 1988, 33 received a transplant within a year. But, of the 1,923 on the wait list in 1995, only 975 received a transplant.

More than 40 percent of all lung transplants treat either smoking-related conditions such as emphysema or a disorder called chronic obstructive pulmonary disease (COPD). Some 1.65 million Americans have end-stage emphysema.

One promising solution for many of these patients is a procedure known as lung volume reduction, which involves removing part of the diseased lung, Keller explained.