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What is the viability of using lung
transplantation to battle ARDS?
The ARDS Support Center received inquiry concerning whether lung
transplantation might be considered in battling severe ARDS. This inquiry has come up from
time to time. We forwarded the inquiry to some of our medical advisors for their comments
and advice.
From: Mark D. Siegel, M.D.
Unfortunately,
lung transplantation has not been considered a viable option for patients with ARDS
because the patients are critically ill at the time. In general, lung transplants are
given to patients who are otherwise clinically stable. I get this question from time to
time and I understand the frustration of the patient's family.
From: Roy Brower, M.D.
The idea of
transplanting lungs for ARDS has been considered but is not currently a reasonable option.
There are a few reasons for this. The first is that many, perhaps most patients with ARDS
who do poorly have infections in the bloodstream, lungs, other organs, etc. When a patient
receives a lung transplant, it's necessary to give medications that suppress the immune
system, to prevent the body from rejecting the transplanted lungs. An important side
effect of these medications is that the patient is then at risk for more and worse
infections. If there is a severe infection at the time of the transplant and the immune
suppression medications are given, the infection goes out of control and leads quickly to
death. Another reason that transplants are not a good option for ARDS is that the
operation is very difficult, and most ARDS patients are not in good enough shape to
undergo the procedure.
I hope this is
helpful, perhaps to reassure the writer that a good option was not overlooked in the care
of her son.
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