Monday, September 08, 2008

New Jersey lung patients breathe easier

From The Star Ledger:

by Angela Stewart

New Jersey residents in need of a lung transplant no longer have to travel out of state, as doctors in Newark announced yesterday that two patients have received new lungs as part of the state's first approved transplant program.

The surgeries were carried out at Newark Beth Israel Medical Center, which had not performed a lung transplant since 1997, when such operations were authorized by state officials on a case-by-case basis. After receiving permission from the state in 2006 to start a formal transplant program, Beth Israel recruited doctors from two of the nation's leading programs -- the University of Pittsburgh Medical Center and the Mayo Clinic -- to lead the effort.

"New Jersey needs a lung transplant program," said Lawrence McBride, the program's surgical director, formerly of the Mayo Clinic. "It's the 10th most populated state in the country and it didn't have one."

Last year, 52 lungs from New Jersey donors were transported out of state because no formal program existed, McBride said. Doctors say those organs now will be offered first to state residents who use the Beth Israel transplant program.

The first operations, overseen by a six-member team, were performed last week on Charles McFarlin, 49, of Irvington and Craig Lawton, 54, of Toms River. As the two men continued recuperating yesterday in adjacent hospital rooms, they described being unable to even walk across the room before receiving their new lungs.

"Taking a shower, putting on socks, brushing your teeth, when you can't breathe, they're very taxing," said McFarlin, an executive with the Day Care Council of New York.

Lawton, who delivered auto parts for a living, said he feels so good that he is looking forward to picking up his guitar again and rejoining a blues band.

"All I could do was barely breathe," he said. "Everything's better already."

Both men were on oxygen around-the-clock before they were placed on the national transplant waiting list in mid-August. McFarlin underwent surgery Aug. 25, Lawton a day later.

McFarlin, who had a double lung transplant, was suffering from sarcoidosis, a disease characterized by the growth of tiny clumps of inflammatory cells in different areas of the body. Sarcoidosis can affect any organ, and it had made McFarlin's lungs so weak that he could hardly make it to work.

"It had caused a lot of scarring in his lungs since he was a small boy. He was getting weaker and weaker, losing weight and getting more short of breath. He was dying," explained Sean Studer, medical director of Beth Israel's program, who left the transplant program at Pittsburgh to come to Newark.

Lawton had severe emphysema, or chronic obstructive pulmonary disease, a progressive lung disease that results in shortness of breath and reduces one's capacity for physical activity. The disease, which is heavily linked to smoking, is caused by damage to the small air sacs and small airways in the lungs.

"My quality of life was terrible," said Lawton, who received a right lung at the hospital, which is affiliated with St. Barnabas Health Care System.

As of last Friday, 2,126 Americans were awaiting lung transplants, according to the United Network for Organ Sharing, the nonprofit organization that matches organ donors and recipients. Other than the two men who received transplants at Beth Israel, no other New Jersey residents were on the list, UNOS officials said.

McFarlin and Lawton will be required to take medication for the rest of their lives to lessen the chances that their bodies will reject their new lungs. Doctors will be closely monitoring them following their release, as lung transplant recipients have a high risk of both rejection and infection.

"Unlike organs transplanted into the body, the lungs have to be exposed to the environment every day through breathing," Studer said.

The five-year survival rate for lung transplant patients is about 55 percent, according to Studer, but both men said they are looking to the future with nothing but optimism.

"I never let these things determine my outlook," McFarlin said. "There's no guarantees in life, but I think we're both doing very well."

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