Patient Care — Medicare Approves Lung Transplant Center

University of Texas Health Science Center At San Antonio
University Health System
Lung Transplantation – 210-567-5777

Adult Lung Transplant – Dedicated to the Care of Patients with Pulmonary Disease

The Lung Transplant Program at The University of Texas Health Science
Center and University Health System was established in 1987 by Dr. J.
Kent Trinkle. a pioneer in Lung Transplantation. University Health
System in partnership with the Health Science Center has been leaders in
the care of people with end stage lung disease. Our Lung Transplant
program has a strong history of research, education, creative
innovation, comprehensive bilingual medical expertise and surgical
excellence. Our program is Medicare certified as of March 1, 2007 and
our survival statistics exceed national averages. We have transplanted
some of the longest surviving lung transplant patients in the nation in
addition to some of the eldest.

Our lung transplant team, led by Dr. Scott Johnson, includes Drs. A.J. Carpenter, Edward Sako, Luis Angel, Dan DeArmond,
Debbie Levine, John Calhoon, and V. Seenu Reddy.

Pioneering Force in Lung Transplantation

In 1987 we performed the first lung transplant in North America for
the treatment of emphysema.
In 1987 we performed the first heart/double lung transplant in San
Antonio.
In 1989 we performed one of the first single lung transplants in the
World for pulmonary hypertension.
Development and Implementation of a Physician Driven Donor
Protocol

Dr. J. Kent Trinkle developed a new method of lung transplant surgery
called “telescoping” of the anastomosis of the airways . This was
developed to decrease the problems of rupture and narrowing of the new
connection between the donor and recipient’s airways.

Outcomes

1, 3, and 5 Year Patient Survival Rates that Exceed National
Averages
The Shortest Wait Time in the Nation

Diagnoses

A lung transplant may be needed for the following diseases:

Interstitial Lung Diseases
Idiopathic Pulmonary Fibrosis (IPF)
Sarcoidosis
Hypersensitivity Pneumonitis
Pulmonary Manifestations of Collagen Vascular Disease
Eosinophilic Granuloma
Lymphangiomyomatosis (LAM)

Pulmonary Vascular Disorders
Primary Pulmonary Hypertension (PPH)

Obstructive Lung Diseases
Chronic Obstructive Pulmonary Disease (COPD)/Emphysema
Alpha 1 Antitrypsin Deficiency
Cystic Fibrosis
Bronchiectasis

Evaluation Process

Patients must be evaluated to determine their candidacy for
transplantation. An initial visit will be scheduled with our transplant
pulmonologist, surgeon and coordinator. This visit will determine if the
patient should proceed with the transplant evaluation. If performed at
our facility the evaluation will take up to 4 days.

The evaluation consists of:

Bloodwork
Urine tests
Radiologic tests
Heart and Lung tests
Tests for osteoporosis
Dental consult
Interview with a social worker
Gastrointestinal consult for patients with scleroderma or a history
of reflux
Females: pap smear and mammogram

Our diverse and specialized transplant team:

Cardiothoracic Surgeons and Pulmonologists specializing in lung transplantation
Nurse Transplant Coordinators
Financial counselors
Clinical nurse specialist for transplant
Discharge planner
Transplant social workers
Transplant dietician
In-patient rehabilitation facility

Lung Transplant Candidate Selection

Patients with advanced lung disease: Failed all possible medical
therapies available to them.
High risk of death in two or three years
Functionally disabled but still able to ambulate

Transplant Surgery

Most Transplant Patients…

Are in surgery approximately 3-7 hours
Spend 1 day on the breathing machine
Spend 1-2 days in the intensive care unit
Are discharged 7-12 days after their surgery

Hospital Stay

The J. Kent Trinkle Transplant unit creates an atmosphere dedicated to
the compassionate care of the patient and family:

State of the art facilities
Cutting edge technology
All private rooms

Follow up Care

After transplant, patients are followed closely in our clinic. The first
3 months we require weekly visits to our clinic. During this period
blood levels are drawn to adjust medications as necessary; chest x-rays
and pulmonary functions tests are performed to assess the condition of
the lungs. After the first 3 months the appointments will be scheduled
further apart depending on the progress of the patient. Once the patient
is stable we start sharing responsibility with the referring
pulmonologist for patient care. We strongly encourage the referring
doctor to contact us with any questions or problems.

Reasons not to transplant

Advanced heart, kidney or liver disease
HIV infection
Cancer
Hepatitis B
Hepatits C with proven cirrhosis by liver biopsy
Current substance abuse: tobacco, alcohol and illicit drugs
Body weight less than 80% or greater than 120% of predicted
Inability to carry out the responsibilities necessary to maintain a
healthy lifestyle and remain compliant with all medications

Other Areas of Expertise

Pulmonary hypertension
Lung cancer
Tracheal stenosis
Complicated pleural effusions
Tracheomalasia
Minimally invasive surgery

Interventional Pulmonology

Rigid bronchoscopy
Stent placement
Laser, Cryotherapy, Electrocoagulation
Medical thoracoscopy under conscious sedation
Percutaneous tracheostomy