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Duke University Medical Center

Duke University Medical Center Lung Transplant Program
Durham, NC
1-800-249-LUNG
Email: Lung_Transplant@mc.duke.edu
Website: Duke website

Program Director:

Palmer, Jr.,Scott M.D.
Lung Transplant Program
Program Director
Medicine - Pulmonary and Critical Care Medicine

Surgical Team:

Davis, R. Duane M.D.
Milano, Carmelo M.D.
Messier, Robert M.D.

Transplant Pulmonologists:

Palmer, JR., Scott M.D.
Steele, Mark M.D.
Martinez, Maria M.D.
Eu, Jerry M.D.

Transplant Coordinators:

Curl, Julia R.N., B.S.N
curl0001@mc.duke.edu

Lawrence, Cindy R.N., M.S.N., C.C.T.C.
Lawre010@mc.duke.edu

Rea, Jean R.N., M.N., C.C.T.C
rea00002@mc.duke.edu

Setliff, Karen R.N., B.S.N., C.P.T.C.
Setli002@mc.duke.edu

Physical therapy and rehabilitation:
Physical therapy and rehabilitation

Pediatric Transplant Coordinator:
Steele, Pamela M.S.W.

Transplant Social Worker:
Stone, Ellen M.S.W.

Financial Counselors:
Joe Robbins
Julia Boatwright-Holden

Support Group:
Durham Support Group

Volumes

	1997	1998	1999	2000	2001
Single	35	19	25	6	5
Bilateral	20	16	27	48	57
Heart-Lung	3	4	2	2	2
Duke Total*	58	39	54	56	64
Duke as a % of NC Total*	62%	68%	65%	73%	80%
US Rank	2	2	1	1	1

Outcomes
Outcomes are for the duration of post-procedural survival of patients. Each pair of percentiles compares Dukes outcomes with the national average of all transplant centers as tabulated by the United Network for Organ Sharing (shown in parentheses). Outcomes are computed using the Kaplan-Meier Method, a statistical technique that can produce expected transplant outcome statistics for a given year when data is incomplete.


	1 Year	3 Year	5 Year
Lung	80% (76%)	62% (57%)	50% (43%)

Recipient's length of stay from transplant admission to discharge: Median: 13.5 days Average: 22.9 days Notes on Duke data: 1-year data: 1/94 - 12/01 3-year data: 1/94 - 12/01 5-year data: 1/94 - 12/01 Notes on UNOS data: 1-year data: 1/98 - 12/99 1-year data: 1/96 - 12/97 5-year data: 1/94 - 12/95

Lung Clinical Trials

Gastroesophageal Reflux (GERD):
We have had a strong interest in the relationship between gastric reflux and lung allograft dysfunction and were the first center to demonstrate that GERD can cause allograft dysfunction in lung transplant recipients. Ongoing studies seek to define the prevalence of GERD in our patient population, to clarify the association between GERD and long-term pulmonary allograft dysfunction known as Bronchiolitis Obliterans Syndrome, and to determine the optimal therapy for prevention of complications in patients with gastroesophageal reflux disease. Preliminary data suggest that a surgical approach involving Nissen fundoplication can lead to improved lung function and perhaps improved survival in lung transplant recipients with severe posttransplant GERD. Additional studies seek to better understand the mechanisms by which GERD may either directly or indirectly cause damage to the lung.

INSPIRE study (a telephone-based psychosocial intervention for patients awaiting lung transplantation):
This 600 patient NIH funded study led by investigators in the Duke lung transplant team seeks to determine the prevalence of anxiety, depression, and psychological distress among patients awaiting lung transplantation and determine the impact of treatment of these factors on pre- and posttransplant quality of life and survival. A prospective randomized study design is employed. Half of the patients enrolled in the study will be randomly selected to receive treatment with a telephone-based psychological intervention designed to directly address anxiety and other psychological concerns as patients undergo the process of waiting for transplant. Our hypothesis is that treatment of these psychosocial variables will lead to improved quality of life and improved long-term medical outcomes. The study is currently on target to meet its enrollment goals and should be completed within the next two years.

Aerosolized Amphotericin B Lipid Complex versus Aerosolized Conventional Amphotericin B:
This study is designed to compare two different forms of aerosolized amphotericin B used for the prevention of invasive fungal infections. Fungal infections commonly occur after lung transplant, and the Duke program has pioneered the use of these aerosolized medications to prevent these infections from occurring. The current study is designed to determine if one aerosolized amphotericin B preparation is superior in terms of safety or efficacy to the other. This prospective study will enroll a total of 100 lung transplant recipients and is nearing completion.

Immunogenetics of Lung Allograft Rejection:
This NIH funded study led by Dr. Scott Palmer seeks to better understand the genetics and immunology of lung allograft rejection, both early acute allograft rejection and late chronic allograft rejection. The studies specifically focus on novel gene polymorphisms that may either increase or decrease a patient's risk of allograft rejection. Polymorphisms associated with innate immune response genes are a target of particular interest.

Xenotransplant:
The Duke University Lung Transplant Program has had an active interest in developing successful animal models of xenotransplantation led by Dr. R. Duane Davis. This research has been supported through NIH and other funding mechanisms and has identified several key pathways in the development of xenotransplant rejection, including describing a key role for the coagulation pathway in acute lung injury after xenotransplantation.

DISCLAIMER:The information provided in this site is for educational purposes only, and it is not intended nor implied to be a substitute for professional medical advice. Always consult your own physician or healthcare provider with any questions you may have regarding a medical condition.