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Friday, April 18, 2014
Is Lung Transplant a Treatment Option?
My sister is 23 years old and has been diagnosed with ARDS (Acute Respiratory Distress Dyndrome). She also had Down Syndrome and a little bit of asthma. She is currently hospitalized and on a ventillator for 11 days with 50% oxygen pressure, 1% nitrogen and the peep is on 14. She was recently started on dialysis. She has had repeated abnormal chest x-rays. They are trying to bring down the nitrogen and when they close the nitrogen, her oxygen levels decrease. She will soon need a tracheotomy. When awake she needs additional sedation in order to maintain the oxygen level. Her prognosis is poor. We would like to know what other alternatives are available? Is a lung transplant an option for the patient with Down syndrome? Please give us some feedback.
I am very sorry to hear about your sister. ARDS can be a very sudden and severe illness. Recovery can occur, but the longer the process continues, the more likely there will be difficulty in recovery, and the longer the recovery takes, if it is to occur.
The tracheotomy tube you describe is commonly recommended after 1-2 weeks on the ventilator to try to avoid scarring or narrowing of the windpipe and to improve the comfort of the patient, which sounds like it may be important for your sister.
Regarding whether your sister might be a candidate for lung transplantation, it is difficult to say, but I would honestly not be very hopeful for this possibility. Most transplant centers do not list patients who require ventilator support for sudden illness such as ARDS. Also, most centers require that the patients themselves be able to oversee and assure their own complicated medication schedule.
I would recommend that you speak with your sister's physicians about your questions. They will have all of the information that would be necessary for a transplant center to determine if she might be a candidate. The physicians may be able to contact local transplant centers to find whether she meets their criteria. I hope this information is of some help to you and your family. Kind regards.
Amy L Pope-Harman, MD
Clinical Associate Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University