What is the longest living lung transplant patient

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Posted: November 06, 2013
Last Updated: November 06, 2013

Lung transplant recipients, doctors and nurses are celebrating the 30th anniversary of world's first successful lung transplant in Toronto  2:20

Lung transplant recipients, doctors and nurses are celebrating the 30th anniversary of the world's first successful lung transplant in Toronto.

In 1983, Tom Hall was the 45th patient in the world to receive a single lung at what was then Toronto General Hospital.

Tom Hall visits Paris, five years after his lung transplant. Before his successful operation, transplant recipients had not lived beyond a few days or weeks. (University Health Network)

Hall lived more than six years — the first to survive for more than days or weeks after receiving the organ.

"Most people don't recognize that Canada is No. 1 in some things and this [lung transplants] is one of them," Dr. Shaf Keshavjee, director of the lung transplant program, said in an interview.

On Wednesday, Toronto's University Health Network gathered health professionals and patients to mark the anniversary and to chronicle the challenges of lung transplants, noting how far the field has come and what's next.

In a video presentation, doctors recalled carefully describing how risky the operation was, why their research gave them optimism and Hall's courageous decision to go ahead, which they credited to his stamina and force of will.

A series of steps have improved the survival rate for lung recipients to 97 per cent, says Dr. Shaf Keshavjee. (CBC)

"I said, Tom, there have been about 44 attempts thus far and no one has survived. Are you sure you want to go ahead with it?"  Dr. Joel Cooper, now chief of the thoracic surgery division at the Hospital of the University of Pennsylvania, said in an interview. "He said, 'I am grateful to be number 45.' That is exactly what he said. He was an upbeat person."

"Tom was not a quitter," his widow, Barbara Hall, recalls in a hospital YouTube video.

Dr. Shaf Keshavjee said several features of lungs make them more difficult to transplant, including:

• Fragility of the organ.
• Need to restore blood supply to not only the organ but also the airways.
• Preservation challenges.

Keshavjee, then a medical student, heard about the transplant success on the radio and was inspired to enter the field. In 1986, he scrubbed in for the first double lung transplant, also at Toronto General.

In the early 1990s, there was a 50/50 chance of surviving to leave hospital after lung transplantation. Now, Keshavjee said, they have a 97 per cent survival rate.

Katie Sutherland from London, Ont., received a lung transplant in Toronto five years ago. Before the transplant, she would run out of breath walking down the street or up a flight of stairs.

"I'm playing sports again," Sutherland said. "I'm just living a normal life for someone who is 21. I'm doing everything I dreamed of doing."

• Tiny artificial lung breathes life into Ontario mother

Before her transplant, Sutherland benefited from a Novalung, an external artificial lung. Other improvements in the field include transplants for cystic fibrosis and the development of ex vivo repair, a system that treats and improves high-risk donor lungs so they can be used for transplant.

"Can we engineer super lungs, if you will?" said Keshavjee, who is also surgeon-in-chief at the University Health Network's Sprott surgery department.

Researchers are developing strategies to use gene therapy to modify the lungs to better handle the stresses of transplant, as well as testing stem cells for repairing the organs.

Ann Harrison (September 24, 1944 – April 20, 2001) was the recipient of the world's first successful human double lung transplant. She survived for almost fifteen years after the surgery and died of unrelated causes.

Harrison suffered from end-stage emphysema and thoracic surgeon Joel D. Cooper had told her that without surgery, she had only a few months to live.[1] The operation was performed at Toronto General Hospital on November 26, 1986, when she received the lungs of an 18-year-old Kingston, Ontario, native who had recently died in a car accident.[2] Cooper had previously successfully performed a single lung transplant on pulmonary fibrosis victim Tom Hall on November 7, 1983, but this was the first successful double lung transplant.[3]

Ann Harrison died aged 56 at Toronto General Hospital on April 20, 2001, of a brain aneurysm unrelated to her operation.[4] She was the world's longest surviving double-lung recipient until her 15-year record was broken in 2005 by cystic fibrosis patient Howell Graham of Wilmington, North Carolina.[5]

Her surgeon Dr Joel Cooper in a eulogy said of her, "Ann began a new era, one that has brought immense relief to emphysema patients. Having received this gift, she became a den mother for so many other patients, encouraging them in their quest, celebrating with them their victories, and consoling them and their families in their losses." Dr Cooper shows a picture of Ann Harrison every time he lectures on transplantation and says, "I still marvel when someone so close to death is returned to a vigorous life."[4]

1. ^ The man who gives the gift of breath Toronto Star, January 27, 2014
2. ^ On This Day in History, A look at what happened on previous November 26ths[permanent dead link] The Vancouver Sun, November 19, 2013
3. ^ Lung Transplantation Turns 30: Joel Cooper performed world's first successful double lung transplant on an Alpha Archived 2014-01-27 at archive.today COPD Digest, May 23, 2013
4. ^ a b First double-lung transplant recipient dies, Canadian Medical Association Journal May 29, 2001, vol 164 no 11
5. ^ Early double-lung transplant patient celebrates 20 years of breathing free by Vicky Eckenrode, Star-News, October 7, 2010

• Fact Sheet for the Lung Transplant Program at Toronto General Hospital, University Health Network PDF

Retrieved from "//en.wikipedia.org/w/index.php?title=Ann_Harrison_(lung_transplant_recipient)&oldid=1088105150"

Background: There are approximately 2000 lung transplants performed across the United States annually. There is limited data to identify factors predictive of long-term survival.

Objective: We evaluated 10-year survivors after lung transplant to determine predictors of long-term survival.

Methods: Data were collected from the United Network for Organ Sharing registry database from a single institution. Inclusion criteria were: patients who received a lung transplant between 1989 and 2005. Descriptive statistics were calculated, and survival outcomes were analyzed using the Kaplan-Meier method.

Results: Three hundred sixty-one patients received a lung transplant between 1989 and 2005, and 77 patients survived at least 10 years (21%). Diagnoses at the time of transplant included: chronic obstructive pulmonary disease/emphysema 45 (58.4%), idiopathic pulmonary fibrosis 12 (15.6%), alpha 1 anti-trypsin deficiency 6 (7.8%), cystic fibrosis 4 (5.2%), primary pulmonary hypertension 2 (2.6%), and Eisenmenger's syndrome 1 (1.3%). Seventy-four recipients (96.10%) were Caucasian; 46 (59.74%) were female. Age at the time of transplant ranged from 19 to 67 years (mean 50.8; median 52). Forty-two patients (54.5%) were double lung recipients. Survival ranged from 10.0 to 21.9 years (mean 15.5y; median 15.48y). Forty-two (54.5%) subjects are currently alive; the most common causes of death included: chronic rejection (20%), and infection (17.14%).

Conclusions: Ten-year survivors were significantly younger, weighed less, and had significantly shorter lengths of hospitalization after transplantation. Bilateral lung transplantation was a significant factor in prolonged survival. Survival also improved with institutional experience.

Keywords: clinical review; transplant.