Friday, April 3, 2009
A 49-year-old Maryland man suffering from end-stage emphysema is believed to be the first person in the United States to be liberated from both a ventilator and traditional, cumbersome lung machine while waiting to receive a lung transplant. Doctors at the University of Maryland Medical Center have adapted a small, portable artificial lung, using a newly approved catheter, so that the patient, Ward Forsyth, of Williamsport, Md., can walk, talk, eat and even exercise on a treadmill while he waits for new lungs.
Patients on a ventilator are usually thought to be too ill to be considered for a transplant. Doctors at the medical center say this new portable artificial lung offers promise for patients such as Mr. Forsyth, improving their chances of having a successful surgery.
The portable device is a simplified version of an ECMO machine, which employs a pump to circulate blood through an artificial lung and back to the bloodstream. It infuses the blood with oxygen and removes carbon dioxide, similar to healthy lungs. Previously, a person who was on the system had to remain lying down with large tubes placed in the neck and groin. But, doctors have modified the ECMO system so that a simple IV line is placed in the upper chest, allowing the patient to sit up, walk and remain active.
"We have been able to help Mr. Forsyth with a different approach. He is the first person in the United States, we believe, who is using this new, modified system to keep him alive as he waits for a lung transplant. Since he went on the machine on March 16th, he has been alert and has gradually grown stronger, even able to walk on a treadmill," says Aldo T. Iacono, M.D., medical director of the lung transplant program at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine.
"It's a great alternative. Mr. Forsyth is not sedated or bedridden anymore and he is in better shape for undergoing a transplant," Dr. Iacono says. This mobility increases the chance that the patient will be in better physical condition for a lung transplant and may reduce the risk of infection and pneumonia. This new treatment may provide new hope for a better quality of life for thousands of patients awaiting a lung transplant.
Mr. Forsyth, a former truck driver who held a number of other jobs where he was exposed to substances that likely contributed to his emphysema, says, "I think this is the greatest thing because at this point I wouldn't be able to walk if it weren't for this machine."
Bartley P. Griffith, M.D., chief of cardiothoracic surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine, has been at the forefront of developing a small, portable artificial lung to help patients with severe lung disease. "This new approach may help us to further refine the technology to the point that patients can go home with an even smaller device. Eventually, we hope that some patients might be able to use this device indefinitely, even if they're not a candidate for a lung transplant," Dr. Griffith says.
Almost 2,000 people in the United States are on waiting lists today for a lung transplant, according to the United Network for Organ Sharing. Emphysema is the most common type of chronic obstructive pulmonary disease (COPD). COPD affects about 32 million people in the U.S. and is the fourth-leading cause of death.