The Center for Advanced Lung Disease and Transplantation is leading the effort to improve outcomes in life-threatening lung diseases. Our research has contributed to recent advances in the understanding of advanced lung disease and lung transplantation including innovative medical and surgical treatments yielding improved quality-of-life and survival for patients. These achievements have been most notable in the areas of emphysema, idiopathic pulmonary fibrosis, pulmonary arterial hypertension, and cystic fibrosis, both before and after lung transplantation.
The center is currently investigating new methods of assessing patients with advanced lung disease in order to improve prioritization of lung transplant candidates. We are an investigational site for studies of new medical therapies for idiopathic pulmonary fibrosis. Investigators at our medical center participated in the National Emphysema Treatment Trial and our physicians are currently performing lung volume reduction surgery for patients with emphysema.
The center is also conducting several studies in collaboration with academic medical centers throughout the country. These include studying genetic factors in lung donors and recipients that may determine the clinical course after transplantation. We are investigating the determinants of good outcomes in the early post-transplant period, so that peri-operative outcomes may be optimized. We are currently planning studies using measurements of gene expression in peripheral blood to diagnose acute lung rejection without invasive procedures. Studies of new post-transplant immunosuppression regimens are ongoing.
Our center is committed to improving the care of patients with lung disease before and after lung transplantation. Through research efforts such as these, we will continue to improve the outlook of patients with advanced lung disease.
Ex Vivo Lung Perfusion
The multi-center NOVEL Lung Trial (Normothermic Ex-Vivo Lung Perfusion as an Assessment of Extended/Marginal Donor Lungs) is under the direction of Principal Investigator Frank D'Ovidio, MD, PhD, Director, Ex-Vivo Lung Perfusion Program and Associate Surgical Director, Center for Advanced Lung Disease and Transplantation. The trial is a study to evaluate the 30-day mortality of patients undergoing lung transplant with lungs from marginal or extended donors treated with ex vivo (outside of the body) lung perfusion versus those undergoing lung transplant with lungs considered transplant suitable.
The NOVEL study is using the ex vivo lung perfusion technique to improve donor lung assessment before transplant, and thereby safely increase the number of available lungs for transplant. If the lungs demonstrate a favorable ex vivo evaluation, the lungs will be transplanted into a patient.
NYP/Columbia researchers have recently discovered the role played by a pair of protein receptors in the immune system's ability to develop tolerance to a new organ. Their work is part of an ongoing investigation into why and how transplanted organs are rejected by the body so that new and improved methods for protecting a transplanted lung can evolve.
New immunological surveillance techniques are now being developed at NYP/Columbia to enable the diagnosis of more subtle forms of rejection earlier than ever before, which ultimately could improve a lung transplant patient's quality and length of life. The researchers are also investigating methods for preserving donor lungs for a longer period of time before they must be transplanted into the recipient. Additionally, lung transplant program clinical investigators are focusing on identifying specific factors in patients that may help determine the optimal timing of transplantation.