With a considerable number of patients in the United States, approximately 1,050, eagerly awaiting lung transplants, finding innovative ways to address this shortage becomes a top priority. Furthermore, the stringent screening and comprehensive criteria for identifying viable organs contribute to the complexity of the situation. The scarcity of organs directly impacts decisions concerning single- or double-lung transplantation. As a consequence, single lung transplants have become more prevalent due to their relative simplicity and their ability to improve patient quality of life by restoring lung function. To combat these challenges and potentially save more lives, OPOs are increasingly turning to telepulmonology as a means to expedite and enhance the assessment of suitable lungs for transplantation.
Increasing Lung Donation
Lung donation is heavily dependent on proximity, requiring patients to be within four to six hours of travel time from the donor. By employing remote assessments, OPOs can evaluate potential donors and match them with patients awaiting lung transplants in nearby hospitals. Diagnostic studies and Pulmonary Function Tests (PFTs) supply crucial data to OPOs in need of lung donations. Through remote testing, donors from any location can be assessed round-the-clock, enabling the measurement of lung volume, capacity, flow rates, and gas exchange to identify lung disorders that do not align with the ideal donor criteria. Patient data is promptly relayed to medical staff, expediting the transportation process once the lungs are approved. Without telepulmonology, remote donors would be unable to undergo testing, resulting in delayed removal of lungs for transportation. By leveraging available technology, a broader range of lungs can be accessed from various locations.
Types of Telepulmonology Services
Telepulmonology services provide board-certified specialists who perform a wide range of diagnostic pulmonary function tests, including bronchoscopy, lung volume tests, respiratory muscle strength tests, lung diffusion capacity tests, altitude simulation tests, exercise challenges, cardiopulmonary exercise tests, methacholine inhalation challenges, maximal voluntary volume tests, shunt studies, ambulatory oximetry, arterial blood gas tests, body plethysmography, exhaled nitric oxide tests, spirometry, and sleep studies. These telemedicine services grant OPOs access to the expertise of board-certified sleep and pulmonary medicine professionals, even in remote areas. Their accurate interpretations and collaboration with OPOs can greatly increase lung availability and potentially lead to improved outcomes for transplant patients.
Evaluation of Non-Ideal Lung Donors
Traditionally, lung donor evaluation focused on absolute contraindications such as significant medical history, minimal smoking history, and robust pulmonary function. However, there is potential for transplantation from non-ideal donors based on extended criteria. Telepulmonology testing aids in evaluating lungs based on patient-specific and organ-specific considerations, taking into account the impact of specific risk factors on post-transplantation allograft function. This testing process expedites the identification of a broader selection of viable donors. Telepulmonology provides essential information for scoring lung matches, including lab values, test results, disease diagnosis, active infection, size, and oxygenation. Expedited testing and interpretations enable prompt delivery of lungs to waiting patients within the restricted transportation times.
Telepulmonology After Circulatory Death
Lung allograft donation after circulatory death (DCD) has historically faced scrutiny. However, the International Society of Heart and Lung Transplantation confirms that survival rates are comparable to donations after brain death (DBD). Telepulmonology offers a solution to address misconceptions surrounding DCDs, integrating supportive technologies such as ex vivo lung perfusion to expand the utilization of DCD lungs. Telepulmonology streamlines the evaluation process, enabling remote pulmonologists to assess lung viability and confirm interpretations via teleconferencing at ICU locations. This ensures that OPOs can confidently accept DCD lungs.
Donor Management Protocols
Improved donor management protocols play a crucial role in achieving positive outcomes and increasing the availability of donor lungs. Having remote pulmonologists readily available provides additional expertise to ICU teams that may lack specialized healthcare services. Telepulmonology allows pulmonologists to assist ICU teams in real-time via telecommunication technology, ensuring optimal preservation of lungs and maximizing lung function.
Telepulmonology interpretations are particularly valuable in identifying chronic obstructive pulmonary disease and other pulmonary conditions through spirometry tests. Telespirometry and telepulmonology facilitate digital consultations between OPOs and practitioners, enabling the assessment of test quality to determine lung viability.
Addressing Rural Lung Related Conditions
Telepulmonology proves instrumental in addressing the challenges faced by patients in rural areas, where lung-related conditions such as asthma, a history of smoking cigarettes, COPD, and other lung health issues are more prevalent. Patients can access specialized pulmonary testing, reducing the need for extensive travel. Furthermore, telepulmonology solutions increase the likelihood of lung donors in remote areas being within suitable travel range for transplant recipients.
Telepulmonology solutions provide interpretations of sleep studies and employ state-of-the-art diagnostic tools, thereby enhancing diagnostic capabilities. Access to expertise at any time also improves outcomes in emergency situations. Real-time collaboration is available to OPOs and transplant surgeons, fostering effective communication.
Organ procurement organizations are in need of methods to increase lung donations. Telepulmonology services offer a promising avenue to expand the donor pool and explore the potential of non-ideal donors. Leveraging collaborative telemedicine during the donation process enables OPOs to identify acceptable donors, enhance donor management protocols in the ICU, and ultimately improve lung availability for transplant patients. At Specialist Direct, we provide Telepulmonology and to get started, please contact us at (888) 317-0776, and our friendly customer service representatives will assist your medical establishment.