Orthotopic lung transplantation is sadly limited by the availability of donor organs. With approximately 1,050 patients awaiting lung transplants in the United States, finding ways to increase lung availability is a high priority for organ procurement organizations (OPOs). Adding to the challenge is the rigorous screening and in-depth criteria for finding viable organs. Decisions related to single- or double-lung transplantation are always a concern and are directly influenced by organ availability.
As a result, single lung transplants are more common. The procedure is less complex, improving patient quality of life with excellent lung function. Finding ways to make faster, more accurate assessments of lungs suited to transplantation has brought telepulmonology to the forefront for OPOs hoping to increase lung availability for transplant patients. Remote telepulmonology and sleep medicine diagnostics offer access to board-certified sleep and pulmonary medical professionals to help improve the performance of OPOs. Through quick assessment of lung viability for donors, telepulmonology has the potential to save more lives.
Increasing Lung Donation
Lung donation relies heavily on location. Patients must be within four to six hours of travel time or less. Through remote assessments, donors can be assessed and matched to patients awaiting donations in nearby hospitals. Diagnostic studies and Pulmonary Function Tests (PFTs) provide data for OPOs waiting for lung donation. Through remote testing, donors in any location can be assessed 24/7/365 to measure lung volume, capacity, rates of flow, and gas exchange to diagnose lung disorders not aligned with ideal donor criteria.
Patient data is sent directly to medical staff without delay to expedite lung transportation once the lung is approved. Without telepulmonology, donors in remote locations cannot be tested, resulting in lungs not being removed for transportation soon enough. With the technology available, more lungs can be accessed in more locations.
Types of Telepulmonology Services
Through telepulmonology services, board-certified specialists perform the following diagnostic pulmonary function tests:
- Bronchoscopy
- Lung volume test
- Respiratory muscle strength test
- Lung diffusion capacity test
- Altitude simulation tests
- Exercise challenges
- Cardiopulmonary exercise tests
- Methacholine inhalation challenge
- Maximal voluntary volume
- Shunt studies
- Ambulatory oximetry
- Arterial blood gas test
- Body plethysmography
- Exhaled nitric oxide test
- Spirometry
- Sleep studies
Telemedicine provides board-certified medical professionals in sleep and pulmonary medicine expertise, even in remote areas. Their accurate interpretations and collaboration between OPOs and specialists can help increase lung availability and the potential for improved transplant patient outcomes.
Non-Ideal Lung Donors
Traditionally, lung donor evaluation relies on perceived absolute contraindications to donation, including no significant medical history, minimal smoking history, and robust pulmonary function. However, there is also potential for transplantation from non-ideal donors based on extended criteria. Telepulmonology testing helps evaluate lungs based on both patient-specific and organ-specific considerations weighing the impact of specific risk factors on post-transplantation allograft function. As a result, testing can expedite the process of finding a broader selection of viable donors. Telepulmonology provides the information used to score lung matches, including:
- Lab values
- Test results
- Disease diagnosis
- Active infection
- Size
- Oxygenation
Expedited testing and interpretations provide results to get lungs to waiting patients within the restricted times for transportation.
Telepulmonology After Circulatory Death
Lung allograft donation after circulatory death (DCD) has often been met with scrutiny. However, the International Society of Heart and Lung Transplantation says survival rates are comparable to DBDs. Telepulmonology offers a solution to overcome misconceptions about DCDs with supportive technologies such as ex vivo lung perfusion to expand possibilities for DCD lung usage. Telepulmonology offers a more efficient evaluation process. Assessment at ICU locations via teleconferencing allows remote pulmonologists to test lung viability and confirm interpretations to ensure OPOs confidently accept DCD lungs.
Donor Management Protocols
Improved donor management protocols contribute to positive outcomes and increase the availability of donor lungs. The availability of remote pulmonologists provides more expertise to donor ICU teams unprepared to assess lungs accurately. Telepulmonology allows pulmonologists to assist ICU teams in real-time via telecommunication technology to ensure lungs are preserved to optimize lung function.
Telepulmonology Interpretations
Spirometry tests identify chronic obstructive pulmonary disease and other pulmonary diseases using telepulmonology interpretations. Telespirometry and telepulmonology provide digital consultations with OPOs and practitioners to assess test quality to determine lung viability.
Rural Lung Related Conditions
Overcoming the challenge of meeting the needs of patients in rural areas where higher rates of lung-related conditions like asthma, a past history of smoking cigarettes, COPD, and other lung health issues exist is easier with telepulmonology. Patients can access specialized pulmonary testing to reduce the need for travel. Patients awaiting lung donors in remote areas also increase the likelihood of receiving lungs within travel range through telepulmonology solutions.
Accessible Pulmonology
Certified remote pulmonology and sleep specialists are the ideal solutions to augment remote teams lacking specialty healthcare services. Telepulmonology solutions interpret sleep studies and use state-of-the-art diagnostic tools to improve diagnostic capabilities. Having access to expertise at any time also improves outcomes in emergency situations. Collaboration is also available in real-time for OPOs and transplant surgeons.
OPOs require methods to increase lung donations. Telepulmonology services allow them to expand their donor pool and understand the opportunities available through non-ideal donors. The utilization of collaborative telemedicine at the time of death allows OPOs to identify acceptable donors and improve management protocols in the ICU.
At Specialist Direct, we offer Telepulmonology and sleep science solutions. Contact us now by calling (888) 317-0776, and our friendly customer service representatives will help your medical establishment get started.
