Researchers at WashU Medicine have reported improved long-term outcomes among adult lung transplant recipients after analyzing the center’s experience with 2,000 lung transplants performed over nearly 35 years. Led by Ruben Nava, MD, an associate professor in the Section of Thoracic Surgery,the study found that median lung graft survival increased from 5.5 years in the earliest era of transplantation (1988–2000) to 9 years in the most recent era (2012–2023). The findings were published in The Journal of Thoracic and Cardiovascular Surgery.
The researchers evaluated changes in patient characteristics, surgical practices and outcomes across three eras of transplantation at WashU Medicine and Barnes-Jewish Hospital.
Overall survival of transplanted lungs improved steadily over time. In-hospital mortality also declined, reflecting advances in surgical techniques, perioperative care and long-term management of transplant recipients.
Despite these gains, the study identified ongoing challenges that continue to limit long-term success after lung transplantation. Rates of severe primary graft dysfunction, a serious form of early transplant injury, remained largely unchanged, and chronic lung allograft dysfunction – a form of chronic rejection and the leading cause of permanent graft failure – continued to develop in many patients within four years of transplantation.
The findings highlight both the progress made in lung transplantation and the need for continued research by Nava and colleagues in the Thoracic Immunobiology Lab to better understand the immune mechanisms that drive graft injury and rejection and to develop new therapies that extend the life of transplanted lungs.
The Thoracic Immunobiology Lab studies a broad spectrum of thoracic immunology, ranging from the alloimmune response after lung transplantation to pulmonary innate immunity and tumor immunology. The laboratory performs basic scientific investigations as well as translational and outcomes studies directly related to patient care.