UT Southwestern Medical Center recently reported the case of Mr. John Bunton, a man living in Georgetown, Texas, who was diagnosed with early pulmonary fibrosis at age 67 in a routine physical examination and underwent a successful double lung transplant.
Pulmonary fibrosis is a progressive fatal lung disease in which the lung tissues and alveoli are damaged, becoming thick and scarred (fibrosis), leading to severe breathing difficulties and compromising oxygen transfer between the lungs and the bloodstream. Pulmonary fibrosis has a poor prognosis and respiratory failure is the main cause of death associated with the disease. When another family member of the patient has the same or similar lung disease, as is the case of Mr. Bunton, the clinical condition is considered familial pulmonary fibrosis. It is estimated that around one in every 50 pulmonary fibrosis patients have this inherited form of the disease.
Mr. Bunton was aware of his disease progression and searched for the possibility of a lung transplant. Pulmonary fibrosis is responsible for more than half of all lung transplants performed. A lung transplant is more challenging for the patient than other organ transplants because the lungs are more exposed to the environment, meaning that every breath of air can represent a potential exposure to microorganisms that may lead to respiratory infections.
Dr. Fernando Torres, an Associate Professor and Medical Director of the Lung Transplant Program at UT Southwestern, believes that this risk is worth taking. “For years, they cannot walk to the mailbox, cannot walk that flight of stairs, without gasping for breath. Suddenly, you can do all the simple things that make up life again,” said Dr. Torres in a news release.
Mr. Bunton, who was older than 65 and on oxygen 24 hours a day, was initially refused a lung transplant by some medical institutions due to his age. At UT Southwestern, however, physicians evaluate the patient’s physiological age, not chronological age. “We don’t consider age an absolute contraindication to transplantation,” said Dr. Matthias Peltz, an Assistant Professor and Surgical Director of Cardiac Transplant at UT Southwestern. “If an older patient is an otherwise good candidate, we are comfortable transplanting them. Mr. Bunton fit that profile. His end-stage interstitial lung disease was his major illness. He was otherwise quite fit and highly motivated. In fact, he kept himself in much better condition than many of our younger candidates.”
In 2013 Mr. Bunton underwent a successful double lung transplant. He was discharged from the hospital eleven days after the surgery and after six weeks he was able to walk a mile. “My healthy new lungs are a precious gift. Should my donor’s family ever know who I am, it is important to me that they find that I am taking very good care of my gift and that I do worthwhile things with my life,” said Mr. Bunton. At 77, Mr. Bunton carefully takes his anti-rejection medicines and has an active life that includes hiking activities, traveling and volunteer work. He expects in June to walk his daughter down the aisle.
“As an academic medical center, we bring our advanced research and our experience to the bedside, benefitting patients who come to our institution with few remaining alternatives,” said Dr. Torres. “UT Southwestern is consistently one of the top 10 centers in the nation for lung transplant, having done more than 60 a year for the last three years.” According to the Scientific Registry of Transplant Recipients, the one-year and three-year survival rates of lung transplanted patients in UT Southwestern are among the highest in North Texas.
“At UT Southwestern, with the efforts of our multidisciplinary team, we are comfortable transplanting patients that other programs might not consider and, more important, we achieve good outcomes in these higher-risk patient populations,” concluded Dr. Peltz.