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Recently, two people with “very advanced” lung cancer were saved by a double lung transplant. What is this transplant? And what are the chances of survival? Professor Redha Souilamas, thoracic surgeon at the “Cleveland Clinic” in Abu Dhabi answers us.
In France, lung cancer is the 3rd most common cancer with 46,363 new cases diagnosed in 2018. However, it is sometimes diagnosed very late, in stage 4. The vital prognosis of the patient is then strongly committed. Fortunately, some techniques give hope to patients. This is the case of the “double lung transplant”, which has recently borne fruit.
A double lung transplant performed on two terminally ill patients
It is the hospital center “Northwestern Medicine” in Chicago, which announced the good news.
Two people, a 54-year-old man from Chicago and a 64-year-old Minnesota resident, both with stage IV lung cancer, underwent double lung transplants which did not cause any complications. nor recurrences.
Yet these two patients were doomed.
“We are really excited about this achievement because these were two patients who were among the most desperate cases. In such a dramatic situation, this feat is quite convincing.”says Dr. Ankit Bharat, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute.
A high risk of recurrence
As a reminder, until now, lung transplants in patients with advanced lung cancer have been extremely rare. And for good reason: the anti-rejection treatment of the transplant greatly weakened the immune system of the transplant patient. In fact, the risk of recidivism was very high.
“The anti-rejection treatment must be taken for life, because the body fights against this lung which is not its own” says Prof. Redha Souilamas, thoracic surgeon at the “Cleveland Clinic” in Abu Dhabi. “The problem is that this rejection is much more frequent in the case of a lung transplant than for other organs. Fortunately, lung transplantation has made a lot of progress over the past 10 years and the survival rate is now acceptable..”
However, not everything is a foregone conclusion. As the expert reminds us, the famous anti-rejection treatment undermines the patient’s immune defenses – which was the case for the two transplanted Americans.
“In the case of bronchioloalveolar carcinoma (BAC), anti-rejection treatment promotes recurrences in transplanted lungs. It is believed to be related to immunosuppression, i.e. inhibition of immune system activation“, advances the thoracic surgeon. “This is why the risk-benefit balance must be calculated and the potentially eligible subjects rigorously selected..”
Despite everything, the lung transplant specialist wants to be optimistic.
“We now have access to more “healthy” lungs than before, which lowers the mortality rate and the number of patients on the waiting list. Immunosuppression is also better controlled. If we have this equation and the cancer has not become metastatic, why not try a lung transplant on young cancer patients? Admittedly, this process is still somewhat experimental in terms of vital prognosis, but it can save lives.“, concludes Professor Souilamas.