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Is a Lung Transplant the Right Way to Treat Your COPD?

POSTED BY: Florida Hospital

Though it is the third-leading cause of death in America, chronic obstructive pulmonary disease (COPD) is frequently misunderstood.

“Often, my patients say they were short of breath, but thought it was because they were out of shape or overweight,” says Cynthia Gries, MD, MSc, medical director of the Florida Hospital Transplant Institute lung transplant program. “Their first response is to stop being active, but with the right treatment you can continue exercising and keeping your lungs strong.”

As a transplant specialist, Dr. Gries sees plenty of patients whose severe COPD requires them to get new lungs.

“COPD often goes unrecognized for many years, and it’s not until patients are hospitalized or get pneumonia that a diagnosis is made,” Dr. Gries says.

Though there is no cure for COPD, treatment can slow its progression and delay the need for a lung transplant. Treatment can also make you a better candidate for a transplant if the need arises.

But COPD isn’t only a physical affliction; it can affect people mentally and emotionally, as well.

“Patients who have COPD have often been exposed to a lot of painful experiences, like hospitalizations and breathing tubes,” Dr. Gries says. “They might have a lot of anxiety, which makes it more difficult to exercise.”

Part of helping patients with COPD live a longer, healthier life means supporting them holistically. That’s why the transplant program works with a psychologist and therapist to see if medication or counseling can help.

“We give patients tools to deal with their anxiety and avoid panic attacks that could send them to the emergency room,” Dr. Gries says.

What is COPD?

COPD, which includes and is also known as emphysema or chronic bronchitis, is a long-term illness of the lungs. The disease is progressive, meaning it gets worse over time.

In 2016, Americans lost more years of healthy life to COPD than to diabetes or stroke, according to a study published in The Lancet, a medical journal.

According to the American Lung Association, 85 percent to 90 percent of COPD cases are caused by cigarette smoking. A burning cigarette creates harmful chemicals that weaken the lungs.

Long-term exposure to air pollution, secondhand smoke and other pollutants, often work related, can also lead to COPD.

In addition to shortness of breath during normal activity, signs of COPD include:

  • Cough that doesn’t go away
  • Frequent infections involving the nose, throat or airways, such as a sinus infection or the common cold
  • Blueness of the lips or fingernails
  • Fatigue
  • Wheezing
  • Producing a lot of mucus or phlegm

Though some of these signs, particularly the early ones, may seem easy to ignore, taking action early on can slow the progression of COPD. This means you can maintain your quality of life and your independence by paying attention to your body and talking to your doctor if you are experiencing any of these symptoms.

Using What Works Against COPD

Even without a cure, researchers have learned several ways to slow the advance of COPD.

“The things we know prolong and save lives are appropriate oxygen therapy, smoking cessation, proper vaccination and pulmonary rehabilitation,” Dr. Gries said.

Fortunately, these are all attainable ways to improve the way you feel through lifestyle changes and rehabilitative care:

  • Oxygen therapy: Because COPD reduces the lungs’ ability to absorb oxygen, patients often need to be provided with extra oxygen, whether at home or in a hospital. The amount and length of time oxygen is provided is different for each patient, but the goal is to help them feel better and stay more active.
  • Smoking: People with COPD who smoke experience faster declines in their lung function, but when they stop, their rate of decline becomes similar to a nonsmoker, Dr. Gries says.
  • Vaccination: Those with COPD have a greater chance of dangerous complications from the flu, including a higher likelihood of developing pneumonia afterward.
  • Pulmonary rehabilitation: From proper nutrition to exercise to breathing techniques, people with COPD can do a lot on their own to improve their quality of life. Pulmonary rehabilitation is a general term that refers to the many ways people can take some control over their condition.

All of these therapies are more effective when COPD is caught early. But even with these treatments, COPD can flare up from time to time.

“Patients with COPD know when they’re getting sick, and we are able to give them access to a person who can quickly react, potentially avoiding the need for a hospital visit,” Dr. Gries says. “One of the things we’re excited about is our app, eCare, which can give an immediate response, almost like concierge services.”

Even though COPD can’t be cured, treatment can often help you do more of what you enjoy, from taking an evening stroll to planting a garden.

The Transplant Decision

With some conditions, patients are obvious candidates for transplant because they aren’t likely to survive without one. Though COPD can be fatal, it can be hard to predict how quickly it will progress.

That makes the decision about when and whether to get a transplant more difficult.

Though about six in 10 people who receive a transplant say their quality of life is improved a year later, about two in 10 people don’t survive the first year after transplant.

If transplant is the best option, the patient is given a score that determines their priority on the waiting list for lungs, which has about 1,500 people on it nationwide. This score is designed to ensure that each pair of donated lungs is put to the best use.

After a transplant, patients remain under the care of the transplant program for the rest of their lives.

Whether a transplant is your best option or not, your doctor can share strategies for long-term health and well-being. At the Florida Hospital Transplant Institute, our treatment takes into consideration each patient’s body, mind and spirit.

“The thing that I love most about my job in transplant medicine is the ability to get to know patients on a personal level and learn about their hopes, dreams and families,” Dr. Gries said.

Visit our website to learn more and download a transplant application or call us at 407-303-2474.