Referral for lung transplantation: experience of a Birmingham Adult Cystic Fibrosis Centre between 1987 and 1994.

Abstract

Background -Whilst much is known of

‘Double or quits’: perceptions and management of organ transplantation by adults with cystic fibrosis

“…In 1992, the survival rate for adults with CF post HLT was reported to be 49% at 3 years at one London centre (Madden et al, 1992). The survival rate seems to be similar at 5 years to the 3-year rate (Hodson, 1998) 6 and similar to outcomes reported by other centres (Ryan & Stableforth, 1996) and to recipients with other respiratory conditions (Geddes, 1998b). In reporting long-term survival doctors themselves are surrounded by uncertainty over the long-term effectiveness of organ transplantation (Geddes, 1998b).…”

“…In the context of modern medicine risk assessment is 'by definition, imperfect' as it contains so many unknown quantities . With all transplant surgery there is certainly an element of luck in a successful outcome, despite the obvious scientific progress made (Kahan, 1996), especially in not dying before suitable organs became available (Ryan & Stableforth, 1996). …”

“…The shortage of suitable donor organs means that around half of adults with CF will die on the transplant list (Ryan & Stableforth, 1996;Hodson, 1998). Various ways to reduce the demand: supply ratio (see for example Fisher et al, 1998;Obermann, 1997); have been discussed; moving away from the notion that donation of part of one's body is a 'gift' in the tradition suggested by Titmuss (1970) towards a 'trivilisation and commodification of what is sacred about the human body' (Fox, 1996, pp.…”

Only when I Cough? Adults’ Disclosure of Cystic Fibrosis

“…However, the shortage of suitable donor organs in the UK means that half of adults with CF on the transplant list die before donor organs are found (Hodson, 1998;Ryan & Stableforth, 1996). Due to increased survival age, infertility is now an issue for adults with CF; the vast majority of men with CF are infertile (Sawyer, 1996) and IVF therapies have been developed to assist adults to become parents (Silber, Ord, Balmaceda, Patrizio, & Asch, 1990).…”

Improving donor lung evaluation: a new approach to increase organ supply for lung transplantation

“…2 Unfortunately up to 50% of patients identified as suitable candidates to undergo lung transplantation will die from their underlying lung disease before an organ becomes available 34 The severe shortage of donor lungs is now the major limitation to the use of the procedure as a widely available therapeutic option.…”