In 1988, Washington University general thoracic surgeons at Barnes-Jewish Hospital began one of the first hospital programs in the United States fully dedicated to lung transplantation. Washington University specialists have since performed more than 860 lung transplants, making Barnes-Jewish Hospital one of the most active lung transplant centers in the world.

Lung transplantation is an important treatment option for end-stage lung disease in appropriately selected patients with:

1. Antitrypsin deficiency emphysema
2. Chronic obstructive pulmonary disease (COPD)
3. Cystic fibrosis
4. Eisenmenger syndrome
5. Eosinophilic granuloma
6. Lymphangioleiomyomatosis
7. Pulmonary fibrosis
8. Pulmonary hypertension
9. Respiratory disorders
10. Sarcoidosis

The lung transplant program accepts some of the most challenging cases, including patients who may have been turned down at other centers. Nevertheless, Barnes-Jewish Hospital has substantially higher survival rates for all single and double lung transplant recipients than other institutions.
In coming years, ongoing clinical and basic research will provide even greater understanding of transplant medicine and surgery, refine patient care and further improve outcomes. Washington University specialists have been at the forefront of these developments and will continue to make important contributions in improving lung transplantation.

Fellowship Program

The Abdominal Organ Transplant Fellowship Program is a nationally recognized, two-year program certified by the American Society of Transplant Surgeons. Established in 1992, the program is tailored to suit the individual interests and previous experience of the trainee.
The program's goal is to prepare fellows for careers in liver and kidney transplantation, both adult and pediatric, particularly in an academic setting.
One fellow matriculates in the program each year. Five full-time liver and kidney transplant surgeons who are members of the faculty of Washington University School of Medicine provide training to the fellows. Transplant nephrologists and hepatologists, a dedicated transplant nursing staff, social workers, dietitians, financial analysts, and a fellowship training office administrator and secretary also offer support.
Typically, the first 12 to 18 months of the fellowship are dedicated to clinical responsibilities. The kidney and liver services are not separated, and the transplant surgeon-in-training has responsibility for inpatient and outpatient management of both services. The fellow participates in the vast majority of all cadaveric multi-organ donor operations, living donor nephrectomies, living donor hepatectomies, kidney transplants, liver transplants and small bowel transplants.
The fellow also receives experience in a number of other clinical areas:

1. Islet cell transplantation. Washington University Medical Center is an international leader in this field.
2. Solid pancreas transplantation. This program was initiated in recent years.
3. Vascular access procedures. The fellow participates in 20 to 50 percent of the 500 to 700 vascular access procedures performed annually, depending upon experience and interest.
4. Non-transplant hepatobiliary (HPB) cases. The fellow may participate in a significant number of HPB cases, depending on the level of interest.

Pre- and post-transplant care for both liver and kidney transplant patients is provided in a clinic operated jointly by the departments of surgery and medicine. The fellow participates in the clinics and performs biopsies under the supervision of attending physicians, both medical and surgical.
Research comprises six to 12 months of the fellowship, as determined by the prior experience and interest of the fellow. An active research program in the Department of Surgery provides many opportunities for fellows to pursue their interests. Research mentors also may be selected from other departments within the Medical Center.
Fellows are expected to develop an independent research project and to present their findings at one of the program's weekly conferences. In addition, fellows are strongly encouraged to present their experimental data at a national meeting and to publish their outcomes in peer-reviewed journals. The goal is for trainees to develop a plan for continued research and to prepare to compete for extramural funding as independent investigators, if they wish to pursue opportunities in the field of transplantation research.