Temple University Hospital giving older patients a better shot at a second chance with transplants

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Tuesday, March 5, 2024
Giving older patients a better shot at a second chance with transplant
Temple has topped the nation for lung transplants for nearly a decade by reducing age limits.

TOMS RIVER, New Jersey (WPVI) -- For nearly a decade, Temple Hospital has topped the nation for most lung transplants.

One reason is the innovative way Temple helps people -- ruled out elsewhere -- survive and thrive.

When Michele Corcione first felt out of breath, she thought she was just out of shape.

It quickly became a crisis.

"We went to Aruba, and I just about every 5 feet had to sit down on the floor, on the ground, because I couldn't breathe," Michele recalls.

Corcione was stunned to find out the cause was pulmonary fibrosis, and she needed a lung transplant.

She told her doctor, "I'm going on a cruise in October. I don't have time right now for a fix it. No, I don't have time. And he said, 'You're gonna have to make time.' "

Corcione's rheumatoid arthritis was probably to blame.

"It could attack anything. And it just attacked my lungs," she notes.

Corcione was in her late 60s, over the transplant age limit for many hospitals.

But Temple University Hospital is different.

"We think age is just a number," says Dr. Rachel Criner, a Temple Health pulmonologist.

"If you otherwise have a healthy heart, liver, kidney, and brain, and it's really just your lung disease, why not consider those patients?" says Dr. Criner.

She says UNOS - the United Network for Organ Sharing - has recommended guidelines, but individual transplant centers can set their own.

"I would say the biggest way we that we differ is age," she says.

Temple also doesn't automatically reject lung patients with connective tissue disease, an autoimmune disorder that makes them vulnerable to reflux after transplant.

Dr. Criner says three months with a feeding tube directly into the stomach usually gives their bodies time to recover.

"We reevaluate their swallowing and then we remove the feeding tube, because most of them end up OK. It's just the initial three months they're very weak," she says.

She adds that pulmonary rehab before and after transplants is especially important for older patients, who tend to be more physically deconditioned.

"The stronger you are going into a transplant, the better your success, the faster your recovery after a transplant," Dr. Criner says firmly.

That rehab and following her team's instructions to a T, had Michele out of the hospital in just 10 days, less than half the original estimate.

"I did everything they told me to. Everything," she emphasizes.

Corcione and her husband have a blended family of four adult children, plus grandchildren, and their kids friends are often house guests.

So she was determined to make a strong recovery.

"When people complain about, 'Oh, it's too many meds. Oh, okay. So don't take them. And then what a waste of an organ? You have to be totally committed," she says.

But a year later, at age 70, she is living proof of her efforts.

"I clean, I cook, I walk, I walk every day. Do I do 10,000 steps? No, but I've never done 10,000 steps, honestly, in my life," Michele notes with a smile.

Dr Criner says many older patients are even more grateful for their second chance, because they've been so tied to oxygen machines.

One was thrilled to simply take a shower without stopping to catch his breath.