Breathing new life into VCU Health’s lung transplant program
An array of excellence in caring for advanced lung disease has led to approvals for VCU Health Hume-Lee Transplant Center to resume lung transplants.
March 07, 2025
With strong collaborations across several departments, VCU Health team members are recognized for their innovative approaches to care for patients with complex and chronic lung conditions. (MCV Foundation)
By Holly Prestidge
After a nearly 20-year hiatus, VCU Health’s lung transplant program is returning.
Word came in late September that the health system’s application to restart the program had been accepted. For Vipul Patel, M.D., the past nine months of planning — securing multidisciplinary teams involving everyone from surgeons to dietitians and identifying potential transplant candidates — had led to this new reality.
Lung transplants are scheduled to begin in early 2025, and when they do, VCU Health will be only the third health system in Virginia to offer the procedure.
Vipul Patel, M.D., medical director of the lung transplantation at VCU Health Hume-Lee Transplant Center, was hired in 2024. (Daniel Sangjib Min, MCV Foundation)
“It’s a big achievement,” said Patel, the physician hired in March 2024 to lead that program. “We are active again.”
The achievement did not happen in a vacuum.
In fact, the Division of Pulmonary Disease and Critical Care Medicine at Virginia Commonwealth University’s School of Medicine has transformed in recent years. Strategic hires and recalibrated mission statements have sharpened the focus to do more for patients by diving into and expanding care within pulmonary subspecialty areas like asthma, for which Virginia is a hotspot nationally, and interstitial lung disease, which includes pulmonary fibrosis, or scarring of the lungs, one of the leading indicators for lung transplant candidacy.
Establishing a lung transplant program is not an easy task. You must have the subspecialty programs to eventually support lung transplant, and that takes years of very thoughtful and intentional planning.
Patrick Nana-Sinkam, M.D., chief of the Division of Pulmonary Disease and Critical Care Medicine at VCU School of Medicine
Cystic fibrosis and pulmonary hypertension are other disease areas, as is chronic obstructive pulmonary disease, better known as COPD, which is the third leading killer of adults worldwide behind cancer and heart disease.
Sarcoidosis, an inflammatory disease that can affect multiple areas of the body, is yet another disease with higher prevalence in Virginia and the Southeastern U.S.
Each of these pulmonary care areas has been meticulously addressed at VCU Health through handpicked expert faculty, aggressive research pursuits and highly selective educational programs that train the next generation of pulmonary health care professionals. Collectively, these subspecialties represent the foundation on which VCU Health is building a successful, high-volume transplant program.
“We are a multidisciplinary, multispecialty, comprehensive care center,” said Patrick Nana-Sinkam, M.D., chief of the Division of Pulmonary Disease and Critical Care Medicine, “and now we have the ultimate treatment.”
Building from the ground up
As transplants go, lungs are a different beast.
Often considered more challenging than transplants for hearts, livers or kidneys, lung transplants pose serious risks. Immunosuppressant drugs needed to help reduce the risk of organ rejection also weaken the recipient’s immune system, which opens the door for infections. Those drugs are taken for the rest of the patient’s life.
Unlike the heart, liver or kidney, for which a transplanted organ can add many years to the patient’s life, lung transplants offer no such promise of longevity. Five to seven years is a best-case scenario for most people.
Still, lung transplants provide relief to patients who have no other options.
More than 3,000 lung transplants were performed nationally in 2023, a milestone for that organ, according to UNOS, the national organ sharing network in which VCU Health now has membership for lung transplants.
Under Patel, the program will initially perform 10 to 30 transplants annually over a span of several years, then up to 50 transplants each year.
It’s a stark contrast to the lung transplant program that existed at VCU Health between 1991 and 2006. During that time, a total of 38 lung transplants were performed. At most, four were done in one year.
Patrick Nana-Sinkam, M.D., chief of the Division of Pulmonary Disease and Critical Care Medicine, VCU School of Medicine. (Virginia Commonwealth University)
Lung transplant programs thrive when volumes are high and outcomes are successful, said Patel, who came to VCU Health after working at several high-volume centers in Arizona and Maryland, where annual transplants numbered 80 to 100 and 30 to 40, respectively. He specializes in transplants involving both lungs, which, with few exceptions, he said, is the norm around the world.
Nana-Sinkam, who was recruited to VCU Health in 2016 specifically to expand pulmonary care, echoed those thoughts. VCU Health has gained momentum over the past decade as a pulmonary comprehensive care center, he said, so about two years ago, faculty members set their sights on reviving the lung transplant program.
“Establishing a lung transplant program is not an easy task,” he said. “You must have the subspecialty programs to eventually support lung transplant, and that takes years of very thoughtful and intentional planning because a successful program is entirely dependent on infrastructure.”
Every hire is crucial, every connection across disciplines must be strong, from preoperative evaluations to operative care and postsurgical pulmonary rehabilitation. VCU Health Hume-Lee Transplant Center leads the lung transplant program and collaborates closely with the Division of Pulmonary Disease and Critical Care Medicine to ensure the best possible patient care.
“Outcomes, and ultimately accreditation, are directly linked to the number of patients you manage and infrastructure,” Nana-Sinkam said. “If you don’t have a multidisciplinary team that works together in a seamless manner, or the pulmonary rehabilitation facilities aren’t equipped to support our patients prior to and following surgery, the transplant program is unlikely to succeed. We are fortunate to have an amazing team who has worked collaboratively to make this a reality for our patients.”
A unique approach to care
For a so-called “rare” disease, VCU Health sees roughly 2,500 sarcoidosis patients a year. In fact, a heat map posted on a hallway bulletin board near the West Hospital office of Aamer Syed, M.D., shows a prevalence of the disease in Virginia and neighboring Southern states.
There is no definitive reason why, but enough people are affected throughout Virginia that VCU Health took a novel approach to treating it.
An inflammatory disease, sarcoidosis affects the lungs as well as the heart, kidneys, joints, eyes and other areas. It occurs when there’s an inappropriate response by the body that produces persistent inflammation, which eventually leads to organ damage, blindness, heart failure and other serious conditions. If found early enough, the disease is manageable.
We do everything collaboratively. I don’t think there’s any other program that has this many physicians of different specialties embedded together.
Aamer Syed, M.D., co-founder of the VCU Health sarcoidosis clinic
One of the first 10 centers globally to receive a World Center of Excellence designation, VCU Health’s sarcoidosis clinic sees patients of all ages, from 18 to 80.
Among the patients, about 70% are African American women, Syed said.
Sarcoidosis spans various areas of the body, and for that reason, VCU Health’s treatment system was built around addressing patients’ needs simultaneously. The sarcoidosis clinic started 12 years ago with a team from pulmonology, cardiology and rheumatology, and now includes neurology, neuro-ophthalmology and hepatology.
“Our clinics are very unique,” said Syed, one of the founders of the sarcoidosis clinic. Health care is often fractured, he said. Many doctors stick to their specialty areas.
“That means patients are the go-between among their specialists, which can be problematic depending on the patient’s recall,” he explained. “But sarcoidosis can affect so many parts of the body at one time, so we bring all of those issues under one roof through combined visits.”
Aamer Syed, M.D., co-founder of the VCU Health sarcoidosis clinic, studies a patient’s scans. The clinic is one of the first 10 designated as a World Center of Excellence. (Daniel Sangjib Min, MCV Foundation)
During one visit, sarcoidosis patients can see Syed at VCU Health’s Stony Point location as well as their cardiologist and rheumatologist.
“Patients like the interconnectedness,” he said. “We are the quarterbacks managing all these organ systems, and it’s proven to be very popular.”
VCU Health’s program is among the largest in the country, he said, noting that the group intentionally does not have a director.
“We do everything collaboratively,” he said. “I don’t think there’s any other program that has this many physicians of different specialties embedded together.”
Looking ahead
VCU Health will be opening a new pulmonary and cardiac rehabilitation facility in Reynolds Crossing in Henrico County, Va., in 2025. The facility will provide lung transplant candidates with the presurgical care they need to be healthy enough for transplant.
Pulmonary rehab works with nearly 300 patients annually. Currently, the services are housed in VCU Medical Center in downtown Richmond.
The new facility is one more feather in the cap for pulmonary care at VCU Health.
“We have dedicated ultra-specialists everywhere,” said Alpha “Berry” Fowler III, M.D., former chair of the Division of Pulmonary Disease and Critical Care Medicine and the current William Taliaferro Thompson Professor of Medicine.
“Research sets us apart,” he said. “We train future pulmonology doctors, and we have one of the best programs in the country.
A version of this story was originally published by MCV Foundation
