Duke Research Blog

Following the people and events that make up the research community at Duke.

Author: Sarah Haurin

Happy Patients, Healthy Lungs

Lung-shaped leaves

Evaluating a patient’s mental health before and after lung transplant surgery can help improve long-term outcomes. Source: tikyon, Flickr.

Diseases like Chronic Obstructive Pulmonary Disease (COPD) and Cystic Fibrosis (CF) are hard to treat. Lung transplant is important option for people who do not benefit from other treatments, and understanding the outcomes for these patients is crucial.

Patrick Smith, PhD, a clinical psychologist at Duke Hospital, shared his research into predictors for outcomes of lung transplant with a group of transplant physicians and surgeons at the Duke Hospital on Sept. 14.

“Patients receive transplants to live longer and to feel better,” Smith said.

Focus on the first goal has increased the median survival time after a lung transplant to six years. But Smith began his research because of an interest in the second goal.

An incredibly complex, long, and difficult procedure, transplants require extensive testing and therapies before a patient enters the operating room (OR). Among the pre-operative testing is a mental health assessment to determine if any psychological issues exist that could make recovery more difficult. Mental health issues can affect adherence, or a patient’s commitment to continuing the prescribed post-op medication after release from the hospital.

Smith’s research found that some of these tests can be incredibly useful at predicting outcomes not previously explored; patients who show cognitive impairments before surgery were found to be more likely to fall victim to delirium, a post-operative state of confusion and psychosis that has been linked to an increased risk of complications and death.

While acknowledging the usefulness of pre-operative testing, Smith also pointed out the inadequacy of this model. Failing to continue psychological assessments after the surgery and throughout the recovery means that doctors are missing important clues that could indicate how well patients will recover.

Through his research, Smith has found that the presence of depressive symptoms after transplant is actually a much more useful and accurate tool for predicting risk of mortality than symptoms exhibited before surgery.  

This point is strengthened by a previous study that found that successful treatment of depressive symptoms in liver transplant patients reduced the mortality rate of depressive patients to that of their non-depressive counterparts.

These results are promising for the possibility of improving transplant outcomes; by valuing and treating both pre-operative and post-operative signs of risk, doctors can improve the outcomes for their patients and ensure the limited supply of organs is being used in the best and most successful way possible.

Post by Sarah Haurin

 

 

New Blogger Sarah Haurin, Neuroscience Sophomore With a Thing for Criminal Minds

Hello! My name is Sarah Haurin (rhymes with Heron), and I am a sophomore at Duke. Along with being pre-med, I am pursuing a double major in neuroscience and German. I grew up outside of Philadelphia, Pennsylvania, and I originally fell in love with Duke both because of its vast research opportunities and also its mild winters. In grade school, a requirement to read nonfiction books led me to start reading popular science books for fun. Beginning with books about forensic science and articles about the chemistry of cooking, I soon expanded my interest to include natural and health sciences.

Since then, I have discovered my favorite genres to be abnormal psychology and biomedical research (my favorites being You Are Not So Smart and The Psychopath Whisperer), which interestingly enough make great beach reads (as evidenced by this picture of me from my family’s most recent vacation to Hilton Head Island, SC). In high school, I decided to take this love of reading scientific literature to a new place, and I joined the school newspaper, which allowed me to share recent and exciting findings with my peers through my articles in our health and science pages.

Sarah reading non-fiction at the beach.

I have always loved writing, which is what originally led me to joining my high school newspaper, and through my roles as section editor and eventually editor-in-chief, I came to appreciate the whole writing and publishing process. At Duke, I have written several articles for The Chronicle about the impressive and diverse ongoing research going on here at Duke.

I hope that being a well-rounded person, by allowing myself to enjoy activities not directly related to my majors, will eventually help me to be a better doctor, but for now I just enjoy the ability to combine my loves of writing and science. I hope to be able to further pursue this combination by writing for the Duke Research Blog.

One of the aspects of Duke’s community that I love the most is its diversity, which extends from the people who make up the student and faculty to the passions and interests that they pursue. I hope that writing for the Duke Research Blog will provide me with the opportunity to meet more of the incredibly passionate people who make up Duke’s campus.

Post by Sarah Haurin

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