Establishing Expertise in Advanced Lung Disease and Transplant

Inova’s advanced lung disease and transplant team has performed about 150 lung transplants over the past five years. And the Medical Director of the Lung Transplant Program at Inova, Shambhu Aryal, MD, knows every one of those patients.

“We develop a very intimate relationship with our patients,” Dr. Aryal says. “That kind of personalized care is hard to find at a large practice.”

But the advanced lung disease care offered at Inova isn’t only about bedside manner. Inova is one of only two lung transplant centers in Virginia and the commonwealth’s only center to provide complex heart and lung transplants. The team’s expertise includes a spectrum of advanced lung conditions, both common and rare.

Specialized Care for All Types of Advanced Lung Disease

Most types of lung disease are progressive and get worse with time. At an advanced stage, the disease requires more than what standard pulmonology or primary care can provide.

While there is no cure for lung disease, there are ways to manage the symptoms. But because those symptoms vary depending on the type and stage of lung disease, successful management requires a specialized team.

“As the advanced lung disease and transplant program developed over the past 25 years, specialized care became our focus,” Dr. Aryal says. “Our physicians and advanced practice providers see various patients and conditions, but many of us have our own niche. And our nurses and support staff are often condition-specific experts as well.”

Inova holds eight national and international accreditations for its expertise in treating advanced lung diseases. It’s a designated center for lung transplant and has certifications for five lung conditions:

• Chronic obstructive pulmonary disease
• Cystic fibrosis
• Pulmonary fibrosis
• Pulmonary hypertension
• Sarcoidosis

“Many universities and pulmonology departments in the region may have one or two of these specialized programs,” Dr. Aryal says. “Having a combination like ours is unusual.”

Complex Care for Rare Lung Diseases

Some advanced lung diseases are difficult to treat because they are rare, are too advanced or require complicated procedures. To combat these challenges, Inova offers care such as:

• Rare disease management of conditions including sarcoidosis, cystic fibrosis, pulmonary fibrosis, pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension
• Thoracic surgery including complex procedures for rare and severe lung disease
• ECMO (extracorporeal membrane oxygenation) for patients who need advanced life support targeted at the heart and lungs or are awaiting a transplant
• Clinical trials, which offer access to novel drugs and treatment through Inova’s clinical research center for lung disease
• Lung transplant when available treatment options are not successful

Why a Multidisciplinary Approach Matters

As lung disease advances, it often affects other areas of the body. Managing advanced lung disease and transplant requires a team of specialists looking at the diagnosis from every angle.

End-stage disease may also require collaboration with other specialists including (but not limited to) cardiologists, neurologists, rheumatologists, nephrologists and gastroenterologists.

“Across the spectrum of conditions that we manage, we need to take an extensive multidisciplinary approach,” Dr. Aryal says. “The support and involvement of different specialties and ancillary staff are critical in the care of our patients.”

Each patient’s care team may include:

• Advanced practice providers
• Condition-specific nurses
• Condition-specific social workers
• Dieticians
• Pharmacists
• Pulmonologists

“The advanced lung disease and transplant program at Inova gets patient referrals from all over the region,” Dr. Aryal says. “That’s a true reflection of our team’s expertise and the personalized care we offer.”

Learn more about Inova’s advanced lung disease and transplant program.