Vanderbilt University Medical Center is launching the Vanderbilt Lung Institute (VLI), a unique collaboration between Pulmonary Medicine, Allergy and Thoracic Surgery, designed to provide coordinated care for patients with all types of respiratory diseases.
The Vanderbilt Lung Institute One Hundred Oaks Clinic opened in November, a 10,725-square-foot space including 16 exam rooms and five patient consult rooms. The new space is only the flagship of the VLI’s reach; patients will also continue to be seen at VUMC’s main campus as well as the Vanderbilt Asthma, Sinus, and Allergy Program (VASAP) clinics in Lebanon, Gallatin, Brentwood and Franklin.
According to Timothy Blackwell, MD, Rudy W. Jacobson Professor of Pulmonary Medicine and professor of Medicine and Cell and Developmental Biology, “Opening of the VLI represents the culmination of an extensive planning process that began in 2017 with a vision to develop comprehensive clinical care for patients with complex lung disease, expand our lung transplant program and advance cutting-edge respiratory research.”
The VLI is led by two recently-recruited faculty members. Matthew Bacchetta, MD, MBA, MA, associate professor of Thoracic and Cardiac Surgery, is surgical director, and Joao de Andrade, MD, professor of Medicine, is medical director. Lindsay Henderson, MHA, is administrative director.
“Formation of the VLI will be transformative for our patients battling respiratory illnesses. In true multi-disciplinary fashion, our team has brought together the very best and brightest physicians, surgeons and staff into one convenient and collaborative setting at our One Hundred Oaks campus to provide the very latest care in the most effective and efficient manner,” said C. Wright Pinson, MBA, MD, Deputy Chief Executive Officer and Chief Health System Officer for Vanderbilt University Medical Center. “I want to express my appreciation to everyone who helped in the planning and execution to bring this dynamic new clinic to fruition.”
Bacchetta came to Vanderbilt in fall 2018 from Columbia University Medical Center where he was the director of Adult ECMO, surgical director of the Pulmonary Hypertension Comprehensive Care Center, director of the Pulmonary Thrombo-endarterectomy Program and co-director of the Center for Acute Respiratory Failure at New York-Presbyterian Hospital/ Columbia University Medical Center as well as being a lung transplant surgeon.
de Andrade came to Vanderbilt in summer 2019 from the University of Alabama at Birmingham (UAB), where he established the UAB Interstitial Lung Disease (ILD) Program and served as the director of the Pulmonary and Critical Care Fellowship Program and director of the MICU at the Birmingham VA Medical Center.
“The idea of the VLI, I keep emphasizing to everyone, is unique — unique integration of pulmonary medicine and thoracic surgery,” de Andrade said. “You won’t find anything similar anywhere in the country, perhaps in the world. What we’re working on now is really increasing access to patients with complex and advanced lung disease through our system.”
Blackwell added, “This new institute allows us to think strategically from a service line perspective to achieve smart, integrated growth that meets the needs of patients with severe and difficult-to-manage lung diseases.”
The institute will include a variety of specialty clinics with the goal of integrating and expanding both clinical care and patient-centered research. “Our major areas of focus will include interstitial lung disease (ILD), pulmonary hypertension, lung cancer, and chronic obstructive pulmonary disease (COPD),” Blackwell said. “In addition, asthma and allergic diseases are important areas of expertise that we hope to expand as a result of this initiative.”
de Andrade added, “We have recently recruited three physicians with expertise in ILD and we are in the process of retooling access to become a more inclusive center that is more responsive to the needs of the community,” de Andrade said.
Blackwell said that developing a clinical and research program focused on COPD is an important priority for VLI. Vanderbilt sits in the middle of the so-called COPD belt — the hotspot for the disease, including Tennessee, Alabama, Kentucky and West Virginia.
“We are geographically and intellectually well-located to provide superb care for patients with lung diseases, and it’s incumbent upon us to build a world-class system to meet those needs,” Bacchetta said. “Vanderbilt is driven to develop a team of first-rate clinicians and researchers working together to create the future of advanced therapies for our patients.”
Jonathan Nesbitt, MD, professor and chair of the Department of Thoracic Surgery, said the highly specialized clinicians and researchers will make VLI a destination lung-care center for patients both regionally and globally. “The heightened integration and focus of care will certainly make a difference in the quality of life and outcomes in this broad group of patients,” he said.
To improve access to transplant, the team has proven the ability to rehabilitate and transplant lungs that would not be accepted at many other transplant centers using ex vivo lung perfusion (EVLP). In addition, Vanderbilt has expanded access to donors by successful use of DCD (donation after cardiac death) organs, which can be more challenging to transplant than lungs that are typically gathered after brain death. Many other centers don’t accept DCD lungs. The lung transplant team is also using advanced devices called Extracorporeal Membrane Oxygenation (ECMO) to keep severely ill patients alive until they can receive a transplant. Before the use of ECMO, these patients would not have survived to receive a transplant.
“We are so excited to be able to partner our world-class physicians and surgeons into a collaborative institute to provide the finest care to patients with pulmonary disease,” said Seth Karp, MD, H. William Scott Jr. Professor, director of the Vanderbilt Transplant Center and chair of the Section of Surgical Sciences. “The lung institute will combine the best diagnostic technologies with comprehensive, individualized care based on patient need, whether it requires medical therapy, an advanced procedure or a wide range of surgical options.”
de Andrade said the institute will focus on growing other programs that address advanced lung disease, and new clinical space will open to serve the increased number of patients. An advanced respiratory care unit has been established on 8 North to serve pre- and post-transplant patients as well as others with advanced lung disease, in addition to the new Vanderbilt Lung Institute One Hundred Oaks Clinic.
Behind all the improvements on the clinical side, there will be expanded translational and basic science research. The expanded patient population will contribute to a better understanding and improved treatment for lung diseases.
“We hope that we can test initiatives to improve patient outcomes, reduce length of stay and improve efficiency,” de Andrade said. “We are very excited about what the future holds both near and far.”
More information about VLI can be found at vanderbiltlunginstitute.com.