Krakow: First lung transplantation in Małopolska center

The patient is a 40-year-old woman with interstitial lung disease, which resulted in irreversible fibrosis of the organ. She had been struggling to breathe for several years. The slightest exertion was a very great difficulty. In late May, she was urgently hospitalized in the Interstitial Lung Disease and Transplantation Unit. A team led by Dr. Miroslaw Necki, MD, conducted tests, determined the severity of the disease and qualified her for lung transplantation as a life-saving procedure.

- After receiving information from the Poltransplant Coordination Center that there is a potential donor who, based on a number of imaging and biochemical tests, is optimal for our patient, there was an acceptance, which is always done as a team, i.e. a team of cardiac surgeon, pulmonologist and anesthesiologist," says clinical transplantologist and cardiac surgeon Jacek Piątek, MD, PhD, deputy head of the Clinical Department of Heart, Vascular and Transplant Surgery.

The first stage of the operation was to retrieve the organ from the donor and transport it to a Krakow hospital. Assistance in this regard was provided by military personnel from the 8th Transport Air Base in Krakow. The procedure for transplanting both lungs was then carried out in the operating room of the Clinical Department of Heart, Vascular and Transplant Surgery. The procedure, which is one of the technically demanding ones, turned out to be extremely complicated, due to bilateral massive adhesions in the pleural cavities, which caused anatomical difficulties in performing the operation. The operation lasted 14 hours and was successful.

- After the operation, the patient was transferred to the 1st Anesthesiology and Intensive Care Unit, where, thanks to the joint work of the medical (anesthesiologist, pulmonologist), nursing and physiotherapy team, she was awakened as early as the second postoperative day and was able to breathe fully with her own new lungs without the need for ventilator support, adds Prof. Jacek Piątek.

- During his stay at the Department of Anesthesiology and Intensive Care, among other things, immunosuppressive treatment was implemented to prevent rejection of the transplanted organ, and intensive rehabilitation began. For many people, lung transplantation is the only salvation and a chance to prolong life," says Miroslaw Necki, MD, specialist in clinical transplantology, lung diseases and internal medicine, head of the Interstitial Lung and Transplantation Unit

As emphasized by dr. Grzegorz Fitas, director of Krakow's St. John Paul II Specialized Hospital, lung transplantation is an operation that for some patients is the only way to live, and is performed in very few centers in Poland.

- It is important that we as a society express the will that if a person dies, his organs can be used to save the lives of others. I am glad that the patient is feeling better and better. This is thanks to the fact that such a great team of experienced lung transplant doctors performed this difficult and complicated procedure. It is also necessary to acknowledge here the tremendous effort of the entire team that worked together during and immediately after the transplant: the anesthesiologists, the perfusionist, the nursing team and the physiotherapy team. It's a very complicated process, but as a hospital we have many years of experience in heart transplant operations, so it's all the easier for us to carry out the lung transplant procedure," says Grzegorz Fitas.

Krakow's St. John Paul II Specialized Hospital in early April 2023 signed an agreement with the National Health Fund to finance lung transplantation procedures. In December 2022, the hospital received permission from the Minister of Health to store and transplant lungs taken from deceased donors. So far in Poland, only five cities have performed such operations: in Gdansk, Szczecin, Poznan, Warsaw and Zabrze.

Elaborated. on the basis of: szpitaljp2.krakow.pl