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2023/10/19 14:39:14

Lung transplantation

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{{# https://www.tadviser.ru/images/3/32/IMG 3742.MP4|100%|auto||Breathable lung of a person waiting for a transplant, 2020}}

2023: The first successful repeated lung transplant in Russia was carried out at the Sklifosovsky Research Institute

On October 19, 2023, it became known about the first successful lung transplant in Russia. The operation was carried out by transplantologists of the N.V. Sklifosovsky in Moscow.

As reported on the official website of the capital's mayor, the patient has been suffering from histiocytosis for 11 years - a disease in which air cysts form in the lungs and this organ gradually ceases to function. In 2013, the man first felt shortness of breath, and in 2018 he was on the waiting list for a lung transplant at the N.V. Sklifosovsky.

In Russia, for the first time, a successful repeated lung transplant was carried out

In 2019, doctors successfully transplanted his lungs, after which the man was able to return to normal life. But in 2022, he again began to feel bad.

It is noted that drug treatment did not help, shortness of breath was growing, and six months later the man was again hospitalized at the N.V. Sklifosovsky. Here he was treated in intensive care and, due to the progression of the disease, was transferred to an ECMO machine, which completely took over the function of his lungs.

In August 2023, the doctors of the institute received a suitable donor organ and decided to re-transplant. According to experts, the difficulty of re-transplanting is that after the first operation, adhesions and scars form between the heart and lungs, through which it is technically very difficult to make your way. Attempts to dissect adhesions often lead to bleeding during and after surgery, which is the cause of the unfavorable outcome.

The lung transplant operation lasted about 9 hours. A few days later, the patient was disconnected from the ECMO apparatus, and two weeks later he was able to breathe on his own. The man will have a long rehabilitation.[1]

2022: A camera is presented evaluating the suitability of donor lungs for transplantation

In mid-July 2022, the medical and technological company SQI Diagnostics announced the development of the TORdx LUNG system, which is designed to help doctors assess donor lungs for their suitability for transplantation. Read more here.

2021

Performing the first complete lung transplant affected by COVID-19

At the end of December 2021, it became known that the first complete transplantation of lungs affected by coronavirus (COVID-19) infection was carried out. This is reported by doctors from Lisbon, the patient underwent a double lung transplant after his lungs were badly damaged by the disease. The case report was presented at the European Society for Anesthesiology and Critical Care Medicine annual meeting held on 17-19 December 2021.

The patient contracted the coronavirus in January 2021 and was discharged from the hospital on August 23, 2021, marking the first successful lung transplant in a person who had undergone COVID-19. The man, who had a history of dyslipidemia, unusually high levels of cholesterol and other fats in his blood, also had gastritis. The patient was admitted to the emergency department with SARS-CoV-2 pneumonia on January 12, 2021.

The first complete transplantation of lungs affected by coronavirus was carried out

Despite the support of a ventilator, the patient's condition worsened due to severe shortness of breath caused by low oxygen levels. The man needed advanced lung support therapy, extracorporeal membrane oxygenation (ECMO), which fully takes over lung function. The patient spent 74 days on ECMO before being transferred to extracorporeal carbon dioxide removal, a device designed to remove carbon dioxide but not providing such high levels of oxygen. Over three months, the patient suffered many infections, including pneumonia and prostatitis, as well as complications from the blood, including impaired blood clotting and a life-threatening reaction to a blood thinner. The operation took about seven hours and included two weeks of postoperative intensive care.

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About 75% of the patient's lungs were damaged by COVID-19, and it was clear from the scan that his lungs were permanently damaged and would not recover. The patient was suitable for transplantation because he was young and strong enough to withstand risky procedures, and no other organs were affected by COVID-19. After a thorough clinical assessment in May 2021, vital organs were transplanted into the patient, says anesthesiologist Dr. Carolina Almeida.
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It was six months after the transplant, but the patient's recovery is not yet complete. Lung function is good and no longer requires daytime oxygen support, but on the road to recovery, the man had to overcome many difficulties including atrial fibrillation, collapsed lung, subcutaneous emphysema, type 2 diabetes and several infections. The patient continues to undergo rehabilitation to improve mobility, lung function and quality of life, and will have to take more than a dozen medications for the rest of his life to prevent organ rejection and infections.

Lung transplantation is a lifesaving treatment for a carefully selected group of COVID-19 patients whose lungs have been irreparably damaged by the virus and the patients themselves must be strong enough to undergo major transplant surgery. Given the impact of COVID-19 worldwide and the growing number of younger, healthier patients, the number of transplant candidates is likely to increase significantly. This number may increase due to those who survived COVID-19, whose lungs may deteriorate over time.[2]

OCS Lung System for washing, storing and transporting donor lungs has entered the market

In late July 2021, TransMedics began selling its OCS Lung System to provide hypothermic flushing, storage and transportation of donor lungs for transplantation. Read more here.

Sales of donor lung storage and transportation system LUNGguard began

In early January 2021, Paragonix Technologies announced the release of its LUNGguard donor lung storage and transportation system in the United States and Europe. This solution provides hypothermic protection of the lungs during transport and subsequent transplantation to the recipient using refrigerated storage solutions. At the same time, LUNGguard allows you to maintain lung viability for up to eight hours in a strictly controlled environment with real-time digital monitoring, the manufacturer says. Read more here.