Until recently, science fiction writers only dreamed about transplanting internal organs. Fortunately, progress does not stand still, and today such operations are carried out around the world. The answer to the question: "When was the first lung transplant in our country?", As well as detailed information about this operation are presented to your attention in our article.
The first successful lung transplantation for a child in Russia
In the middle of autumn 2016, many Russian media published sensational news. In Russia, the first successful lung transplantation was performed for a child. The patient, a thirteen-year-old girl, suffered from cystic fibrosis, and at the time of the operation, her condition was assessed as very serious. Surgical intervention was personally led by Sergey Gauthier, head of the Federal Research Center for Transplantology and Artificial Organs named after Shumakova. The performed lung transplantation is unique primarily due to the age of the patient. It was hard enough to find a donor. As a result of searches and compatibility checks, the organs of an adult male were selected. Until the very last moment, doctors did not give accurate predictions to the girl's family. And so, some time after the operation, the patient looks completely healthy. Before transplantation, the girl practically did not get out of hospitals for 2 years, and could only breathe in an oxygen mask. Just a month after the operation, the patient's condition did not cause concern. The girl gradually learned to live in a new way, without an oxygen mask, drew a lot and even walked with her family. Doctors give extremely positive predictions, but still the patient will have to go through a number of examinations and tests.
Russian experience of lung transplantation for an adult patient
The first experiments on lung transplantation in our country were carried out by V.P. Demikhov in 1940. Dogs acted as patients, the researcher was able to prove that organ transplantation in the chest of experimental animals can be performed. As for human lung transplantation, domestic doctors managed to get a positive result only in 2006. Surgical intervention, which became a medical sensation, was carried out in St. Petersburg. The patient, a female doctor, was in very serious condition. This lung transplant operation in Russia was carried out thanks to the coordinated work of 45 specialists in various fields and the help of wealthy sponsors. According to a rough estimate, the cost of transplantation was at least 200 thousand dollars. Similar operations are carried out today in our country, but they cannot be called massive. Each surgical intervention is planned and prepared individually.
Respiratory transplantation - the reality of our time?
World medical practice proves that transplantation of internal organs is possible. Surgery for unilateral or bilateral lung transplants, as well as the complex “lungs and heart” are carried out today in many countries of the world. More and more clinics and individual doctors are developing such transplants. In recent years, at least 3,000 operations are performed annually in the world, and this figure continues to increase. Many experts agree that if there were more donors, a lung transplant would be performed for all patients with indications.
Diseases requiring surgery
What are the diagnoses for transplantation? Most often, surgical treatment is indicated for patients with obstructive diseases, such as pulmonary emphysema. Surgery can help patients with congenital diseases such as cystic fibrosis. Lung transplantation in Russia and other countries of the world is carried out with restrictive diseases, the most common of them is idiopathic fibrosis. Eisenmenger syndrome and pulmonary hypertension are also indications for surgery. Transplantation is prescribed only in those cases when medical and alternative surgical treatment does not bring positive results. The task of doctors is to assess the general condition of the patient and the severity of his illness. It is possible to understand whether transplantation is required and whether there are chances for its successful implementation on the basis of laboratory tests and clinical tests.
Indications for a lung transplant
Lung transplantation can be performed in patients under the age of 60-65 years. The operation is prescribed for severe damage to the lung tissue, significantly worsening the quality of life of the patient. If, according to the forecasts of observing experts, the patient has only a few months to live without a transplant (no more than a year), most likely, he will also be offered surgical treatment. It is advisable that the applicant for transplantation be in good physical shape and not have serious deviations from ideal body weight. Some experts also pay attention to the psychosocial state of patients.
Absolute and relative contraindications
A lung transplant operation cannot be performed in patients with HIV infection or significant internal organ dysfunctions. Any oncological diseases, hepatitis C and the presence of HBs antigen in a patient are contraindications to transplantation. At least six months before the expected date of surgery, the patient should completely stop taking drugs, alcohol and smoking tobacco. There is also a list of relative contraindications for surgical intervention. Some clinics or specialists consider them absolute. A high mortality rate among overweight people who decide to have a lung transplant. The complexity of transplantation increases, provided that the patient has previously undergone surgery on the chest organs. If lung disease is caused by an infection, the fight against microorganisms should begin before surgery. Diabetes mellitus is another aggravating factor. In the presence of this disease, a lung transplant can be performed, but it is necessary to constantly monitor the amount of sugar in the blood.
Search and donor selection
One of the most significant problems of global transplantology is the insufficient number of donor organs for transplants. The thing is that donation is possible only after a clinical statement of the fact of brain death. Moreover, the removal of organs for transplantation has a number of medical and legal subtleties. An insufficient number of people living today manage to correctly execute a will before their death, even if there is a desire to become donors. Most often, donation is based on the consent of the immediate family of the deceased. A safe and timely lung transplant for a child in Russia is a happy exception to the rule when a suitable donor is found quickly enough. Usually, people who have lost their close relative are not ready to make such serious decisions immediately after receiving sad news. It is worth noting that not everyone can become a donor. The main requirements: age up to 55 years, the absence of aspiration masses in the lungs and normal radiographs. It is advisable that the donor be a non-smoker or a non-smoker (up to 20 packs of cigarettes per year). Before transplantation, lung and donor compatibility is assessed.
The subtleties of lung transplant surgery
After receiving a referral for transplantation and passing all the necessary examinations, the patient can only expect the receipt of a suitable donor. As soon as donor organs appear in the clinic, the patient awaiting surgery will be urgently called for. Lung transplantation in Russia, as well as in Western countries, is carried out unilaterally and bilaterally. If one lobe of the lung is replaced, the incision is made on one side of the chest. In bilateral transplantation, an incision is made in the middle of the chest. In some cases, two symmetrical long cuts can be made. Any transplantation of internal organs is carried out under complete anesthesia, during the entire operation the patient is unconscious and does not feel anything.
Rehabilitation after transplantation
The effectiveness of lung transplants is largely dependent on how the rehabilitation was carried out. After surgery, patients require complex intensive care. It is necessary to ensure the prevention of infections, physiotherapy,
postural drainage. According to individual indications, pleural cavity drainage and bronchoscopy can be prescribed. Without high-quality rehabilitation, a lung transplant for a child or adult is unlikely to bring a positive result.
Is there life after a lung transplant?
There are several criteria for evaluating lung transplantation. The most significant of these is survival. The first lung transplant in Russia with a positive result was performed in 2006, but this does not mean that there were no unsuccessful attempts before. It is possible to say that the operation was successful if the patient lived after it for more than a year and no complications were identified. According to world statistics, the average life expectancy of patients after lung transplantation is 5-6 years. Most patients after surgery report a significant improvement in quality of life. What is curious, after the end of the rehabilitation period, many people who have undergone lung transplantation admit that they live without any physical restrictions.
World experience
The first lung transplant in the world, after which the patient lived 18 days, was performed in 1963. This surgery has proven that surgery can be performed. The history of productive and successful lung transplantation begins in the 80s of the last century. It was at that time that a new effective drug, Cyclosporin, regulating the functioning of the body’s immune system, appeared. Gradually, the technology of organ transplantation was improved. Today, organ transplants are performed in many developed countries. More than 3,000 such operations are performed per year. Despite such impressive statistics, only about 30% of patients have time to wait for their surgery. In Russia, there are all the resources to approach foreign standards. A successful lung transplant for a girl in our country is vivid proof of this.