Until recently, science fiction writers only dreamed of transplantation of internal organs. Fortunately, progress does not stand still, and today similar operations are carried out around the world. The answer to the question: "When was the first lung transplant performed in our country?", as well as detailed information about this operation are presented to your attention in our article.
First successful lung transplantation for a child performed in Russia
In mid-autumn 2016, many Russian media published sensational news. The first successful lung transplantation for a child was performed in Russia. 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. The surgical intervention was personally supervised by Sergei Gauthier, head of the Federal Scientific Center for Transplantology and Artificial Organs. Shumakov. The performed lung transplant is unique primarily because of the age of the patient. It was quite difficult to find a donor. As a result of searching and checkingcompatibility, the organs of an adult male were selected. Until the very last moment, doctors did not give accurate forecasts for the girl's family. And now, some time after the operation, the patient looks completely he althy. Before transplantation, the girl practically did not get out of hospitals for 2 years, and she could only breathe in an oxygen mask. Only 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, she drew a lot and even walked with her family. Doctors give extremely positive forecasts, but the patient will still have to undergo a series of examinations and tests.
Russian experience of lung transplantation in an adult patient
The first experiments on lung transplantation in our country were conducted by V. P. Demikhov in the 1940s. The patients were dogs, the researcher was able to prove that transplantation of organs 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. The surgical intervention, which became a medical sensation, was carried out in St. Petersburg. The patient - a female doctor - was in a 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 we althy sponsors. According to a rough estimate, the cost of transplantation was at least $200,000. Similar operations are being carried out today in our country, but they cannot becall it massive. Each surgical intervention is planned and prepared individually.
Respiratory transplantation a reality of our time?
World medical practice proves that transplantation of internal organs is possible. Operations for unilateral or bilateral lung transplantation, as well as the "lungs and heart" complex, are carried out today in many countries of the world. More and more clinics and individual doctors are mastering such transplants. In recent years, at least 3000 operations are performed annually in the world, and this figure continues to increase. Many experts agree that if more donors were available, lung transplants would be performed on all eligible patients.
Diseases requiring surgery
At what diagnoses is transplantation indicated? Most often, surgical treatment is indicated for patients with obstructive diseases, such as emphysema. Surgery can help patients with congenital diseases such as cystic fibrosis. Lung transplantation in Russia and other countries of the world is performed for restrictive diseases, the most common of which is idiopathic fibrosis. Also indications for surgical intervention are Eisenmenger's syndrome and pulmonary hypertension. Transplantation is prescribed only in cases where 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 disease. understand requiredwhether transplantation and whether there are chances of its successful implementation can be based on laboratory tests and clinical analyzes.
Indications for a lung transplant
Lung transplantation can be performed on patients up to the age of 60-65. The operation is prescribed for severe damage to the lung tissue, which significantly worsens the quality of life of the patient. If, according to the forecasts of observing specialists, the patient has only a few months left to live without a transplant (no more than a year), most likely, he will also be offered surgical treatment. It is desirable that the applicant for transplantation be in good physical shape, have no serious deviations from the ideal body weight. Some specialists also pay attention to the psychosocial state of patients.
Absolute and relative contraindications
Lung transplant surgery cannot be performed on patients with HIV infection or significant organ dysfunction. Any oncological diseases, hepatitis C and the presence of the HBs antigen in a patient are contraindications for transplantation. At least six months before the expected date of surgery, the patient must completely stop taking drugs, alcohol and tobacco smoking. There is also a whole list of relative contraindications for surgical intervention. Some clinics or specialists consider them absolute. The mortality rate is high 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 the lung disease is caused by an infection, the fight against microorganisms should be started before surgery. Diabetes is another aggravating factor. In the presence of this disease, a lung transplant can be performed, but the amount of sugar in the blood must be constantly monitored.
Search and selection of a donor
One of the most significant problems in the world of transplantology is the insufficient number of donor organs for transplantation. The thing is that donation is possible only after a clinical statement of the fact of brain death. At the same time, the removal of organs for transplantation has a number of medical and legal subtleties. An insufficient number of people living today have time to properly issue a will before their death, even if they have a desire to become donors. Most often, donation is carried out on the basis of the consent of the next of kin of the deceased. A successful and timely transplantation of lungs to a child in Russia is a happy exception to the rule when a suitable donor was found quickly enough. Usually, people who have lost their close relative are not ready to make such serious decisions immediately after receiving the sad news. It should be noted that not everyone can become a donor. The main requirements are: age up to 55 years, the absence of aspiration masses in the lungs and normal radiographs. It is desirable that the donor be a non-smoker or a light smoker (up to 20 packs of cigarettes per year). Beforetransplantation evaluates the compatibility of patients' lungs and donor lungs.
Subtleties of lung transplant surgery
After receiving a referral for transplantation and passing all the necessary examinations, the patient can only wait for a suitable donor to arrive. As soon as donor organs appear in the clinic, the patient waiting for the operation will be urgently called for it. Lung transplantation in Russia, as well as in Western countries, is carried out unilaterally and bilaterally. If the patient is going to have one lobe of the lung replaced, the incision is made on one side of the chest. In a bilateral transplant, an incision is made in the middle of the chest. In some cases, two symmetrical long incisions may be made. Any transplantation of internal organs is performed under full anesthesia, during the entire operation the patient is unconscious and does not feel anything.
Rehabilitation after transplantation
The effectiveness of a lung transplant largely depends 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, drainage of the pleural cavity and bronchoscopy can be prescribed. Without quality rehabilitation, a lung transplant in a child or adult will most likely not bring a positive result.
Is there life after a lung transplant?
There are several evaluation criterialung transplant. The most important of these is survival. The first lung transplant in Russia with a positive result was carried out in 2006, but this does not mean that there were no previous unsuccessful attempts. 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 report a significant improvement in their quality of life after surgery. Curiously, after the end of the rehabilitation period, many people who have undergone lung transplantation admit that they live without any physical restrictions.
Global experience
The first lung transplant in the world, after which the patient lived for 18 days, was carried out in 1963. This surgical intervention proved that the operation could be performed. The history of productive and successful lung transplantation begins in the 1980s. It was at that time that a new effective drug "Cyclosporin" appeared, which regulates the functioning of the body's immune system. Gradually, the technology of organ transplantation improved. Today, organ transplantation is carried out in many developed countries. More than 3,000 such operations are performed per year. Despite such impressive statistics, today only about 30% of patients have time to wait for their operation. Russia has all the resources to approach foreign standards. Successful lung transplantgirl spent in our country is a clear proof of this.
