Life with transplanted lungs: Among the people who have them is an actor or a Formula 1 pilot

Every year, we send around five lungs to Prague for a transplant. The lives of Slovaks are in the hands of Czech surgeons
07.Dec 2021
 
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Instead of Vienna, Slovak patients now have to travel to Prague for lung transplants. The Austrians terminated the contract they had with Slovakia. The Ministry of Health of the Slovak Republic therefore turned to the Czech Republic, which agreed to establish cooperation with the neighbouring country.

Akční hrdina Sylvester Stallone, telenovelový herec Toño Mauri a jeho dcera Carla Mauri.

Lung transplantation is one of the most complicated surgical procedures. It takes 6-8 hours on average. In Slovakia, nobody performs this procedure, and in the Czech Republic, there is only one workplace where one can get a lung transplant - III. Department of Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital. The good news is that the door is open here for Slovak patients.

"Lung transplants are not performed in Slovakia at all, as the estimated annual number of procedures did not require the introduction of the program in the past, and the surgery itself, as well as postoperative care, requires experience and a degree of routine that is difficult to achieve with a low number of procedures. Since 2018, the topic of the introduction of lung transplants in Slovakia has been open and thoroughly discussed, and options are being sought to launch the program. The program is also planned as part of the optimization of the hospital network - in a certain national centre,"

the Ministry of Health of the Slovak Republic commented for LP-Life.com.

The Prague Hospital in Motol started with lung transplants in Slovak patients

Doctors at the Motol University Hospital performed their first lung transplant on a Slovak patient on March 5, 2018. The memorandum was signed by the ministers of the Slovak Republic and the Czech Republic in October 2017. Thanks to this agreement, patients from Slovakia can be certain to get a lung transplant in Prague.

Dům u jezera s tenisovým kurtem - pozemek 2852
Dům u jezera s tenisovým kurtem - pozemek 2852, Okolí Prahy

Operace plic.
Operace plic. • Source: Unilabs

Lung transplantation is not a common procedure, it is necessary to find a donor with a suitable organ. Patients are therefore placed on a waiting list and live with their damaged lungs until they can have the surgery. Slovak patients are put on the lung transplantation waiting list in the Czech Republic, together with Czech patients.

"Slovak patients are placed on a waiting list in the Czech Republic whenever the need arises. Currently (according to data from A. Šenková, MD) there are four Slovak patients on the joint waiting list, another four have had a transplant this year, eight Slovak patients are about to be placed on the waiting list, which currently includes a total of about 60 patients."

explains the Ministry of Health of the SR.

"When it comes to organ donation, the lungs are the most problematic organ because, unlike the heart, liver or kidneys, they need very gentle treatment in the donor's body - otherwise they lose their function. Moreover, in comparison with other organ transplants, the lungs are connected with the greatest postoperative complications and the worst long-term results,"

explains the head of the clinic prof. MUDr. Robert Lischke, PhD.

There is a centre directly at the Motol University Hospital, which accepts patients from the Czech Republic and now also from the Slovak Republic. Those have previously been in the care of Austrian surgeons, who, however, no longer have sufficient capacity. At present, transplants of Slovak patients are carried out in Motol. Pre-transplant and post-transplant care is provided to patients by the Center of Patient Preparation for Lung Transplantation and Post-transplant Care at the Department of Pneumology and Phthisiology of the Slovak Medical University and the University Hospital Bratislava in Bratislava-Ružinov.

How is the procedure performed?

Čeští lékaři provedli současně transplantaci srdce a plic. Na snímku Robert Lischke (vpravo), přednosta III. chirurgické kliniky FN v Motole a Jan Pirk (uprostřed) z Institutu klinické a experimentální medicíny.
Čeští lékaři provedli současně transplantaci srdce a plic. Na snímku Robert Lischke (vpravo), přednosta III. chirurgické kliniky FN v Motole a Jan Pirk (uprostřed) z Institutu klinické a experimentální medicíny. • Source: Jan Handrejch / Právo / Profimedia

The surgeon begins with a large incision in the chest area to remove the old lungs. The surgical team then connects the new lungs to the main airways and blood vessels. After the necessary functions are restored, the incision is closed and the patient is transferred to the intensive care unit. The average surgery of one lung can take 4 to 8 hours. If both sides of the lung are transplanted, the process can take up to 12 hours.

Risks of transplantation

However, the body may reject the new organ. It may happen that the recipient's immune system attacks the transplanted lungs because it considers them diseased. This can lead to complete failure of the donated lungs. Other serious complications can result from medications used to prevent rejection. These medicines are called immunosuppressants and reduce the immune response. Thanks to them, the body is less likely to attack the new lungs. But immunosuppressants also increase the risk of infections. Other risks of lung transplantation include bleeding and blood clots, cancer and malignancy due to immunosuppressants, diabetes, kidney damage, stomach problems and thinning bones.

Which diagnoses are most often indicated for lung transplantation?

Transplantation is performed in patients with terminal lung failure due to pulmonary fibrosis, cystic fibrosis, pulmonary arterial hypertension and/or chronic obstructive pulmonary disease.

"These are the 4 most common diagnoses. Then there is a group of patients that we indicate for retransplantation. Transplanted lungs lose their function as they age, and the only way to prolong the patients’ lives is to replace them,"

says Professor Lischke, adding that technological advances are increasing the number of retransplantations worldwide.

We have to give the lungs to the person who will benefit the most from them

 Cvičící žena.
Cvičící žena. • Source: Freepik

The team that decides on the definitive inclusion of the patient on the waiting list includes a psychologist, among other experts. Why? Because doctors must be sure that the patient will follow the treatment conscientiously.

"The issue of solid organ transplantation is associated with a great ethical dilemma because you distribute something that is very rare and you have to distribute it fairly. Patients sometimes say, let's try it, and if it doesn't work out, we'll accept it. We, however, cannot just accept it, because we have to give the lungs to the person who will benefit the most from them. That’s why the patients are examined very thoroughly and we look for possible contraindications that could cause the transplantation to fail,"

the professor explains.

Prodej luxusního bytu 5+kk Praha 7 - Bubeneč
Prodej luxusního bytu 5+kk Praha 7 - Bubeneč, Praha 7

Fatal mistake! A woman received a coronavirus-infected lung transplant. She didn't make it...

In Michigan, a patient died 61 days after receiving a coronavirus-infected lung transplant, NBC News reported. There was no indication that the donor, who had been fatally injured in a car accident, was positive. Her chest x-ray was clear and test negative.

 Lékaři se dívají na snímek plic.
Lékaři se dívají na snímek plic. • Source: Freepik

However, doctors at Ann Arbor University Hospital, where the patient had undergone the transplant, began to question these results at the end of last year when her condition worsened. They concluded that the donor had covid-19, and further research revealed that her lungs infected not only the patient but also the surgeon. This was the first confirmed case of a patient infected by a donated organ.

VIPs with lung transplants

Toño Mauri

Toño Mauri.
Toño Mauri. • Source: Profimedia

If you watched the soap opera The Right to Love, you probably remember the character of Alonso, who was head over heels in love with Cristina. However, he decides to give her up during their wedding, so that Cristina can be happy with Victor Manuel. Few people know that the actor who portrayed Alonso in this soap opera had to undergo a bilateral lung transplant due to covid.

Toño Mauri po operaci s personálem nemocnice.
Toño Mauri po operaci s personálem nemocnice. • Source: Nemocnice UF Health Shands

Robert Goulet

Robert Goulet.
Robert Goulet. • Source: Profimedia

Goulet was a veteran of both theatre and concert stages. He made his Broadway debut in 1960, when he was cast in the musical Camelot. His greatest musical success came in 1962, when he won a Grammy Award in the Best Newcomer category. After his last performance, he began to complain of breathing problems. Ten days later, he was already in a hospital bed. Goulet died of pulmonary fibrosis while waiting for a lung transplant.

Niki Lauda

Niki Lauda.
Niki Lauda. • Source: Profimedia

F1 legend Niki Lauda underwent a lung transplant in Vienna. According to the reports, Niki brought the so-called summer flu, which affects the immune system, manifesting itself with fever, chills and cough, home from Ibiza. Lauda allegedly underestimated the disease and had to be flown to a hospital in Vienna. Other reports mentioned his related kidney problems.

Legenda F1 Niki Lauda.
Legenda F1 Niki Lauda. • Source: Profimedia

The Austrian has already undergone transplantation in the past. In the 1990s, both of his kidneys had to be replaced.

"I was worse off than I had been back then. I've stayed in the hospital longer now and I'm basically living my third life,"

he said for the Italian magazine Gazetta dello Sport.

Alex Pangman

Alex Pangman.
Alex Pangman. • Source: Profimedia

The young jazz musician from Toronto, who was diagnosed with cystic fibrosis shortly after birth, lives her life to the fullest, rides horses, and is a successful singer whose first album was produced in 1999 by the legendary Jeff Healy. The surgery took place in Toronto in 2008. Pangman never found out who her saviour was.

"He gave me everything,"

adds Alex.

Kathlyn Chassey

Kathlyn Chassey.
Kathlyn Chassey. • Source: Reagan UCLA Medical Center

Not only celebrities may need a lung transplant. And sometimes, celebrities help ordinary people find a new organ.

Peter William Mayhew.
Peter William Mayhew. • Source: Profimedia

The parents of a young girl called Kathlyn Chassey already feared the worst. Her only hope was a lung transplant. However, all hospitals rejected her on the grounds that her case was too risky. But her parents refused to give up and approached Peter Mayhew, the actor who portrayed the giant Žvejkal in the Star Wars film series.

Peter William Mayhew, představitel obra Žvejkala ve filmové sérii Hvězdné války.
Peter William Mayhew, představitel obra Žvejkala ve filmové sérii Hvězdné války. • Source: Profimedia

Mayhew reached out to hospitals through social media, asking for help. Thanks to his effort, Kathlyn successfully received a lung transplant.

Do you know what the average survival rate of lung transplant patients is? 90% survive 1 year, 55% survive 5 years and 40% survive 10 years. The longest-living Slovak patient has survived for 19 years with new lungs.

Sources: Lekar.sk, Unilabs, Národný portál zdravia, Pravda, Kurier.at, CBS Los Angeles, NBC NEWS, own inquiry

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