Lung transplant surgery site. Courtesy of the hospital
Wuhan Evening News (reporter Wang Chunlan correspondent Du Weiwei Yang Cen) In the field of lung transplantation, the preservation time of donor lungs after leaving the body is too short, the survival rate of the perioperative period is not high, and the recovery time after transplantation is long, which has been the key problem of "stuck neck".
The lung transplant team of the Department of Thoracic Surgery of Wuhan University People's Hospital (Hubei Provincial People's Hospital) focused on lung ischemia and reperfusion injury, extended the donor lung ischemia reperfusion time from 6 hours to 12 hours, and achieved zero deaths in the perioperative period of transplant patients within three years, and recovered and discharged from the hospital in as little as 13 days after lung transplantation. This research achievement, which revolves around the major key problem of lung transplantation, won the first prize of the 2020 Hubei Provincial Science and Technology Progress Award at the Hubei Provincial Science and Technology Innovation Conference. The expert group agreed that the technical achievements in the same field as a whole have reached the international leading level.
Zhu An (pseudonym), a 27-year-old who has been engaged in stone processing for many years, was diagnosed with irreversible fibrosis of the lungs at the Department of Thoracic Surgery of Wuhan University People's Hospital on April 20, 2020, and the only vitality was to do lung transplant surgery.
After passing the lung transplant evaluation, he joined the waiting list of "China Organ Allocation and Sharing Computer System" in the Department of Thoracic Surgery of Wuhan University People's Hospital. In the early morning of December 19, the lung source donated by a brain-dead patient was successfully matched with Zhu'an, and in the afternoon of the same day, under the escort of the team of deputy chief physician Wu Yang of the Department of Anesthesiology, Professor Lin Huiqing, deputy director of the Department of Thoracic Surgery, carried out a double lung transplant. After successfully completing the operation, Zhu An was under the postoperative rapid rehabilitation system organized by Xiong Juan and nurse Hu Xiaoqing, and the ecmo was removed in only 1 day, and the ventilator was completely evacuated after 48 hours.
As the youngest lung transplant recipient in Hubei Province, Zhu An finally fulfilled his New Year's wish – to breathe freely and live freely. What he didn't know was that behind a lung transplant patient like him, there was a team of experts who had worked hard to study it.
According to reports, as one of the major advances in modern medicine, organ transplantation work has developed rapidly in China, and the number of large organ transplants alone is nearly 15,000 cases per year. Among them, lung transplantation can be called "the most difficult organ transplant" in terms of technical and management difficulties.
Professor Geng Qing of the Department of Thoracic Surgery of Wuhan University People's Hospital introduced that lung transplantation, as the only treatment for end-stage lung diseases, can effectively improve the quality of life of patients with end-stage lung diseases and prolong their survival. The pulmonary ischemia-reperfusion injury is the main cause of lung insufficiency after lung transplantation, and it is also a high-risk factor for the occurrence of acute and chronic rejection and obstructive bronchiolitis after surgery, which seriously affects the short-term and long-term survival rate and has become the focus of international lung transplant research.
Since the lung transplant surgery was carried out at the end of 2017, the team of Professor Geng Qing and Lin Huiqing of the Department has jointly carried out research on "Lung Transplantation Lung Ischemia and Reperfusion Injury Mechanism and Clinical Key Technological Innovation" around the problem of "stuck neck" of lung transplantation, and together with the team of Professor Chen Jingyu of Wuxi People's Hospital. By breaking through a series of key problems, the lung transplant team of the hospital continued to improve the utilization rate of donor lungs, especially the "marginal donor lungs", bringing hope to many lung failure patients who are eager for new life. In the past three years, the department of thoracic surgery in the hospital has carried out 21 lung transplants, and the department of cardiac surgery and thoracic surgery have successfully implemented the first combined heart-lung transplant in Hubei. The farthest lung source has expanded from a radius of 1,000 kilometers with Wuhan as the center to border areas such as Hainan and Yunnan.
The thoracic surgery team applied the research results in the field of donor lung ischemia and reperfusion to practice, which significantly improved the quality of donor lungs, and also applied the concept of rapid rehabilitation (eras) to lung transplantation, and the postoperative recovery time was significantly shortened, and single lung transplant patients recovered and discharged in as little as 13 days.
This research result has great clinical significance and social value for improving the success rate of lung transplantation, expanding the lung donor pool, improving the safety of marginal donor lung transplantation, and carrying out emergency rescue lung transplantation. The research results have been promoted in more than 10 large-scale tertiary hospitals across the country, with 8 authorized patents, 9 guidelines, norms and expert consensus, which play an important role in the basic and clinical research of lung transplantation in China and the orderly development of lung transplantation norms, and bring vitality to more patients who need lung transplantation.
Source: Wuhan Evening News