Zabrze/ Doctors performed the second simultaneous lung and liver transplant in Poland

Transplant teams from two clinical hospitals of the Silesian Medical University performed the second simultaneous lung and liver transplant in the history of Polish medicine. The procedure performed in May was a success. The 47-year-old patient will leave the hospital in good condition on Wednesday.

The doctors performed the operation on a patient suffering from primary pulmonary hypertension, a rare and severe disease that leads to lung and liver failure. In such cases, the only effective solution may be a simultaneous transplant of both organs.

"It was a huge challenge. We were dealing with two organ failures and, additionally, due to the patient's underlying disease, also with reversible right ventricular failure. Maintaining stable vital functions, such as circulation, breathing or clotting, was particularly difficult," said intensive care anesthesiology specialist Anna Pióro-Lewandowska during a press conference.

The procedure involved medical teams from two specialized centers: the Independent Public Clinical Hospital named after Andrzej Mielęcki in Katowice and the Silesian Center for Heart Diseases in Zabrze. The first team was responsible for the liver transplant, the second for the lung transplant.

"It was also a difficult operation for the recipient, because the abdominal cavity and both pleural cavities are opened, which significantly complicates the procedure. An additional difficulty is the so-called ischemia time of each of the transplanted organs, i.e. the time during which the organ can remain outside the body without a blood supply," explained prof. dr hab. Robert Król.

The choice of the order of operations – first liver transplantation, then lung transplantation – was dictated by the latest medical standards based on the experience of European centers, including Hanover. This allowed for minimizing the risk of metabolic disorders and avoiding complications resulting from pulmonary hypertension.

The total duration of the procedure, from the start of anesthesia to the end of the operation, was about 20 hours. As the doctors emphasize, not only the surgical procedure was crucial, but also intensive, interdisciplinary postoperative care. Due to the very complicated clinical condition of the patient, close cooperation between anesthesiologists, surgeons and physiotherapists was necessary.

"The patient got back on his feet very quickly, which was a great achievement. Now we encourage him to be as physically active as possible. It's not worth limiting yourself. The lungs, heart and the entire body function better when we are moving," emphasized physiotherapist Joanna Ulfik.

The patient, who underwent surgery on May 15, is doing well. He will be discharged home on Wednesday, where he will continue rehabilitation.

"I waited five years for everything. It was hard, I was suffocating, I couldn't even walk 20 meters. The water was collecting, I went to drain it, it would catch me at night, I couldn't sleep. Now I feel very good. It's getting better day by day, I walk without a problem, I function normally. I feel like I'm coming back to life," emphasized 47-year-old patient Mariusz Woźniak.

So far, only about 150 such procedures have been performed in the world, with the most experience in centers in the United States and Germany. In Poland, doctors performed the first such procedure in September 2019, also in Zabrze, on a minor patient suffering from cystic fibrosis.

"All his tests are fantastic. He feels very well. He is studying. He enjoys life, so much so that the disease is completely invisible," said transplantologist Dr. Tomasz Stącel.

Specialists hope to develop similar procedures, especially for patients with rare respiratory and liver diseases. On the list of people waiting for a transplant at SCCS is a patient who will require an exceptionally complicated simultaneous transplant of three organs: heart, lungs and liver. (PAP)

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