Lung transplantation in Slovenia - experience in the first three years

ABSTRACT

Background: Lung transplantation is a highly complex treatment method for selected patients with terminal lung disease. With the increase in the number of eligible candidates and the standardization of the technique, it was possible to set up a transplantation centre in University Medical Centre (UMC) Ljubljana in 2018. We report our initial experience. Method(s) We analysed the registry of patients with lung transplantation. Patients' characteristics were compared to the previous group referred to AKH Vienna for lung transplantation. Result(s) From 15 September 2018 to 15 September 2021, 37 lung transplantations (13 females) were done in UMC Ljubljana. Indications were COPD (n = 13, 35%), pulmonary fibrosis (n = 7, 19%), cystic fibrosis (n = 5, 14%), covid-19 pneumonia (n = 4, 11%), bronchiectasis (n = 3, 8%), pulmonary hypertension (n = 2, 5%), lymphangioleiomyomatosis (n = 1, 3%), al-pha-1-antitrypsin deficiency (n = 1, 3%) and bronchiolitis (n = 1, 3%). Compared to previous cohort referred for transplantation to AKH Vienna (71 patients, 35 females), there was higher proportion of patients with COPD (35% vs. 16%, p = 0.019) and the patients were older (median [range], 59 [14-68] vs. 43 [4-58] years, p = 0.001). 76% of donated lungs did not fit standard donor criteria (30% of donors were older than 55 years, 22% had infiltrates on chest radiographs, and 24% did not meet other criteria). Lung size reduction was required in 43%, which did not result in primary graft failure. Short-term survival was similar in both cohorts of patients (1-year survival in UMC Ljubljana vs. AKH Vienna, 89% [95% CI 78-99%] and 83% [95% CI 74-92%], respectively). Conclusion(s) Initial results show similar early lung transplantation outcomes between patients transplanted in UMC Ljubljana or in AKH Vienna. Copyright © 2022 Zdravniski Vestnik.