Demographic and Psychosocial Characteristics of Lung Transplant Candidates: Single-Center Analysis.

BACKGROUND: Lung transplantation has changed the course of treatment of lung diseases for the better; however, there are various factors that should be considered to increase the probability of a better outcome. Factors such as the patient's background, level of education, and income could affect their perception and eventually the results of the procedure. METHODS: The present study involved patients who underwent the qualification process for lung transplant along with psychological and sociologic assessment at the Lung Transplant Unit in the Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdansk. The following data were identified in the patients' medical history: marital status, size of the city, source of income, profession, voivodeship, and their Stanford Integrated Psychosocial Assessment for Transplant (SIPAT) score for psychosocial prediction of the outcome. RESULTS: A group of 121 patients were included in the study: 77 (63.64%) men and 44 (36.36%) women. The average age of the patients was 55.4 ± 9.81 years. Eighty (66.12%) lived in the city, and 26 (21.49%) of patients were professionally active with a fixed salary as their source of income. One hundred two patients were married. The median SIPAT score was 10.0 ± 3.0 for men and 10.0 ± 2.75 for women (P = .0974). CONCLUSION: For optimum care and results of the lung transplant procedure, it is important to consider these background patient factors because they play a crucial role in determining the course of the surgery. The analysis of demographic data is undoubtedly one of the elements helpful in the further fate of the whole process.

Routine Coronary Angiography is Still the Key Test for Patients Eligible for Lung Transplantation Also for Those With No Symptoms and With High Risk of Coronary Artery Disease.

BACKGROUND: Coronary artery disease (CAD) has a considerable morbidity and mortality effect on the outcomes of a lung transplant. Currently, coronary angiography is performed as part of the pretransplant evaluation process. Unfortunately, there are no clear guidelines about performing cardiac angiography in lung transplant candidates. BACKGROUND: The aim of our work is to find a correlation between cardiovascular risk and coronary arterial status to optimize the selection of patients for coronary angiography prior transplantation. METHODS: We retrospectively analyzed 48 patients in whom coronary angiography and cardiac catheterization was performed during assessment for bilateral lung transplantation at the Medical University of Gdansk from 2018 to 2021. The coronary artery disease status was classified into 2 categories: without any stenosis and with stenosis. For each patient, the 10-year cardiovascular risk was estimated by using a Systematic COronary Risk Evaluation calculator modified for the Polish population. RESULTS: Coronary stenosis was detected in 15 patients during angiography (31%). The group with coronary stenosis had a median SCORE risk of 8%, which is considered as high risk, and in patients without stenosis it was 5%, which is also considered a high risk. Median mean pulmonary artery pressure in patients with stenosis was the same as that in patients without stenosis (23 mm Hg). CONCLUSIONS: CAD among lung transplant candidates cannot be predicted by risk factors, so coronary angiography is very important as a part of the evaluation process. Because pulmonary hypertension has a big impact on surveillance after transplantation, performing heart catheterization during the qualification process is crucial.

A Single-Center Experience with Lung Transplants During the COVID-19 Pandemic.

BACKGROUND This single-center study analyzed distinctions between lung transplants performed in the Department of Cardiac and Vascular surgery of the University Clinical Center in Gdansk, Poland before and during the COVID-19 pandemic. MATERIAL AND METHODS There were 189 patients who underwent the qualification procedure to lung transplantation in the Department of Cardiac and Vascular Surgery of the University Clinical Center in Gdansk, Poland in the years 2019 and 2020. The control group consisted of 12 patients transplanted in 2019, and the study group consisted of 16 patients transplanted in 2020. RESULTS During 2019, the qualification process was performed in 102 patients with pulmonary end-stage diseases. In 2020, despite the 3-month lockdown related to organizational changes in the hospital, 87 qualification processes were performed. The mortality rate of patients on the waiting list in 2020 was 14.3% (6 patients died), and during 2019 the rate was also 14.3% (4 patients died). Donor qualifications were according to ISHLT criteria. The distribution of donors in both years was similar. There was no relationship between the geographic area of residence and source of donors. In 2019, all 12 patients had double-lung transplant. In 2020, 11 patients had double-lung transplant and 5 patients had single-lung transplant. There was no difference in ventilation time and PGD aside from a shorter ICU stay in 2020. CONCLUSIONS Lung transplants were relatively well-conducted despite the continued obstacles of the COVID-19 pandemic.