Initial experience with lung transplantation in Slovakia--an example for successful bilateral cooperation between countries.

OBJECTIVE: To review initial experiences, results of single lung transplantation (SLT) and double lung transplantation (DLT) on the basis of bilateral cooperation between Slovakia and Austria. PATIENTS AND METHODS: During the period between July 1998 and January 2003 ten patients from Slovakia underwent lung transplantation in Vienna, Austria. There were 7 males and 3 females with an age range from 21 to 48 years. Eight patients underwent double lung transplantation, two patients had single lung transplantation. Indications were: pulmonary fibrosis in 2, cystic fibrosis in 2, emphysema in 2, primary pulmonary hypertension (PPH) in 4 cases. In the PPH patients (n = 4) and in the patients with cystic fibrosis (n = 2), bilateral lung transplantation under ECMO support was performed. One patient (n = 1) with postradiative pulmonary fibrosis and intracardial myxoma underwent bilateral lung transplantation under cardiopulmonary bypass. Only three patients (e.i. the two with emphysema and one with pulmonary fibrosis) underwent lung transplantation without any intraoperative circulatory support. RESULTS: No perioperative mortality was recorded. Two patients died in late postoperative period: one due to multiorgan failure on 93rd day after DLT, the other one--on a liver failure caused by cirrhosis after 2.5 years after LTX. All the remaining eight patients, but the two ones who underwent LTX several days ago, are with improved functional status in full work activity. The follow up period for all patients ranges between 10 days and 54 months. CONCLUSION: Both unilateral and bilateral lung transplantations are accepted treatment modalities in patients with end-stage pulmonary disease. Bilateral cooperation for such countries as Slovakia (with limited possibilities) offers a unique example of possible and successful way how to deal with such demanding procedures. (Tab. 3, Fig. 2, Ref. 19.).