Groote Schuur Hospital repeated history yesterday when the first bilateral sequential lung transplant was performed in the Western Cape and the state sector nationally.Twenty-five years after the first unilateral transplant, a 38-year-old woman with a severe airflow obstruction, secondary to childhood respiratory viral infection, is now breathing comfortably with her new lungs. Doctors are happy with her progress and said so far all the parameters look promising.
Before the operation, Dr Greg Calligaro, a specialist pulmonologist, and Dr Tim Pennel, a cardiothoracic surgeon, went abroad to learn more about the difficult procedure.
“This is the last of the solid organ transplants that is gaining traction and it is the hardest. The lungs have a surface area of 70m2, that’s about half a tennis court, so they receive a massive blood supply.”
He said the fact that lungs were in contact with the outside world added to the challenge. “The barrier to the outside is very thin. Lungs are exposed to all viruses, bacterias and pathogens. We have to be very careful how we match the donor and recipient as infections are common in lung transplants.”
He said globally there is a long waiting list for donors.
“Those who are on waiting lists do better because they keep themselves healthy and do their best - to be able to get a transplant.”
Calligaro said the patient in question was only on the waiting list for a week.
“In lung transplants sizing is very important. You cannot take lungs from a 1.8m tall rugby player and give them to a 1.5m woman, for instance.”
Pennel said the team experienced a delay during the surgery, which started at 10am and finished at about 4pm.
“There had to be co-ordination between the teams at the separate hospitals. The lungs were at another hospital, so we had to co-ordinate. The patient was wheeled into the theatre around 8am and we started at 10am and there were some waiting periods in between and we finally left around 4 in the afternoon.
“The lungs themselves, for the right one, there was about an hour delay from the time it was removed until they got blood supply.”
The hospital’s chief executive, Dr Bhavna Patel, said it was elated that history was repeated at the hospital.
“The hospital is extremely proud of this achievement as it continues to remain at the cutting edge of clinical care offered to patients and is committed to improvement through innovations such as this.”
Health MEC Nomafrench Mbombo congratulated the team yesterday.
“I couldn’t be more proud of our entire Groote Schuur Hospital team. Indeed, this hospital continues to do outstanding work.
"This happened a few days after we celebrated the 50th anniversary of the first heart transplant performed in the same hospital.
"This goes to show that our clinicians go over and above their call of duty to save the lives of our patients."