238 people, including 7 children, were new lungs in 2012.

-the number of lung transplants almost reaches the heart transplant, which is 247

-patients on waiting list are 499 and the time they remain in it is 179 days

-donation in asystole offers new ways to increase the number of donations

Spain, February 2013.- lung transplantation is the therapeutic procedure for patients with advanced, irreversible and debilitating lung disease. It is usually a patient dependent oxygen, presenting a poor prognosis of life in the short term despite medical treatment drug, rehabilitation, etc. This past year, 239 people, including 7 children, have obtained new lungs through the generosity of donors who allow them to live and opt for a better quality of life. It is, therefore, essential and vital for hundreds of pulmonary patients surgical treatment, to which SEPAR (Spanish society of Pneumology and thoracic surgery) shows his support to devote this year 2013 to lung transplantation.

Are faithful to the objectives of the SEPAR in terms of outreach, research and awareness of respiratory diseases, this year engaged year SEPAR essential treatment such as lung transplantation. This dedication allows us, as a scientific society, focus efforts and be a speaker for all those involved in this intervention: patients, associations, physicians, surgeons and researchers ” said Dr. Pilar de Lucas, President of SEPAR.

Dr. Eusebi Chiner, Secretary General of the SEPAR, has passed the balance of the data on this intervention in Spain, provided by the national transplant organisation (ONT). The number of lung transplants in Spain in 2012 was 238, very similar figure of the last two years (230 in 2011 and 235 in 2010); perhaps the quantitative leap more important occurred in previous years (192 in 2008 and in 2009 219) ”, explained the expert.

Taking into account the planting activity in Spain, the numbers of lung transplantation continued away from the kidney (2.551 cases) or the liver (1,084 cases), while it begins to approach the transplant heart (247 cases), says Dr. Chiner.

To be a complex process, both in the preoperative, during surgery and in the postoperative but also in the conservation of organs from the donor, the lung transplant only occurs in Spain in 7 reference centres, three of which were also ready to do cardiopulmonary transplant: Hospital Puerta Madrid iron (pulmonary and cardiopulmonary), Hospital Vall d ’ Hebron in Barcelona (adult and child), Hospital Universitario La Fe de Valencia (pulmonary and cardiopulmonary), Reina Sofia Hospital in Cordoba (pulmonary and cardiopulmonary), Hospital Marquis of Valdecilla Santander, A Coruña hospital complex and Hospital Doce de Octubre in Madrid. These seven hospitals receiving patients from the hospital, from the rest of Spain hospitals and health centers.

The activity centers during the last 2012lidera the Hospital Vall d ’ Hebron with 66 transplants, the A Coruña hospital complex with 35, Hospital Marqués de Valdecilla with 34, the Hospital Puerta de Hierro in Madrid and the Hospital Universitario La Fe de Valencia with 30 each, the Reina Sofia Hospital in Cordoba with 24Hospital 12 de Octubre with 18 and this year should be added the Hospital de La Paz, which has made a child transplant for the first time.

There are different types of transplantation: a lung, two, or sometimes cardiobipulmonar. The type of transplant – uni or bipulmonar – depends on, fundamental but not exclusively, of the disease to be treated. Thus, the septic processes (cystic fibrosis and bronchiectasis) necessarily need bipulmonar transplantation, fibrosis tend to be one-lung transplant. In the rest of conditions susceptible to TP can opt for two options according to the specific case, the availability of donors and criterion and the experience of different groups of transplant ” has explained the DRA. Pilar Morales, neumologa and coordinator of the SEPAR 2013 year of the pulmonary Trasnplante. In 2012 have been 107 unipulmonares interventions, 130 bipulmonares and 1 cardiobipulmonar ”, explains.

The average age of a recipient of a lung is situated in 51 years; a very similar age of the donors, which is 50 years. Both ages have suffered a considerable ageing as in 1998, for example, the average age of donor and transplanted stood around age 40. In addition, note that 74.1% of extracted lungs a 60.9% correspond to people who have never smoked.

Diseases which most frequently are candidates for lung transplantation in end-stage include: COPD and emphysema (27%), Cystic Fibrosis (14%), Pulmonary Fibrosis idiopathic (16%), deficiency of Alpha-1 antitrypsin (5%), primary pulmonary hypertension (12%), a second Transplant when the first transplant failed (2%) and 24% correspond to other causes including bronchiectasis and sarcoidosis, according to the records of us well can extrapolate to Spain.

The overall survival of pulmonary transplantation is 78% in the first year, 50% at 5 years, and 26% ten years of intervention. The average life of a pulmonary graft is 5 years.

Diseases, patients with COPD and cystic fibrosis (CF) are those who have improved early survival, whereas (HTP) pulmonary hypertension and pulmonary fibrosis (FID) worst initial results presented.

Currently, it is estimated the time of waiting for a receiver of lungs in 179 days. There are 499 people registered on waiting list in Spain and 309 of them are new registrations made through the year 2012. Transplant patients have been in 2012, 238, with 36 exclusions and 21 deaths. In our list of waiting children (under 16 years), the total number of patients on the list is 17, with 10 new inclusions in 2012.

For his part, Dr. Angel Salvatierra, thoracic surgeon and coordinator of the year, has explained that from from the point of view of the surgery, lung transplantation has evolved remarkably since its inception until the present day. The number of donor lungs available has increased through the use of organs that used to be considered unacceptable, while the average age of donors is growing. This fact is due to a better management of the donor, an improvement in lung preservation methods and greater experience in managing intra and postoperative receivers. ”

in addition, the lungs from donors who have died due to heart (donor stopped heart ”) and not by brain deathIt contributes, and will do so even more in the coming years, to increase the number of available donors. Current technology allows to preserve and even to treat lungs previously regarded as non-working for transplantation through the so-called preservation ex vivo ”. This technique allows you to use previously discarded lungs, as well as to modify them to improve the post-transplant course. 58 Transplants uni have been in Spain since 2002 and bipulmonares of donor in asystole in 5 different centres. These advances help make lung transplant a therapeutic modality increasingly effective and safe.

It should be noted that not all donated or offered lungs are valid for transplantation. Thus, 358 lungs donated in 2012, could draw 264 and use only 197, 6 of them donors in asystole. Generally donations by stroke account for 62.1%, the traffic accidents only 6% and the donation in asystole 9.8%.

The presentation of the SEPAR 2013 year of the lung transplant helped to highlight the situation of transplantation in Spain, as well as advances and most important surgical techniques that have allowed increasing the number of usable lungs and reduce complications of intervention.