Lung transplant in Uruguay. Progress in motion for the consolidation of the program

Abstract

Introduction:

a program for Lung Transplant (LT) has been operative in Uruguay since 2003, by means of a bi-national agreement with Fundación Favaloro, a regional reference center in Argentina.

Method:

descriptive, retrospective study performed between 2003 and 2017. Data in the electronic register was compiled and analyzed using SPSS (Statistical Package for the Social Sciences).

Results:

70 patients were entered in the list, 27 of which underwent transplant surgery, 95% of them resumed social like and/or work. Etiologies included emphysema (33%), cystic fibrosis (26%) and idiopathic pulmonary fibrosis (11%). The most frequent complications were respiratory infections and alterations in the airway. Post-transplant mortality is 34% and conditional median survival is higher than 8 years. The increased mortality in the list (32%) encouraged development of new strategies for lung procurement. The following facts are pointed out: longitudinal follow-up of patients, modification of the calling threshold, the performance of alveolar recruitments maneuvers, the systematic performance of fibrobroncoscopy, minimization of transport times and training of the Uruguayan surgical team for ablation. Lung procurement increased from 0 per million of population (pm) in 2014 to 1.8 pmp in 2017

Conclusions:

the Uruguayan program for LT has evidenced significant progress. The last two years have been essential for the increase of lung procurement. Results, survival and morbi-mortality are comparable to those described globally. Future perspectives will focus on consolidating the program in a reference center and performing ablation and implants in our country.