Lung transplantation in Turkey: lessons from surgeons and pulmonologists

Background/aim: In order to actualize an efficient lung transplantation program, it is necessary to determine priorities and set up strategies. This study aimed to estimate the present situation in Turkey by determining the level of interest and knowledge of pulmonologists and thoracic surgeons regarding lung transplantation. Materials and methods: A questionnaire was prepared to establish the level of interest and knowledge of physicians on lung transplantation. It was sent to 2131 pulmonologists and thoracic surgeons, and 130 physicians completed the questionnaire. Results: Of the 130 physicians who responded, 42 were thoracic surgeons and 88 were pulmonologists. There was no significant difference between the two groups regarding the availability of lung transplantation at their hospitals. The rates of correct answers to the questions and responses supporting the transplant initiative were higher in the thoracic surgeon group than in the pulmonologist group. Conclusion: The establishment of a successful system for lung transplantation in Turkey requires an increase in interest, knowledge, and dedication of physicians, coupled with adequate and continuous training. There also needs to be sufficient equipment and financing in addition to disciplined multidisciplinary teams and cooperation. This survey shows there is still much work to be done to achieve success in lung transplantation in Turkey.

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1. Mahida RY, Wiscombe S, Fisher AJ. Current status of lung transplantation. Chron Respir Dis 2012; 9: 131-145.
2. Dabak G. History of lung transplantation. Solunum 2013; 15: 82-87 (in Turkish with English abstract).
3. Yusen RD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Dobbels F, Goldfarb SB, Levvey BJ, Lund LH, Meiser B et al. The registry of the International Society for Heart and Lung Transplantation: thirty-first adult lung and heart-lung transplant report--2014; focus theme: retransplantation. J Heart Lung Transplant 2014; 33: 1009-1024.
4. Oto O. Heart transplantation in Turkey. Interview by Judy Ozkan. Circulation 2007; 115: 101-102.
5. Helvacı A, Meydan B, Akın O, Coşkun T, Kutlu CA, Taşçı E, Tükel M, Ürek Ş, Varer P, Dabak G et al. A single lung transplantation for silicosis: the first successful lung transplantation case in Turkey. Turkish Journal of Thoracic and Cardiovascular Surgery 2011; 19: 455-462 (in Turkish with English abstract).
6. Özbaran B, Erermiş S, Gülen F, Midyat L, Turhan K, Demir E, Yağdı T, Tanaç R, Özcan C, Engin Ç et al. The psychiatric followup process of a lung transplantation case. Anatolian Journal of Psychiatry 2010; 11: 367-370 (in Turkish with English abstract).
7. Yeginsu A, Kutlu C, Kalamanoğlu M, Taşçı A, Erdoğan B. First brain dead donor bilateral lobar lung transplant in Turkey. Exp Clin Transplant 2014; 12: 569-571.
8. Başara BB, Güler C, Yentür GK. Sağlık Bakanlığı Sağlık Araştırmaları Genel Müdürlüğü Sağlık İstatistikleri Yıllığı 2013. Ankara, Turkey: Sentez Matbaacılık ve Yayıncılık; 2014.
9. Kotsimbos T, Williams TJ, Anderson GP. Update on lung transplantation: programmes, patients and prospects. Eur Respir Rev 2012; 21: 271-305.
10. Krueger T, Berutto C, Aubert JD. Challenges in lung transplantation. Swiss Med Wkly 2011; 141: w13292.
11. Munshi L, Keshavjee S, Cypel M. Donor management and lung preservation for lung transplantation. Lancet Respir Med 2013; 1: 318-328.
12. Yusen RD, Christie JD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Dobbels F, Kirk R, Lund LH, Rahmel AO et al. The Registry of the International Society for Heart and Lung Transplantation: Thirtieth Adult Lung and Heart-Lung Transplant Report--2013; focus theme: age. J Heart Lung Transplant 2013; 32: 965-978.
13. Singer JP, Singer LG. Quality of life in lung transplantation. Semin Respir Crit Care Med 2013; 34: 421-430.
14. Whitson BA, Hayes D Jr. Indications and outcomes in adult lung transplantation. J Thorac Dis 2014; 6: 1018-1023.
15. Mallidi HR. Lung transplantation: recent developments and future challenges. Tex Heart Inst J 2012; 39: 852-853.
16. Liu Y, Liu Y, Su L, Jiang SJ. Recipient-related clinical risk factors for primary graft dysfunction after lung transplantation: a systematic review and meta-analysis. PLoS One 2014; 9: e92773.
17. Weill D, Benden C, Corris PA, Dark JH, Davis RD, Keshavjee S, Lederer DJ, Mulligan MJ, Patterson GA, Singer LG et al. A consensus document for the selection of lung transplant candidates: 2014--an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2015; 34: 1-15.
18. Glanville AR. Ethical and equity issues in lung transplantation and lung volume reduction surgery. Chron Respir Dis 2006; 3: 53-58.
19. Westall GP, Snell GI. Lungs dont grow on trees: the ethics of increasing organ donation rates for transplantation and their relevance to the Asia-Pacific region. Respirology 2007; 12: 631- 633.
20. Angel LF, Levine DJ, Restrepo MI, Johnson S, Sako E, Carpenter A, Calhoon J, Cornell JE, Adams SG, Chisholm GB et al. Impact of a lung transplantation donor-management protocol on lung donation and recipient outcomes. Am J Respir Crit Care Med 2006; 174: 710-716.
21. Wojarski J, Jastrzebski D, Zembala M. Current status of lung transplantation in Poland: experience of the Silesian Center for Heart Diseases. J Physiol Pharmacol 2005; 56: 245-249.
22. Laporta Hernández R, Lázaro Carrasco MT, Varela de Ugarte A, Ussetti Gil P. Long-term follow-up of the lung transplant patient. Arch Bronconeumol 2014; 50: 67-72 (article in English and Spanish).
23. Republic of Turkey, Ministry of Health. The Directive of Centers of Organ Transplantation, Date: 02/13/, No: 6157 (With Changes Dated 7/19//2012, No: 5399). Ankara, Turkey: Ministry of Health (in Turkish).