More than 1,350 lung transplants – this is the summary of the Munich Lung Transplant Group on its 35th anniversary. The first lung was transplanted at the LMU Clinic in 1990; Last year, 78 patients were given new lungs and thus a new life. This makes the LMU Clinic one of the largest lung transplant centers in Europe and the two largest in Germany.
“The selection of suitable patients for a lung transplant requires not only medical expertise but also human knowledge and is crucial for the success of the transplant,” says Prof. Dr. Jürgen Behr, DZL-PI and director of the Medical Clinic and Polyclinic V (pulmonology) and head of the Munich Lung Tumor Center. After an initial presentation at the lung center, patients undergo ten days of inpatient preparatory examinations. An interdisciplinary transplant conference at the LMU Klinikum Großhadern then classifies the patients according to urgency and likelihood of success for a lung transplant and puts them on the waiting list.
Interdisciplinary collaboration as a recipe for success
From the very beginning, an important prerequisite for the success of the lung transplant program was the close collaboration between thoracic surgery, cardiac surgery, pulmonology and anesthesiology. These departments merged in 1990 at the LMU Clinic in Großhadern to form the Munich Lung Transplant Group (MLTG). The close cooperation is also evident in the surgical area: While at most centers either thoracic or cardiac surgeons transplant a lung, both disciplines have been operating together here for 35 years. “This increases expertise and quality and does justice to the complexity of the procedure,” emphasizes DZL-PI Prof. Dr. Sebastian Michel, senior cardiac surgeon responsible for lung transplantation at the LMU Clinic. “This means we can safely carry out high-risk procedures at any time of the day or night.”
Close follow-up care at the LMU Klinikum Großhadern
“Lung transplantation can save lives, but it is not a cure, but a highly complex, lifelong therapy,” says DZL-PI Prof. Dr. Dr. Nikolaus Kneidinger, pulmonologist in the Medical Clinic and Polyclinic V in the LMU Clinic. After being discharged from the rehabilitation clinic, the patients are closely monitored every six weeks for the first year and are called to the clinic for examinations such as pulmonary endoscopy and pulmonary function tests. Blood tests and, above all, the correct use of immunosuppressants also play an important role in order to avoid rejection of the donor organ. “Our unique selling point as a transplant center is that we provide follow-up care to all patients with new lungs in our clinic – there are currently between 500 and 600 patients,” emphasizes Prof. Dr. Dr. Kneidinger.
The survival rate has improved significantly over the last 20 years. While in 2000 the average survival rate was only five years, many patients today live on average for over ten years with a donor lung.