title: Surgeon's viewpoint on lung transplantation in cystic fibrosis patients - preliminary report.
abstract: BACKGROUND
  The surgeon's viewpoint on a patient with cystic fibrosis differs from that of a pediatrician or internist. The problems a cystic fibrosis specialist encounters are different from those faced by the surgeon who takes over the patient in a very advanced, often terminal stage of the disease. Hence, the main problem for the surgeon is the decision concerning the surgery (lung transplantation, pneumonectomy, lobectomy). It is, therefore, important to lay down fundamental and appropriate rules concerning the indications and contraindications for lung transplantation, especially in patients with cystic fibrosis.
  
  
  OBJECTIVE
  The aim of this study was to analyze the methods of qualifying and preparing patients for surgery, as well as carrying out the procedure of transplantation and postoperative short and long-term care.
  
  
  METHODS
  The investigation was carried out on 16 patients with cystic fibrosis. Three were operated on and 10 were on the waiting list for transplantation. Two patients on the waiting list died, one patient was disqualified from transplantation. During qualification for lung transplantation, strict indications, contraindications and other factors (such as blood type, patient's height, coexisting complications) were taken under consideration.
  
  
  RESULTS
  All the 3 patients after lung transplantation are alive and under our constant surveillance. Ten patients await transplantation, though four of them are suspended due to hepatitis C infection. Two patients on the waiting list died: one from respiratory insufficiency and the other in the course of bridge to-transplant veno-venous extracorporeal membrane oxygenation due to hepatic failure. One patient has been disqualified because of cachexia.
  
  
  CONCLUSIONS
  Since lung transplantation is the final treatment of the end-stage pulmonary insufficiency in cystic fibrosis patients, the number of such procedures in cystic fibrosis is still too low in Poland. The fast development of these procedures is highly needed. It is necessary to develop better cooperation between different disciplines and specialists, especially between pediatricians and surgeons. The correct choice of the suitable moment for lung transplantation is crucial for the success of the procedure.
authors.affiliation: Thoracic Surgery and Transplantation Department,Pomeranian Medical University of Szczecin, Alfreda Sokołowskiego Street 11, 70-891 Szczecin-Zdunowo, Poland, e-mail: abkubisa@hotmail.com.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Kubisa
authors.forename: Maria
authors.initials: M
authors.lastname: Piotrowska
authors.forename: Justyna
authors.initials: J
authors.lastname: Milczewska
authors.forename: Michał
authors.initials: M
authors.lastname: Bielewicz
authors.forename: Jarosław
authors.initials: J
authors.lastname: Pieróg
authors.forename: Anna
authors.initials: A
authors.lastname: Kozak
authors.forename: Michalina
authors.initials: M
authors.lastname: Czarnecka
authors.forename: Norbert
authors.initials: N
authors.lastname: Wójcik
authors.forename: Piotr
authors.initials: P
authors.lastname: Wasilewski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Feledyk
authors.forename: Anna
authors.initials: A
authors.lastname: Kubisa
authors.forename: Mirosław
authors.initials: M
authors.lastname: Brykczyński
authors.forename: Piotr
authors.initials: P
authors.lastname: Sielicki
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grodzki
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D000075202:Contraindications; D003550:Cystic Fibrosis / Q000601:surgery*; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D018579:Patient Selection; D011044:Poland; D015996:Survival Rate; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult