The Last Hope for Severe Lung Disease Patients... Seoul Asan Hospital Achieves 200 Lung Transplant Surgeries

New Life for Patients with Humidifier Disinfectant Side Effects and COVID-19 Complications
World's Highest Post-Surgery Survival Rate... Two out of Three Survive More Than 5 Years
Establishment of 'Integrated Multidisciplinary Care System' and Intensive Critical Care Management

Professor Dong-Kwan Kim (second from the right) of the Lung Transplantation Team at Seoul Asan Hospital Organ Transplantation Center is performing the 200th lung transplant surgery on a patient with interstitial lung disease.

[Asia Economy Reporter Lee Gwan-joo] #. Ms. Kim (54, female) visited a hospital after a persistent dry cough that started one day did not go away and she felt chest tightness, where she was diagnosed with interstitial lung disease. To make matters worse, she also developed severe pulmonary arterial hypertension. The only way to save Ms. Kim was a lung transplant. After waiting, she received a call from the Organ Transplant Center at Seoul Asan Medical Center informing her that she was selected as the top priority. On the 13th of last month, she successfully underwent a brain-dead donor lung transplant surgery performed by Professor Kim Dong-kwan of the Thoracic Surgery Department at Seoul Asan Medical Center’s Lung Transplant Team. Ms. Kim is currently recovering steadily without major complications and is undergoing consistent rehabilitation treatment.

Lung transplant surgery is the last hope for patients with end-stage respiratory failure or severe lung damage. It is the final option to save patients who find it difficult to breathe without oxygen support or mechanical ventilation devices (respirators). On the 17th, the Lung Transplant Team at Seoul Asan Medical Center’s Organ Transplant Center announced that they successfully performed a brain-dead donor lung transplant on Ms. Kim, who was suffering from severe respiratory distress due to interstitial lung disease accompanied by pulmonary arterial hypertension, achieving their 200th lung transplant surgery.

The Lung Transplant Team at Seoul Asan Medical Center began increasing their surgical experience starting in 2008 with a brain-dead donor lung transplant for a patient with idiopathic pulmonary fibrosis. To date, they have performed 199 brain-dead donor lung transplants and 1 living-donor lung transplant on patients with end-stage respiratory failure. Since 2019, they have conducted more than 30 surgeries annually, accounting for one out of every four lung transplant surgeries in South Korea.

Among the 200 patients who received lung transplants, 127 were male and 73 were female, with males significantly outnumbering females. By age group, those in their 60s accounted for 64 patients, representing 32% of the total, followed by those in their 50s (49), 40s (29), 30s (20), teens (18), and under 10 years old (10). The most common underlying disease was idiopathic pulmonary fibrosis, which causes the lungs to harden and lose function, potentially leading to death. Other patients who underwent lung transplant surgery had conditions such as bronchiolitis obliterans, acute respiratory distress syndrome, interstitial lung disease, severe pneumonia, and chronic obstructive pulmonary disease.

Included among these were 13 patients who suffered severe lung damage due to the side effects of humidifier disinfectants and 10 patients who lost lung function due to post-COVID-19 complications. Among the patients who received lung transplants due to COVID-19 infection, there was a Korean expatriate in his 50s living in Mexico on the opposite side of the globe. This patient, suffering from severe pulmonary fibrosis, was dependent on mechanical devices for survival and was transported by air ambulance to Seoul Asan Medical Center, where he underwent lung transplant surgery in September 2020 and miraculously recovered his health. In 2017, a 20-year-old patient with idiopathic pulmonary hypertension, whose heart could stop at any moment, successfully received a partial lung transplant from his parents and regained health. This was the first successful living-donor lung transplant surgery in South Korea, which led to the revision of the “Enforcement Decree of the Act on Organ, Tissue, and Cell Transplantation” to allow lung transplants from living donors.

The post-transplant survival rate of the Lung Transplant Team at Seoul Asan Medical Center is among the highest in the world. Despite about 70% of the 200 lung transplant patients being severe cases who had long been maintained on extracorporeal membrane oxygenation (ECMO) or mechanical ventilation devices, the team achieved a 1-year survival rate of 80%, 3-year survival rate of 71%, 5-year survival rate of 68%, and 7-year survival rate of 60%. These rates surpass the International Society for Heart and Lung Transplantation (ISHLT) averages of 85% for 1-year, 67% for 3-year, and 61% for 5-year survival rates combined from leading lung transplant centers worldwide. They also outperform the national statistics from the Korea Network for Organ Sharing (KONOS), which report 1-year survival at 63%, 3-year at 53.4%, 5-year at 47.9%, and 7-year at 43.9%.

This success is attributed to the Lung Transplant Team’s integrated multidisciplinary care system at Seoul Asan Medical Center. The accumulated surgical experience of the lead surgeons and the coordinated efforts of thoracic surgery, pulmonology, anesthesiology and pain medicine, infectious diseases, rehabilitation medicine, psychiatry, the Organ Transplant Center, operating rooms, intensive care units, and wards form a single lung transplant team that provides systematic and intensive critical care, significantly reducing postoperative bleeding and complications.

Unlike other organs such as the heart, liver, or kidneys, lungs have fewer brain-dead donors, resulting in longer waiting times for transplants. Additionally, lungs are continuously exposed to external air during breathing, increasing infection risks. Rejection rates are also high, leading to relatively low post-transplant survival rates. Moreover, Seoul Asan Medical Center treats a high proportion of severe patients, many of whom rely on ECMO or mechanical ventilation devices for extended periods while waiting for lung transplants. Transplanting lungs into such patients was considered almost a contraindication, but the Lung Transplant Team at Seoul Asan Medical Center made bold decisions to proceed with surgeries and demonstrated that lung transplants are possible for high-risk patients on ECMO or mechanical ventilation devices without differences in surgical success rates.

Professor Hong Sang-beom of the Lung Transplant Team at Seoul Asan Medical Center’s Organ Transplant Center (Pulmonology) stated, “Through an advanced critical care system, the Lung Transplant Team at Seoul Asan Medical Center appropriately manages immunosuppressant medication for transplant patients and assists with proper respiratory rehabilitation exercises, ensuring long-term survival and high quality of life for patients.” Professor Park Seung-il (Thoracic Surgery) from the same team added, “The survival rate for lung transplants, which was lower compared to other organs like liver or heart, has greatly improved, with two out of three transplant patients surviving more than five years. We will continue to strive so that more patients with end-stage respiratory failure can enjoy a new life based on the Lung Transplant Team’s solid teamwork and integrated multidisciplinary care system.”

This content was produced with the assistance of AI translation services.