Iskandar bin Salem Al-Guthmi, consultant and professor of cardiothoracic surgery at the College of Medicine, King Abdulaziz University Hospital in Jeddah, explained that, by the end of 2009, lung transplants amounted to more than 30,000 operations, but the number is very limited in the Kingdom, referring to the reason behind that To the lack of organ donation after death as a result of the lack of educational awareness of the importance of donating and saving the lives of people in dire need. The deceased is in a closed device the size of the lungs and is connected to a ventilator and then it is used and implanted to the patient. He also dealt with a number of topics, so to the details of the dialogue:
What diseases that affect the lung and cause failure in its function?
Many diseases, but the most common is pulmonary fibrosis of unknown cause, which is characterized by its slow continuous progression and ends in pulmonary failure. There are other diseases such as chronic pneumonia resulting from repeated pneumonia that causes rupture and expansion of the bronchial sacs, and thus lung failure, as well as diseases resulting from smoking that cause erosion of membranes, alveoli and bronchi.
Lung transplant specialists are scarce. What are the reasons? Is this field witnessing development and progress?
Lung transplantation depends on a program and a highly qualified specialized medical team from a technical and professional point of view, resulting from long and continuous training in internationally recognized centers of excellence, but these centers are limited by the number of fingers, and thus this is reflected in the number of specialists in this field.
Lung transplantation is witnessing remarkable developments, especially in finding optimal ways to increase the number of donor lungs, in order to perform a greater number of transplants for patients. There is a new innovation in this field which is the rehabilitation of the donor''s lung after death (cardiac and pulmonary arrest) by placing the lung of the deceased in a closed device the size of the lungs and connected to a ventilator and feeding the lungs with a liquid of low temperature and rich in protein through the pulmonary artery for a period of 24 hours, and then Use it and implant it to the patient.
How many lung transplants have occurred in the world, and in the Kingdom in particular? Do you have a statistic on the number of patients on the waiting list for lung transplantation?
By the end of 2009, lung transplants reached more than 30,000 operations, in the Kingdom the number is very limited. The reason for this may be the lack of organ donation after death due to the lack of educational awareness of the importance of donating and saving the lives of people who need it most, and for the secretariat the Saudi Center for Organ Transplantation It carries out good awareness campaigns by establishing public forums. The waiting list for lung transplantation is large and growing, and unfortunately there are patients on the waiting list who are dying due to the absence of a donor organ.
It is noted that heart surgery centers are concentrated in one or two cities. Do you think that there is a real importance for the distribution of health services in general throughout the Kingdom?
Cardiac surgery centers in the Kingdom are many and are not regulated in terms of geography and the population of different regions and cities, and this in itself reflects negatively on the level of care provided. For example, the city of Jeddah has a population of approximately 3.5 million people. It has ten government and private heart centers. Most of these centers lack scientific, academic and practical competence, due to the lack of a logical distribution of heart patients, and this has led to twice the number of cardiac cases compared to each center. Consequently, it led to weak professional experience based on medical evidence, as well as research experience in most of these centers.
In general, the number of heart centers to be established depends on the geography of the region in terms of population and the percentage of heart diseases prevalent in that region. There are global standards for establishing a new heart center, and in order for it to be recognized as an acceptable, effective and safe center, it is for the center to prove the minimum number of open heart operations, which is not less than 200 heart operations per year for a period of three years from the establishment of the center, with an increase in emphasis. The number of surgeries per year. After that, the continuation or withdrawal of the license shall be reconsidered. Therefore, I call upon the Ministry of Health, represented by its wonderful minister, Dr. Abdullah Al-Rabiah, for whom I greatly appreciate and respect, to monitor these centers in the Kingdom and ensure their eligibility to operate and conform to international standards. For example, in the city of Jeddah, the number of diagnostic or interventional cardiac catheterization cases expected to be performed per year for adults is ten thousand cases, and the number of open heart operations expected to be performed per year is 2,500 operations. I think it is more appropriate to unify efforts and energies and distribute these operations to two or three centers. Heart at most.
The Kingdom has come a long way in the field of heart surgery. How would you describe the achievements in this field? What is new (studies research) in heart diseases and surgery?
Cardiac surgery in the Kingdom has developed over the years from the beginning of the eighties until now, and this is the result of the generous and continuous support of the state - may God protect it - its positive impact on the achievements in the field of cardiothoracic surgery. For example, surgeries for cardiothoracic diseases are performed by using endoscopes through small openings, such as using a robot device that is characteristic of King Abdulaziz University Hospital, where we have performed several successful operations such as excision of the thymus gland in the chest cavity and removal of lung tumors, and these Operations are taking place in limited centers in Europe and America.
Did we talk about chest diseases and how to prevent them?
Lung cancer is a fatal chest disease. Unfortunately, the number of cases in the Kingdom continues to increase in both males and females, and the main reason is the increase in the number of smokers. As 90 percent of lung cancer has a strong smoking relationship. And many of these cases come in advanced stages that cannot be treated. Therefore, prevention is by stopping and avoiding smoking and by continuous periodic health examination to discover it in its early stages and to treat it. Therefore, I urge the general public, females and males who have been afflicted with smoking disease and their age is 50 years and over, to perform low-dose spiral CT rays of the chest cavity every year, and to consult a competent and competent doctor to look into these cases, so that the disease is discovered in its early stages.
