The medical research achievement announcement and press conference for” Lung Love Forward - The First Case of Bilateral Lung Transplantation Surgery accomplished at Tri-Service General Hospital” was conducted on December 20th, 2023. Dr. Yen-Shou, Kuo, from the Thoracic Surgery Division, presented the results of the first case of lung transplantation surgery at the event.

Seven years ago, 65-year-old Mr. Lin visited the hospital due to symptoms such as dyspnea, coughing with sputum, chest tightness, and pain. After examination, he was diagnosed with chronic obstructive pulmonary disease combined with severe pulmonary insufficiency. During severe episodes, he required high-flow oxygen treatment. His condition was difficult to control with medication treatments, leading to repeated pneumothoraxes and frequent hospitalizations, significantly impacting his quality of life. He was referred to the Thoracic Surgery Division for an assessment of lung transplantation surgery. As per the lung function test, his data showed only 14% of the predicted value, which was far below the minimum daily requirement of 40%. In April 2023, after discussions between Dr. Tsai-Wang Huang and Dr. Yen-Shou, Kuo with Mr. Lin and his family, Mr. Lin was registered on the waiting list for transplantation. He was granted a donor graft and arranged to undergo lung transplantation surgery. Mr. Lin was transferred to the ward for care, marking a successful milestone as the very first case of lung transplantation under the military medical system.

Before the moon festival vacation in 2023, we were informed that the organ graft from a 39-year-old male donor with brain injury would take place at 5 p.m. on September 28th. With full support and guidance from Superintendent Yi-Jen Hung, the lung transplantation team promptly initiated the confirmation of information and pre-surgical preparations, including blood and lymphocyte cross-pairing checks, etc. After a night of medical material and device preparations, the team, led by Chief Hsu-Kai Huang, set out for the medical center in the northern area to retrieve the harvested organ graft from the donor. At 12:33 on September 29th, Chief Tsai-Wang Huang and Dr. Yen-Shou, Kuo, serving as the paired chief surgeons, received full support from the Cardiovascular Surgery team (including Executive Officer and Deputy Superintendent Yi-Ting Tsai, Dr. Yi-Chang Lin, Dr. Po-Shun Hsu, Dr. Hsiang-Yu Yang, etc.), Aesthetic team (Chief Tso-Chou Lin and Dr. Yi-Hsuan Huang etc.) and the Registered Nurses in the operating room. They spent nearly 10 hours to successfully complete the first case of bilateral lung transplantation at 21:50, operating under the military medical system. Under the leadership of Surgeon General Chien-Sung Tsai, the Director of the Medical Affairs Bureau at the Ministry of National Defense, the hospital has obtained certification for heart, liver, kidney, pancreas, and lung transplantation. This is an important milestone for Tri-Service General Hospital in the field of transplantation medicine.

At Tri-Service General Hospital, the lung transplantation project commenced later than other medical systems in the past. Under the planning and facilitation of Deputy Director Hung Chang and Chief Tsai-Wang Huang, Dr. Yen-Shou, Kuo was sent to Canada for a one-year lung transplantation training program at Toronto General Hospital in 2018 and obtained the certificate of a lung transplantation surgeon in November 2022. Simultaneously, TSGH obtained approval from the MoHW to serve as the designated lung transplantation hospital. To implement and promote lung transplantation surgery, Dr. Tsai-Wang Huang, who was the Chief of the Division at that time, underwent related training from December 2022 to February 2023 at Temple University Hospital, Philadelphia, the largest lung transplantation center in the US. This training was orchestrated under the planning of Director Chien-Sung Tsai from the Medical Affairs Bureau, Ministry of National Defense. Upon Dr. Huang’s return to Taiwan, he energetically planned and prepared for tasks related to the lung transplantation team, completing the first lung transplantation surgery on September 29th, 2023.

Chief Hsu-Kai Huang from the Thoracic Surgery Division mentioned that lung transplantation represents the final treatment tactic for lung disease at the end stage. It’s also an incredibly challenging surgery for the Thoracic Surgery Division. Since the lung function of brain-dead patients is difficult to maintain, obtaining donor grafts becomes difficult hindering the stable growth of domestic case numbers. Consequently, the related medical training could only be completed and certified overseas. Under the planning of the Medical Affairs Bureau, Ministry of National Defense, and with the support of Superintendent Yi-Jen Hung and Deputy Superintendent Yi-Ting Tsai, we were granted the training needed to complete the mission of expanding the territory of transplantation medicine. I feel that there’s still a long way to go as a surgeon involved in harvesting lungs and assisting in lung transplantation surgery.

Chief Tsai-Wang Huang, the specialty physician of the Thoracic Surgery Division and Chief of the Planning and Management Office, recounted that on the day of the surgery, the team departed at 7:00 a.m. from TSGH to reach another medical center in the northern area. At precisely 8:00 a.m., the entire transplantation team observed a moment of mourning for the donor alongside teams from various hospitals. Following this, they commenced assessing organ functions and prepared for the organ harvesting procedures. After confirming the lung function of the donor, the recipient‘s lung was concurrently removed in the operating room of Tri-Service General Hospital, preparing for the subsequent transplantation surgery. The surgery involved bilateral chest opening while preserving the sternum structure to minimize pain, presenting a notably challenging surgical operation that concluded at 21:50. Deputy Superintendent Tung-Wei Chen, who was the Chief of the transplantation medicine department st that time, was there with the team and guided them throughout the surgical process. From the night before the surgery until D-day of the surgery, the coordination between teams and the meticulous preparation, coupled with the seamless collaboration in the operating room were commendable. The care and support from the nurses, RT specialists, and other professional medical staff in the ICU after the surgery played a crucial role. With the combined efforts involved, the challenging lung transplantation surgery and post-surgery care were completed. this accomplishment serves as the final piece of the puzzle to complete solid organ transplantation within the hospital. Looking forward, the Transplantation Medicine Department of Tri-Service General Hospital is expected to continue progressing, achieving further accomplishments, and providing an elevated class of medical care for the military and the public.