KILIMANJARO 2017

Ascent of Kilimanjaro (Tansania) with patients after lung transplantation

With improvements in the quality of medical care, increasing numbers of people with underlying medical issues are partaking in adventure travel, including travel to high altitude (elevations >2440 m, 8000 ft). One group of individuals who might engage in such activities are solid organ transplant (SOT) recipients who, given improvements in physical well-being following transplantation, may be interested in resuming an active lifestyle after a period of severe limitation due to their underlying illness.

Travel to high altitude carries many potential rewards for these patients, particularly given their difficult prior medical experiences, but there are also important risks, including that of developing acute altitude illnesses such as acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE), as well as the risk of enteric, vector- borne, and bloodborne infection associated with international travel.

(Pub: Travel to High Altitude Following Solid Organ Transplantation. 2016 High Alt Med Biol.)

Scientific literature concerning this topic is scarce and no real guidelines exist how to prepare pats for this adventure and how to minimize the risk and optimize the medical condition of SOT recipients .

Until now just 2 patients after lung transplantation reached the peak of Kilimanjaro (Pub: PLoS One. 2015).

We plan to climb Kilimajaro with 10-12 lung transplant recipients in June 2017. About 20-25 medical experienced person will join these patients to care for their health and to investigate some interesting medical questions regarding altitude medicine in patients after solid organ transplantation. Our expedition will be filmed by a television crew

Planed scientific projects :

To prepare the acsent all participants will be investigated by a sports physician (ergo spirometry, strength test, hypoxic and hypobaric screening and training) and will receive a training program for the expedition. In May 2017 a 5day lasting high altitude training will be performed to optimize training results.

During the Kili ascent measurement of oxygen saturation, blood pressure , heart rate , lung function and blood gas analysis in defined heights will be perfumed in all participants ( lung TX past, accompanying not transplanted persons and local porters and guides)

Furthermore levels of drug levels of tacrolimus, cyclosporine and everolimus will be measured at defined heights and time points to investigate pharmacokinetics of these drugs to answer the question if area under the curve changes depending on sea level .

Additionally sleep screnning of all participants is planned to depict altitude depending changes of the breathing rate and to investigate the autonomic nervous system.

During the whole ascent heart rate and oxygen saturation will monitored and at defined time points heart rate variability will be measured and stored for later analysis .

Finally the entire expedition will be filmed by a camera team (hopefully).