The Department of Pulmonology is the most advanced clinical department in Lithuania, specializing in pulmonology and utilizing the latest diagnostic and treatment techniques. The Department has 4 sectors:

  • Functional diagnostics of obstructive lung diseases and respiratory function
  • Thoracic Oncology and Interventional Pulmonology
  • Vascular and Diffuse Diseases
  • Sleep-disordered breathing and pulmonary ventilation

The doctors at our clinical department work at the following units:

  • Outpatient Sector (2 consulting rooms)
  • Pulmonology Unit (52 beds)
  • Sleep Laboratory (3 specialised testing stations)
  • Pulmonary Function Testing (PFT) room
  • Bronchology Office
  • Pulmonologist’s Office within the Chemotherapy Inpatient Day Unit

The Department also has a Pulmonology Laboratory, where research and other scientific activities take place.

The Department of Pulmonology examines and treats patients with all diseases of the lower respiratory tract. The latest state-of-the-art equipment is used to perform a wide range of pulmonary function tests (spirometry, bronchoprovocation test using methacholine (methacholine challenge test) or allergen, exercise challenge test, gaseous diffusion, plethysmography, respiratory muscle strength measurement, exercise tolerance test, sputum induction, fractional exhaled nitric oxide test, etc.). The Bronchology Office performs complex and wide-ranging interventional procedures, in some cases postponing or even substituting the need for surgical procedures, while minimising the incidence of potential complications. Interventional pulmonology is especially pertinent to lung cancer and interstitial lung diseases. In 2009, the pulmonologists at the Department became the pioneers in Lithuania by introducing endobronchial and endoscopic ultrasound, which is the most advanced and cutting-edge minimally invasive diagnostic technique. This method is equivalent to surgical procedures in terms of efficacy and is characterised by high safety and low complication rate. These tests can also be performed on an outpatient basis, eliminating the need for hospitalisation and surgery. Cryobiopsies have been performed since 2017. It is a new transbronchial lung tissue biopsy technique with relatively high sensitivity that facilitates the diagnosis of diffuse lung diseases.

To enhance the treatment of one of the most common lung diseases, lung cancer, the Department of Pulmonology initiated the first genetic testing for lung cancer in the Baltic States in 2010. This testing involves the detection of endothelial growth factor receptor (EGFR) mutations in both lung tissue and blood serum. Subsequently, they expanded the testing capabilities to include an anaplastic lymphoma kinase (ALK) translocation test. The findings from these studies are used to tailor individualized treatment with targeted therapy drugs for non-small cell lung cancer.

In 2016, the Department began treating idiopathic pulmonary fibrosis with anti-fibrotic drugs that effectively slow down the progression of the disease. The patient registry of the Department helps assess the long-term efficacy and safety of treatment.

Clinical work focuses considerably on multidisciplinary activities. All cases of thoracic oncology, interstitial lung diseases and severe asthma are discussed regularly (weekly) in multidisciplinary consilium meetings. Kaunas Clinics is the only facility in Lithuania performing lung and lung-heart complex transplants, which is why it actively cooperates with the Department of Cardiac, Thoracic and Vascular Surgery.

To optimise the examination of patients with rare diseases and to ensure ongoing specialist care, dedicated rare disease centres have been established at the Department of Pulmonology: Pulmonary Hypertension Centre (headed by Prof. Dr. S. Miliauskas), Adult Cystic Fibrosis Centre (headed by Prof. Dr. K. Malakauskas), Severe Asthma Centre (headed by Assoc. Prof. Dr. K. Biekšienė).

Doctors at the Adult Cystic Fibrosis Centre actively collaborate with paediatric pulmonologists, facilitating the substitution of treating physicians for the patients. Detailed genetic testing, including gene sequencing, and the use of one of the latest sweat chloride tests in clinical practice enable rapid and accurate testing of patients. A strong team of physical medicine and rehabilitation doctors, physiotherapists, and dieticians contribute to the effective treatment of patients. The Department has purchased a cough assist device to assist in clearing bronchial secretions from the airways. Stagnation of these secretions, caused by the pathogenetic mechanisms of the disease, may significantly worsen the patient’s condition. Since 2010, the Adult Cystic Fibrosis Centre has been participating in the European Cystic Fibrosis Society Patient Registry.

At the Pulmonary Hypertension Centre, patients are examined in line with global diagnostic guidelines. Specific treatments are prescribed for primary pulmonary hypertension, and patients receive rigorous monitoring and follow-up care. Patient data is collected, analysed and summarised in a local register.

The Severe Asthma Centre ensures the prompt referral of patients with severe asthma to specialist. It also performs a wide range of tests (from pulmonary function tests to complex radiological and interventional tests) in order to clarify the damage caused by the disease and to rule out other possible causes behind the severe disease process. Since 2017, the Department began implementing active treatment of severe asthma with biologics. These biological drugs are selected after assessing the patient’s disease phenotype, based on validated clinical and biological markers. Since 2018, Assoc. Prof. Dr. K. Biekšienė, head of the Severe Asthma Centre, has been approved as the national leader of the Severe Heterogenous Asthma Research collaboration, Patient-centred Clinical Research Collaboration project, funded by the European Respiratory Society (ERS) by the decision of the Steering Committee.

The Department supervises the following undergraduate module of the Faculty of Medicine:

  • “Thoracic Diseases, Allergology and Clinical Immunology” and “Haematology and Oncology” for 4th year students of the Medical Academy.

The LSMU Department of Pulmonology executes the following postgraduate residency study programme:

  • Pulmonology

Resident doctors have the option to choose the following doctoral programme after completing their second-cycle studies:

  • Pulmonology

One of the main research areas of the Department is the etiology, pathogenesis, pathophysiology, diagnostics, and treatment of chronic obstructive pulmonary diseases. The research is supported by the Research Council of Lithuania, LSMU Research Fund, Kaunas Lung Disease Science Club, and support from foreign researchers. The research equipment of the Pulmonology Laboratory, which is part of the Department, has been upgraded, and a system for growing structural lung cells and establishing cell co-cultures has been introduced. The results are presented at Lithuanian and international conferences, articles are published in journals with an impact factor, referenced in the Institute of Scientific Information database “ISI Web of Science”. The most intensive research is currently being carried out in the fields of asthma, chronic obstructive pulmonary disease, lung cancer, and sleep apnoea.

Researchers at the Pulmonology Laboratory, led by Prof. Dr. K. Malakauskas, actively collaborate with researchers from the University of Groningen (the Netherlands).

Researchers at the Department of Pulmonology participate in an activity under the EU COST programme (European Cooperation in Science and Technology) intended to support international collaboration between investigators, engineers and researchers in science and technology. Prof. Dr. K. Malakauskas represented Lithuania in the following COST activities: BM1201 “Developmental origins of chronic lung disease”, CA15214 “An integrative action for multidisciplinary studies on cellular structural networks”.

Since 2001, 17 doctoral theses were defended at the Department of Pulmonology:

  • Implications of the development and course of hypertension of thromboembolic origin. S. Miliauskas, 2001.
  • Implication of eosinophils in obstructive lung diseases and their kinetics in experimental allergic inflammation. B. Šitkauskienė, 2003.
  • The influence of etiological and clinical factors and the intensity of local innate immune response on the outcomes of severe pneumonia. V. Dudzevičius, 2003.
  • Immune status and clinical aspects of patients with seasonal allergic rhinitis. J. Staikūnienė, 2003.
  • Peculiarities of epigenetic and genetic alterations and proteomic tumor markers in non-small cell lung cancer. M. Žemaitis, 2005.
  • Pathogenicity factors of potential hospital-acquired Pneumonia pathogens, Pseudomonas Aeruginosa and Klebsiella Pneumoniae, and their influence on the course of disease. A. Vitkauskienė, 2008.
  • Changes in cough reflex sensitivity after smoking cessation in healthy subjects and patients with chronic obstructive pulmonary disease. K. Stravinskaitė (Biekšienė), 2008.
  • Tobacco smoke-induced features of immune response in patients with asthma. A.Krisiukėnienė, 2009.
  • Effect of alpha-1 antitrypsin on monocytes activity in vitro and impact of genotype on features of chronic obstructive pulmonary disease. D. Serapinas, 2009.
  • Features of local and systemic immune response in patients with chronic obstructive pulmonary disease and asthma. D. Urbonienė, 2010.
  • Markers of chronic inflammation and epidermal growth factor receptor gene expression in patients with lung cancer. N. Vagulienė, 2013.
  • Non-specific inflammation during acute exacerbation of chronic obstructive pulmonary disease. M. Vaitkus, 2014.
  • Distinctive characteristics of metabolism and inflammation in men with obstructive sleep apnea. G. Pilkauskaitė (Vaitukaitienė), 2014.
  • The Role of Th17 cells in allergic asthma. I. Bajoriūnienė, 2014.
  • Peripheral blood neutrophil and eosinophil activity during allergen-induced late-phase airway inflammation in asthma. S. Lavinskienė (Vaitkienė), 2014.
  • The Role of Th9 cells and eosinophil apoptosis in allergic asthma. D. Hoppenot, 2016.
  • The Role of tumor-infiltrating immune cells and serum cytokines in non-small cell lung cancer. J. Jackutė, 2017.

Participation in registries and similar projects enables the centres to exchange depersonalised patient information to improve the diagnosis, treatment, and follow-up of patients with rare diseases, and to develop international collaboration between researchers and clinicians. The aggregated analysis of registry data enables healthcare professionals and researchers to identify new trends in disease development, to identify the most effective treatments, and to design clinically valid new trials to introduce new pathogenesis-based medicines into medical practice.

The Department has been collaborating for many years with the research centres of Ghent (Belgium), Groningen (the Netherlands) and Amsterdam universities. Close links are maintained with specialists at the University of Mannheim and the Thoracic Clinic (Thoraxklinik) of Heidelberg University. These specialists are among the leading experts in the diagnosis and treatment of lung cancer.

The specialists at our Department actively participate in the activities of the Lithuanian Society of Pulmonology and Allergy (LSPA) headed by the elected chairperson, Prof. Dr. K. Malakauskas, who is also a doctor at the Department of Pulmonology. On 5 April 2017, the LSPA signed an international membership agreement with the ERS, further expanding the opportunities for collaboration with foreign clinicians and researchers. The journal “Pulmonologija ir alergologija” (Pulmonology and Allergology) has been published from 2006 until now, and since 2017, it has a section of peer-reviewed articles.

LSMU Department of Pulmonology
Prof. Dr. Skaidrius Miliauskas
Head of the Department of Pulmonology
All contacts