Persahabatan Respirology Journal was first published in 2025 and is issued twice a year, in June and December. The name "Persahabatan" is derived from the Indonesian National Respiratory Center, Persahabatan Hospital, and reflects the spirit of collaboration, compassion, and dedication. This journal publishes articles in English, and all manuscripts undergo peer review by experts in the field. The journal focuses on respiratory medicine and lung health, including clinical research, translational studies, epidemiology, innovations in diagnostics and therapies, public health initiatives, and management strategies in the respiratory field. Persahabatan Respirology Journal is published by the Clinical Research Unit of Persahabatan Hospital, under the Ministry of Health of the Republic of Indonesia. We highly value every contribution from the scientific groups in medicine, dentistry, nursing, and allied health, as well as the hospital management community. Therefore, we invite academicians, researchers, and clinicians to submit their scholarly work and outstanding research findings in respiratory sciences for publication in this journal.
From Community Movement to Precision Respiratory Care:Prevention, Value, and Rehabilitation AcrossThe Respiratory Continuum
Background:Respiratory medicine is often organized according to diseases, procedures, and anatomicalboundaries. Patients, however, experience respiratory illness as a continuum that includesprevention, acute deterioration, treatment, functional recovery, and reintegration intosociety. This editorial highlights how the articles in this issue of the PersahabatanRespirology Journal reflect a broader and more integrated approach to respiratory care. Discussion:The evolution of Senam Asma Indonesia from a hospital-based asthma club into anationwide community movement demonstrates the importance of translating scientificknowledge into culturally acceptable, accessible, and sustainable rehabilitation programs.The reviews on pulmonary rehabilitation for pathological air-filled spaces and tuberculosisvaccines emphasize individualized risk assessment, prevention, health-system readiness,and equitable implementation. Original studies addressing obstructive sleep apnea riskamong emergency department healthcare workers and the cost-effectiveness ofhemoptysis treatment expand respiratory care into occupational safety and value-basedclinical decision-making. Meanwhile, the case reports on generalized myasthenia gravis andcritical illness illustrate the complexity of cardiorespiratory rehabilitation in patients withneuromuscular weakness, obesity, postoperative deconditioning, respiratory failure, sepsis,and prolonged functional impairment. Collectively, these articles show that respiratoryoutcomes are influenced not only by pulmonary pathology, but also by communityparticipation, sleep health, economic considerations, muscle function, interdisciplinarycollaboration, and access to rehabilitation. Conclusion:Comprehensive respiratory care must extend beyond diagnosis, hospitalization, andsurvival. It should include prevention, individualized treatment, rehabilitation, efficientresource allocation, and restoration of meaningful participation. This issue reinforces thestrategic role of Persahabatan Hospital and the Persahabatan Respirology Journal inconnecting clinical innovation, public health, health economics, and rehabilitation acrossthe respiratory-care continuum.
Copyright (c) 2026 Siti Chandra Widjanantie (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
The Historical Development of Senam Asma Indonesia and the Contribution of Persahabatan Hospital (1985-Present)
Background: Senam Asma Indonesia (SAI) is a longstanding Indonesian structuredasthma exercise program associated with Yayasan Asma Indonesia (YAI), asthma clubs,and Persahabatan Hospital. Its historical development has not previously been synthesizedwith explicit grading of source verification. Methods: This non-systematic narrative historical review used targeted searches ofPubMed/MEDLINE, Google Scholar, Indonesian journal portals, official government andhospital websites, and institutional repositories, without a lower date limit and updated on10 July 2026. Historical statements were appraised according to source type and proximityto the event; discrepancies and unverified milestones were reported explicitly. Results: An official Ministry of Health retrospective account states that YAI activities beganin 1985 as an Asthma Club at RSUP Persahabatan, providing counseling and therapist-ledbreathing exercise. A 1993 standardization seminar is described in secondary sources, butoriginal proceedings were not retrieved. A peer-reviewed retrospective review datesformalization of SAI to 1994. A 2002 clinical publication confirms that SAI was establishedin practice, while the 2003 revision manual is repeatedly cited but was not available in fullthrough open sources. Subsequent Indonesian studies and hospital reports show continuedclinical and community use, although the SAI-specific evidence remains small andheterogeneous. Conclusion: Persahabatan Hospital was an early institutional setting for organized asthmaeducation and breathing exercise and has remained linked to SAI-related activity. Theverified historical record supports a narrative of local development, formalization, revision,and continued use, but national reach and several early milestones require primary archivalconfirmation. Future priorities include archival and oral-history research, national programmapping, standardized outcomes, and multicenter implementation studies.
Copyright (c) 2026 Siti Chandra Widjanantie, Dede Hidayat, Anita Ratnawati, Triya Damayanti, Rita Rogayah, Ratnawati Ratnawati, Wiwien Wiyono, Menaldi Rasmin, Faisal Yunus, Anwar Yusuf (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Early Rehabilitation in adult and paediatric critically ill patients with respiratory failure, sepsis, and pneumonia: Case series
Background: Critically ill patients with acute respiratory failure,sepsis, pneumonia,and complex comorbidities frequently develop prolonged ventilator dependence,impaired airway clearance, intensive care unit-acquired weakness (ICU-AW), anda high risk oof post-intensive care syndrome (PICS). Early, structured rehabilitationthat integrates respiratory support, neuromuscular preservation, and mobilizationmay improve recovery. Case: This case series describes three patients treated in the adult ICU andpediatric ICU of Persahabatan General Hospital's who received individualizedintensive rehabilitation. A young adult with obesity, type 2 diabetes and sepsis; amiddle-aged adult with severe community-acquired pneumonia and prolongedmechanical ventilation; and a preschool child with status epilepticus, sepsis, andbronchopneumonia. Functional status was evaluated using ICU Mobility Scale(IMS), Chelsea Critical Care Physical Assessment Tool (CPAx), Medical ResearchCouncil Sum Score (MRC-SS), Functional Status Scale (FSS), and grip strength.After 2 weeks, case 1 showed IMS improving from 0 to 6, CPAx from 2 to 27, andMRC-SS from 40 to 60, alongside successful ventilator weaning. After 3 weeks,case 2 showed CPAx improving from 5 to 20, IMS from 1 to 4, MRC-SS from 24to 32, grip strength from 5.2 to 11.3 kg in both arms, and cough flow from 45 to 79L/min. Case 3 showed FSS improving from 23/36 to 16/36 and IMS from 0 to 6after 3 weeks. Discussion: These cases illustrate the feasibility of early multimodal rehabilitationin medically complex ICU/PICU patients. The combination of positioning,progressive mobilization, airway clearance techniques, Neuro-Muscular ElectricalStimulation (NMES), and caregiver engagement was associated with meaningfulgains in functional recovery. Conclusion: A structured, multidisciplinary rehabilitation program may supportventilator liberation and functional improvement in critically ill patients across awide age range. Larger prospective studies are needed to define optimal protocolsand long-term outcomes.
Copyright (c) 2026 Putri Alfaridy Lubis, Siti Chandra Widjanantie,, Anitta Florence S. Paulus, Thariq E. T. Hasibuan, Ernita Akmal, Navy G. H. M. Lolong Wulung, Saad Chalid Badegesh, Hening Laswati Putra (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Cost-Effectiveness Analysis of Hemoptysis Therapies Among Hospitalized Patients at Persahabatan Hospital
Background: Carbazochrome has not been included in the Indonesian National Formulary(FORNAS), which serves as a prescribing guideline for patients covered by the NationalHealth Insurance program (JKN). However, Persahabatan Hospital issued a Director’sDecree on January 18, 2024, permitting the use of carbazochrome for patients withmassive hemoptysis or for those who did not respond to tranexamic acid after three days oftreatment. This study aimed to analyze the cost-effectiveness of hemoptysis therapy inhospitalized patients at Persahabatan Hospital. A retrospective cohort study was conductedusing medical records of hospitalized patients with hemoptysis from January to June 2024. Methods: Therapeutic effectiveness was assessed based on the time to bleedingcessation (days), while costs were calculated from total direct medical costs. Costeffectivenessanalysis was subsequently performed. The non-parametric Kruskal–Wallistest was used to compare therapeutic effectiveness and total direct medical costs amongthe three treatment groups. Results: The results showed no significant differences in sex, age, diagnosis, therapeuticeffectiveness, or total direct medical costs among the treatment groups. However, therewas a significant difference in the proportion of patients with massive hemoptysis amongthe three groups (p=0.040), indicating differences in baseline disease severity. Conclusion: There were no significant differences in sociodemographic profiles,therapeutic effectiveness, or total direct medical costs among the three treatment groups.
Copyright (c) 2026 Asri Nurfita Astuti, Tri Kusumaeni, Yulia Paramitha, Dendhi Bagus Andriyanto, Fitri Nurhayati (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Cardiorespiratory Rehabilitation Management of Generalized Myasthenia Gravis Post Thymectomy and Radiotherapy With Type II Obesity
Background: Generalized myasthenia gravis (MG) is an autoimmune neuromusculardisorder that can reduce respiratory reserve, impair cough effectiveness, and limit dailyactivities. These limitations may be exacerbated by thymoma, obesity, previous myastheniccrisis, and post-thymectomy or post-radiotherapy status. Cardiorespiratory rehabilitation mayaddress both physiologic and functional impairments through symptom-limited exercise,breathing retraining, airway-clearance techniques, and energy conservation strategies. Case: A 39-year-old woman with AChR-positive generalized MG, status post extendedthymectomy for thymoma and radiotherapy, was referred to Physical Medicine andRehabilitation because of easy fatigability, exertional dyspnea, and reduced tolerance fordaily activities. Baseline evaluation revealed class II obesity, reduced chest expansion,restrictive spirometry, weak cough, low exercise tolerance, impaired functional endurance,and moderate limitations in daily function and quality of life. Discussion: The patient’s limitations reflected a multifactorial cardiorespiratory conditioninvolving neuromuscular weakness, reduced thoracic mobility, and obesity. The rehabilitationprogram included graded aerobic exercise, breathing retraining, incentive spirometry, airwayclearanceeducation, and energy conservation strategies. After six weeks, the patientdemonstrated reduced fatigue and dyspnea, improved cough effectiveness, increased chestexpansion, and greater walking capacity. Conclusion: Cardiorespiratory rehabilitation produced clinically meaningful functionalimprovement in a patient with generalized MG after thymectomy and radiotherapy despitecoexisting class II obesity. These findings suggest that functional limitations in MG aremodifiable and can respond to a structured rehabilitation program, although long-term followupand weight management remain essential.
Copyright (c) 2026 Nabil Hariz, Peggy Peggy, Telly Kamelia, Siti Chandra Widjanantie (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Association Between Obstructive Sleep Apnea (OSA) Assessed by STOP-Bang and Reaction Time in Emergency Department Healthcare Workers at Persahabatan Hospital
Background: Reaction time is the interval between an external stimulus and motorresponse, is closely linked to alertness and is critical in professions requiring rapid responsessuch as doctors and nurses. Obstructive sleep apnea has an impact on cognitive function,including impaired alertness, poor cognitive performance and difficulty maintaining attention.This study aims to examine the relationship between OSA and reaction time, determine theproportion of OSA measured using the STOP-BANG questionnaire and reaction time inemergency department healthcare workers at Persahabatan Hospital. Methods: A cross-sectional study was conducted in Juny-July 2025 involving healtcareworkers at Persahabatan Hospital. Eligible healthcare workers completed STOP-BANG questionnaire, had their visual and auditory reaction times measured. Results: This study included 70 participants. The mean STOP-BANG questionnaire scorewas 0,917 with the lowest score 0 and the highest score 6. The mean visual reaction timewas 197,2 ms and the mean auditory reaction time was 181,1 ms. A significant associationwas found between reaction time and years of service (p < 0.001). However, no associationwas observed with other factors such as age, sex, work pattern, BMI, neck circumferenceand smoking status. The correlation between OSA and visual reaction time showed r = -0.056 (p = 0.642), while for auditory reaction time r = -0.069 (p = 0.568). The correlationbetween STOP-BANG risk and visual reaction time p = 1.000 and auditory reaction time p =1.000. Conclusion: There was no significant relationship between OSA risk based on the STOP-BANG questionnaire and either visual or auditory reaction time.
Copyright (c) 2026 Feni Fitriani Taufik, Semba Anggen Rachmani, Agus Dwi Susanto (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Tuberculosis Vaccines in Indonesia: Importance and Future Directions
Background: Tuberculosis (TB) remains a major public health burden globally and in Indonesia, despite the availability of established control strategies such as case detection,treatment, TB preventive therapy, and Bacillus Calmette-Guerin (BCG) vaccination. Indonesia continues to carry one of the highest TB burdens worldwide, and ongoing transmission highlights the need for stronger preventive approaches, particularly vaccines. Methods: A narrative review was conducted using literature retrieved from PubMed, Scopus, and Google Scholar. Search terms included "Tuberculosis, “Novel Tuberculosis Vaccine," "BCG Limitations," and “Vaccine Implementation.” Results: Current strategies remain essential but have important limitations. Diagnosis and treatment are often initiated only after disease has developed, treatment duration can affect adherence, and BCG provides limited and variable protection against pulmonary TB in adolescents and adults, the groups most responsible for transmission. In this context, new TB Vaccines may become an important complement to existing TB control efforts. For Indonesia, an ideal TB vaccine should provide durable protection against pulmonary TB in adolescents and adults, have an acceptable safety profile for broad and high-risk populations, require a feasible dosing schedule, and be suitable for integration into existing health system platforms. Successful vaccine introduction will require careful target population selection, health system readiness, public acceptance, sustainable financing, and strong policy support. Conclusion: Strengthening preparedness for future TB vaccine implementation may help Indonesia accelerate progress toward national and global TB elimination targets.
Copyright (c) 2026 Erlina Burhan, Afif Rasyad, Fira Alyssa Sinuraya, Muhammad Prasetio Wardoyo, Raden Roro Raihan Rizki Ramadhani, Novia Ayu Rahma Setyaputri, Rita Fatmi Wiranda, Gracia Kaesatara Marsha, Tsabitah Amaluna Zahra, Fahrizka Nurdia Putri Pakaya, Fathiyah Isbaniah, Heidy Agustin, Faiza Hatim (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Pulmonary Rehabilitation Strategies for Pathological Air-Filled Spaces: From Blebs to Pneumothorax
Background: Pulmonary rehabilitation is an effective non-pharmacological approach forrespiratory conditions. However, its use in patients with bullae, blebs, or pneumothoraxrequires modification to balance therapeutic benefits against the risk of further lung injury.This review outlines strategies for implementing pulmonary rehabilitation in these high-riskpopulations. Methods: A literature review was conducted using PubMed and Google Scholar, focusingon articles and studies on rehabilitation in cases of emphysema, bullae, bleb parenchyma,and pneumothorax. Results: Most articles on this topic were case studies, except for one multicenter trialexamining pulmonary rehabilitation in patients with advanced emphysema. Pulmonaryrehabilitation strategies can be divided into the very acute phase and the early phase. Mostimportantly, pulmonary rehabilitation must be delivered through a multidisciplinary approach,and the team needs to assess medical suitability and tailor the exercises accordingly. Theprogram should be progressed and continued in an outpatient setting to achieve functionalbenefits and improve quality of life. Conclusion: Pulmonary rehabilitation is both feasible and beneficial for patients with bullaeor pneumothorax and critically progressed. Current strategies are largely based on the caselevelevidence and clinical reasoning.
Copyright (c) 2026 Nurulhuda Zakari, Siti Chandra Widjanantie, Sa'ari Mohamad Yatim (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Background: Respiratory diseases continue to be one of the significant burdens of morbidityand mortality in the world, with tuberculosis, pneumonia, COPD, and lung cancer featuringamong the most important causes. These are complex conditions with comprehensivemedical, functional, nutritional, medical rehabilitation, and psychosocial managementrequirements. This narrative review outlines the rationale, structure, and clinical impact ofmultidisciplinary respiratory care and emphasizes how such care may improve outcomes,coordination, and patient satisfaction. Discussion: A multidisciplinary team that includes respirologists, thoracic surgeons, nurses,nutritionists, and palliative specialists can allow for integrated patient-centered management,with enhancement in diagnostic accuracy, treatment efficacy, and continuity of care.Evidence shows reductions in hospital readmissions, improved survival, and better quality oflife with these approaches. Persahabatan National Respiratory Hospital is an example of thisapproach through structured multidisciplinary teams in lung cancer, interstitial lung disease,and tuberculosis. Despite resource and system integration challenges, there is a promisingoutlook for strengthening digital coordination, leadership support, and national policyalignment. Conclusion: Multidisciplinary respiratory care hence forms a very important framework inadvancing high-value, sustainable, and patient-centered respiratory health services inIndonesia and beyond
Copyright (c) 2025 Agus Dwi Susanto, Sita Laksmi Andarini, P Prasenohadi, Heidy Agustin, Ernita Akmal, Elfina Rachmi, I Putu Eka Krisnha Wijaya, Muhammad Arman, Siti Chandra Widjanantie, Rania Azaria Triswiandi, Ibrahim Nur Insan Putra Dharmawan, Arini Purwono, Andi Yussianto (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Persahabatan Hospital’s Experience on Establishing the First Lung Transplant Program in Indonesia
Background: Lung transplant can greatly improve life expectancy, functional status and quality of live for people with lung failure. In severe lung diseases that no longer respond to medication, a lung transplant is often the only treatment. Indonesia, which ranks first in the world for highest smoking rates and have been battling a seemingly endless tuberculosis endemic, have potential lung transplant recipients in abundance. As the National Respiratory Center, Persahabatan Hospital has the responsibility to provide state-of-the-art respiratory service for the country. Therefore, Persahabatan Hospital has been establishing the first lung transplant program in Indonesia. Methods: This paper presents a narrative review of how Persahabatan Hospital is developing the country's first lung transplant program. This review described the journey, along with the challenges and progress of the program. Results: The very first lung transplant surgery has not yet taken place, despite the efforts of the entire hospital staff. Securing a brain-dead donor as the only source of donor lungs remains challenging. However, we have achieved some milestones, such as developing a lung transplant candidate management system, assembling a dedicated team for managing brain death patients, and establishing a program to approach the next-of-kin of brain death patients. Integration and collaboration within this team will grow and represent a multidisciplinary approach that is vital for the program's long-term success. Conclusion: The lung transplant program is complex in many ways. It is an expensive process, requiring cooperation among various specialists, and it is difficult to find suitable donors. There are also non-technical aspects such as sociological and legal considerations that must be taken into account. The success of this first lung transplant program is crucial for developing alternative treatments for patients, gaining acceptance of the procedure in Indonesia, and enabling further expansion of the procedure to other centers across Indonesia.
Copyright (c) 2025 Susan Hendriarini Mety, Muhammad Aris Furqon, Hana Khairina Putri Faisal, Mia Elhidsi, Yenni Maryati, Norman Hardi Utama, Putri Dianita Ika Meilia, Rini Susanti, Selly Christina Anggoro, Siti Chandra Widjanantie, Agus Dwi Susanto (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Unveiling Rare Cases of Genital Tuberculosis: A Two-Case Report Emphasizing Diagnostic Awareness
Background: Female genital tuberculosis (FGTB) is a rare form of extrapulmonary tuberculosis that often mimics other gynecological pathologies, leading to diagnostic challenges and delayed treatment. In tuberculosis-endemic countries like Indonesia, awareness of this condition remains limited. Methods: This study is a descriptive retrospective study that presents two case reports of female genital tuberculosis patients who were treated at Persahabatan General Hospital between 2023 – 2024. Both patients were referred from other hospital with two different diagnosis. The diagnosis in both cases was established through a combination of clinical evaluation, radiological imaging, and confirmatory pathological or bacteriological tests. Results: We reported two cases of FGTB in reproductive-age women. The first case, a 33-year-old woman, presented with abdominal pain, distension, and elevated CA-125 levels serum, raising suspicion of ovarian malignancy. Laparoscopy and histopathological examination confirmed tuberculosis infection, and the patient showed full recovery after nine months of anti-tuberculosis therapy. The second case, a 32-year-old woman with a history of pulmonary tuberculosis, was diagnosed early through ultrasonography findings and successfully managed with medical therapy followed-up by serial ultrasound, avoiding surgical intervention. Conclusion: Many cases of female genital tuberculosis remain underdiagnosed due to the challenges in its diagnosis. Early recognition through careful examination, imaging, and confirmatory tests can prevent misdiagnosis and unnecessary surgery. Greater awareness and multidisciplinary among clinicians can also lead to early diagnosis, proper treatment, and better patient outcomes.
Copyright (c) 2025 Suratih NMD, Zahra FE, Arjunadi B, Z Zakia, Pudyastuti S, Lisnawati Y (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Late-Onset Fluorouracil Extravasation in a Patient with Nasopharyngeal Carcinoma: A Case Report from Persahabatan Hospital
Background: Extravasation in chemotherapy remains one of the serious complications of chemotherapy administration and can result in patient injury with an incidence of 0.09%. Management of extravasation in cancer patients requires interprofessional collaboration. Pharmacists can also play a role in the management of extravasation. Case: In this article, we report the case of a 46-year-old patient diagnosed with advanced-stage nasopharyngeal carcinoma of the squamous cell carcinoma type. The patient had undergone radiotherapy 35 times. Subsequently, the doctor planned adjuvant chemotherapy with a regimen of cisplatin 150 mg on the first day and fluorouracil 1500 mg from the first to the fifth day. Five days after the second cycle of chemotherapy, the patient complained of dark red discoloration and heat along the venous line. The pharmacist managed the patient by identifying the cause, recording and reporting the drug side effects to the hospital and pharmacovigilance, recommending a protocol change by adding dilution to fluorouracil, recommending the application of hydrocortisone ointment for the scar, and monitoring the patient’s condition at home after treatment. The recommendations were accepted, and the patient’s condition improved in the subsequent chemotherapy cycle after the above management. Conclusion: The role of pharmacists is crucial in identifying and recommending appropriate treatments to doctors regarding medications and patient therapy management to ensure patient safety is always maintained.
Copyright (c) 2025 Dendhi Bagus Andriyanto, Rizki Yulisetiawan, Fitri Nurhayati, Andi Yussianto (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Forensic Analysis of a Dead-on-Arrival Case with Recent Hospital Discharge at Persahabatan Hospital
Background: This article explores a complex case involving a patient who was declared dead on arrival (DOA) at the Emergency Departmen of Persahabatan Hospital, having been discharged less than a day prior. The patient had a complex medical history, including pneumonia, a suspected lung tumor, type 2 diabetes, hypercoagulable state, electrolyte imbalance, and hypertension. This case highlights crucial aspects of forensic medicine, medicolegal responsibilities, and medical ethics, particularly in discharge decisions for patients with multifaceted health issues. Methods: A forensic examination was conducted to determine the circumstances of death, focusing on the interplay of the patient's pre-existing conditions. The patient’s medical record was reviewed to assess the clinical rationale for discharge. The ethico-medicolegal considerations surrounding the discharge process and the communication of risks to the patient and her family were evaluated. Results: The forensic analysis suggested that the cause of death was likely linked to a thromboembolic event or severe electrolyte imbalance exacerbated by the patient’s underlying conditions. The review of the discharge process revealed potential gaps in risk assessment and communication of the patient's post-discharge care plan. Conclusion: The case underscores the need for adequate discharge planning and risk communication, particularly for patients with complex medical conditions. It highlights the importance of integrating ethical considerations into clinical decision-making to ensure patient safety and mitigate legal risks. This analysis provides valuable insights for improving clinical protocols and healthcare policies to prevent similar occurrences.
Copyright (c) 2025 Putri Dianita Ika Meilia, Diana Paramita, R. R. Diah Handayani, Arif Rahman Sadad (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Developing Clinical Research Unit in National Respiratory Center Hospital
Background: Persahabatan Hospital, Indonesia’s National Respiratory Center, has strategically aligned its clinical and research missions to advance evidence-based respiratory care. In accordance with the 2020–2024 strategic plan, the hospital established a Clinical Research Unit (CRU) as part of its transformation into a center of innovation and ethical scientific excellence. This article provides a narrative review of the establishment, governance, operational framework, and strategic development of the CRU at Persahabatan Hospital, highlighting its role in strengthening national and international research collaboration. Methods: Data were obtained from official regulatory and institutional documents, including Law No. 17 of 2023 on Health, Minister of Health Decree No. HK.01.07/Menkes/1458/2023, Director General Decree No. HK.02.02/D/1782/2025, and the Organizational Structure and Work Procedures (SOTK) of the CRU Persahabatan Hospital. Additional data were drawn from the hospital’s official website and recent academic literature, including Wang et al. (2025) in Systematic Reviews, which examines the impact of Clinical Research Units on institutional research quality and productivity. All sources were reviewed descriptively to identify key themes related to CRU establishment, governance, operational structure, and its contribution to clinical research advancement. Conclusion: The establishment of the CRU at Persahabatan Hospital represents a milestone in institutionalizing research governance and fostering innovation in respiratory medicine. The CRU’s structure integrates administrative, ethical, and scientific oversight through three core subunits, Administration, Implementation, and Monitoring, to ensure regulatory compliance and data integrity. Collaboration with national networks such as the Indonesia Clinical Research Center (INA-CRC) and adherence to Good Clinical Practice (GCP) principles have strengthened research coordination and enabled participation in multicenter studies. Consistent with findings from Wang et al. (2025), the CRU’s presence has enhanced research efficiency, data quality, and investigator engagement, positioning Persahabatan Hospital as a credible contributor to both national and international research efforts.
Copyright (c) 2025 Heidy Agustin, Siti Chandra Widjanantie, Mila Fitriaty, S Sumedi, Siti Mardiyana Ulfah, Irvan Maulana, Wati Melasari, Armida Oos Evy, Rania Azaria Triswiandi, Emmy Amalia, Agus Dwi Susanto, Indri Rooslamiati, Azhar Jaya (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Genomic and Stem Cell Research for Tuberculosis and Pulmonary Diseases: Experience from Persahabatan Hospital
Background: Chronic lung diseases, including tuberculosis (TB), chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis, remain major health challenges in Indonesia. In recent years, genomics-based approaches and regenerative therapies have become two rapidly growing areas of research to support more precise diagnosis and treatment. Persahabatan Hospital, as a national referral hospital for respiratory diseases, plays an important role in the implementation of genomic research through the Biomedical and Genome Science Initiative (BGSi), particularly in TB with a targeted next-generation sequencing (tNGS) approach. At the same time, Persahabatan Hospital has also initiated stem cell research programs aimed at establishing a regenerative therapy platform for chronic respiratory diseases. The current focus is on the clinical evaluation of umbilical cord–derived mesenchymal stem cells (UC-MSCs) as an adjuvant therapy for COPD, utilizing GMP-certified stem cell products provided by an external partner. Methods: This article is an institutional review describing the progress of genomic and stem cell research at Persahabatan Hospital, as well as its future development direction. The information is compiled based on the BGSi program report, RSP scientific publications, and the institutional research strategic plan. Results: Through BGSi, RSP has achieved genomic infrastructure readiness, ranging from specimen collection from health facilities in 26 provinces and specimen processing in 12 DST Labs to sequencing and bioinformatics analysis in 12 tNGS Labs. The implementation of tNGS has supported rapid diagnosis, drug resistance mapping, and strengthening of the national TB surveillance system. Meanwhile, the stem cell research has entered the clinical translation phase, conducting a randomized, double-blind trial of UC-MSCs as adjuvant therapy in Group E COPD patients. The trial aims to evaluate safety, efficacy, and immunomodulatory effects on cytokine profiles (IL-1β, IL-6, TNF-α, IL-10). The study involves collaboration with an accredited GMP-certified cell processing facility, while the hospital’s long-term goal is to gradually develop internal expertise and infrastructure in cellular therapy. Conclusion: Advances in genomic and stem cell research at Persahabatan Hospital demonstrate concrete steps toward integrating precision medicine and regenerative therapy in respiratory care. Continuous capacity building, regulation compliance, and multidisciplinary collaboration are crucial to achieving clinical implementation that benefits patients and strengthens national biomedical innovation.
Copyright (c) 2025 Heidy Agustin, Triya Damayanti, C Cahyarini, Arini Purwono, Merry Ambarwulan, Budi Haryanto, Y Yulianty, Rimba Trishuta Pathiussina, Nadhifa Salsabila, Irsyad Fikri Salim, Irvan Maulana, Agus Dwi Susanto (Author) https://creativecommons.org/licenses/by-nc-sa/4.0
Advancing Multidisciplinary Excellence in Respiratory Medicine: Lessons from Research, Innovation, and Complex Case Experiences at Persahabatan National Respiratory Center Hospital
Background: Persahabatan National Respiratory Center Hospital has undergonesignificant advancements in multidisciplinary clinical services, research capacity, andinnovative respiratory care programs. This editorial synthesizes key institutionalachievements and scientific contributions featured in the current issue of the PersahabatanRespiratory Journal. Content: The establishment of the Clinical Research Unit (CRU) marks a foundational steptoward strengthening research governance, improving protocol quality, and enablingmulticenter collaboration across pulmonology, rehabilitation, microbiology, radiology,thoracic surgery, and public health. Advances in genomic and stem cell research fortuberculosis (TB) and chronic pulmonary diseases demonstrate the hospital’s commitmentto translational precision medicine, focusing on host susceptibility profiling andimmunomodulatory therapies relevant to Indonesia’s high TB burden.Persahabatan Hospital’s pioneering role in building Indonesia’s first lung transplant programhighlights the importance of multidisciplinary integration involving thoracic surgery,anesthesiology, intensive care, infectious disease management, and post-transplantrehabilitation. The rare case series on genital tuberculosis underscores diagnosticchallenges and the need for cross-specialty awareness between pulmonology, gynecology,and pathology. Additionally, the forensic analysis of a dead-on-arrival patient shortly afterdischarge illustrates the value of integrating clinical and forensic perspectives to enhancesafety and quality assurance. The report on late-onset fluorouracil extravasation innasopharyngeal carcinoma further emphasizes coordinated oncologic, dermatologic, andnursing responses to chemotherapy complications. Conclusion: Collectively, these contributions reflect Persahabatan Hospital’s evolvingstrength as a multidisciplinary, research-driven national respiratory center and underscoreits expanding role in advancing clinical excellence and scientific innovation in Indonesia.
Copyright (c) 2025 Agus Dwi Susanto (Author) https://creativecommons.org/licenses/by-nc-sa/4.0