Written by Professor Dr Arvind Kumar
The first lung transplant happened in India in 2012 but since then, despite advances in technology, the lack of donors has meant that many patients are running short of options and just managing medically. A transplant is the only hope for patients with end-stage lung disease to enhance their life span with a successful operation.
Who needs a lung transplant?
Those who are suffering from end-stage lung disease that cannot be reversed. Any condition, which progresses to the point where the lung function is seriously compromised, is considered end-stage lung disease. Most patients are diagnosed with a specific lung disease long before it progresses to end-stage. In some cases, lung diseases are reversible. For example, many COVID patients who had experienced breathlessness, severe symptoms and fibrosis, improved with recovery.
Who can donate lungs?
There are two types of lung donors – cadaveric (dead) donors and related live donors. In accordance with the law governing organ transplants, a first-degree relative who wishes to give an organ can do so as a living donor. The second option is cadaveric donation, which is more popular in India. An organ is removed and placed into a recipient’s body with the consent of the deceased person’s family.
What are some important components of a lung transplantation?
A lung transplantation procedure consists of three parts: a recipient in need of an organ, a potential donor from whom the organ will be extracted, and a facility with the ability to find a donor for a recipient. The physician guarantees the following:
• Managing the organ after transplant to ensure the recipient’s long-term survival
• Implanting the organ from donor to recipient without harming the donor
What does the evaluation include?
Both the donor’s and the recipient’s blood types should match. Additionally, a few antigens known as H L A also need to be matched. Since the size of an individual’s lungs varies with their respective heights and build, the heights of both the donor and the recipient need to be matched. The slightest mismatch of organs affects the patient’s stability.
Is lung transplant relatively new in India?
Lung transplant has been around in India for over five years. There are lung transplant centres in Hyderabad and Chennai but up north we are planning to offer lung transplant services at Medanta on a regular basis. The hospital is currently planning and developing infrastructure and manpower capacity to be able to provide the same.
Explain the process of lung transplantation?
A transplant is overseen by a team of physicians that includes transplant physicians, transplant surgeons, coordinators, anaesthesiologists, critical care doctors, psychologists and support staff. The entire team is responsible for the entire process, beginning with identifying a recipient, preparing and providing ample support to the recipient, identifying a donor, safely extracting the organ in a trusted facility, ensuring that the organ is fine, safely transporting it to the recipient, implanting the organ into the recipient, and providing post-transplant care to the recipient. This entire procedure is referred to as transplant service. A recipient, a donor and a transplant service are the components that make or break the lung transplant process.
Is a lung transplant safe for both donor and recipient?
The unique aspect of a lung transplant is that it requires a full organ (lung) to function properly. However, a donor’s life may be jeopardised if he or she donates a full lung, which violates the principle of organ donation, which states that the lives of both the donor and the recipient are of the utmost importance.
What’s the post-transplant care protocol?
Post-transplant care comprises follow-up treatment, including regular medication. It is recommended that recipients gradually build their immunity and fitness so that their bodies do not reject the organ. Medications are prescribed to prevent infection and to protect the transplanted lungs from pollutants. As opposed to the kidney and liver, which are located much deeper within the body, the lung is exposed to outside air 25,000 times per day when you breathe. As a result, a recipient should ensure that they breathe clean air, avoid polluted areas and smoking, follow a healthy diet and regular exercise at home, as well as properly follow medications and stay in regular touch with their doctor.
Does the donated lung function on a full capacity?
The lung capacity is determined by the quality of the donor lung. A lung from a healthy, young, non-smoker has a better chance of functioning normally because his or her lungs have never been damaged. The recipient’s body does not reject such healthy lungs and the recipient can resume a normal life after the transplant. Following the transplant, the patients are closely monitored, and if any problems or rejection issues arise, they are treated immediately.