In 2012, a 41-year-old homemaker Jayshree Mehta, got the best gift on her birthday, a fresh breath of life. Jayshree, who was suffering from pulmonary fibrosis, a condition in which breathing is quite difficult, was given a new life with a lung transplant surgery from a senior citizen who was declared brain dead the very same day. And with this successful surgery, the lung transplant process was first introduced in India. There are many such success stories similar to Jayshree throughout the country. Lung-failure patients like Jayshree have been suffering for long and the cure in now closer to home for many Indians, even people living in tier II cities like Lucknow.
The lung is one of the most vital organs in the human body. It performs several important functions like blood exchange, gaseous exchange, and other metabolic activities. People with severe lung diseases like pulmonary disease, infection, chronic disease that are not cured by general treatment need to opt for transplantation of their lung transplantation, also referred to as pulmonary transplantation. It’s a surgical process through which the infected or diseased lung (single or both, depending on your health condition) is replaced by the healthy lung taken from a donor, usually from a deceased donor.
Why is lung transplantation needed?
Several chronic lung diseases are not curable by medicinal treatments, thus require replacement of diseased lung or the diseased portion of the lung with the healthy one. The transplant procedure is complicated, however, it can help in increasing longevity and ensures a healthy life.
Some of the diseases in which people may require lung transplantation are:
- Lungs fibrosis
- Pulmonary hypertension
- Cystic fibrosis
- Chronic obstructive pulmonary disease
Criteria for Lung Transplant
For lung transplantation, the patient must be 60 years of age or less for bilateral lung surgery (both lung transplant); however, for a unilateral or single lung transplant, the age limits are 65 years age or less.
Single lung transplantation surgery takes around 6 to 8 hours, and bilateral or double lung transplant may take about 10 to14 hours. The surgeon must preserve the healthy lung of a deceased person, which is to be transplanted into the body of the patient.
Waiting for a donor organ
If your pulmonologist decides that you’re a candidate for a lung transplant, they will register you on a waiting list. While you wait for a transplant, your doctor may recommend healthy lifestyle changes, such as regular exercise, eating a healthy diet, and avoiding smoking and tobacco. Your doctors may also recommend that you participate in a pulmonary rehabilitation program that can help you improve your health and ability to function in daily life before and after your transplant.
When a donor’s lung is found, here are the criteria that are considered to make sure you get the right lungs-
- Matching the blood type of the donor with a recipient
- Comparing the size of the organ with chest cavity
- Calculation the geographic distance between donor organ and transplant recipient
- The severity of the recipient’s lung disease
- Determining the recipient’s overall health
- Calculating the likelihood that the transplant will be successful
Things to consider before planning a lung transplant
Lung transplantation is not the right treatment for everybody. Certain factors may mean you’re not a right candidate for a lung transplant, including-
- If you have an active or severe infection
- Do not want to make lifestyle changes necessary to ensure the new lungs are safe; this includes quitting alcohol and smoking
- Do not have a recent medical record of having a cancer
- Have severe kidney, heart or liver diseases
- Do not have a supportive network of family and friends
Lung Transplant Procedure
Before the surgery, the patient is suggested to take an antimicrobial shower and do not eat or drink anything for 8 to 9 hours before the procedure.
First of all, the general anesthesia so you will be unaware and won’t feel any pain. A tube is guided through the mouth and into the windpipe so that you can breathe during the surgery.
As soon as the effect of anesthesia starts, the surgeon starts the procedure by making an incision in your chest. Thereafter, they remove the diseased lung and reconnect your blood vessels and airways to the healthy lung.
In bilateral transplantation, the surgeon might connect you to a heart-lung machine as it is more complex and time taking surgery as compared to unilateral lung transplantation surgery. This machine usually oxygenates and pumps the blood in and out of your body, just like the lungs.
Procedure after the lung transplant surgery
After the successful transplantation of the lung, the surgeon will shift you to the intensive care unit (ICU) where you will stay for a few days. Usually, this is done because after this complex surgery, you will need intensive support, frequent nursing care, and constant monitoring. After this, you will be shifted in the normal patient’s room, and the doctor will evaluate the progress about the acceptance of your new lung by the body. Further pulmonary rehabilitation, physical exercise, and other therapy are carried out by the coordinator.
After you are discharged from the hospital, you’ll be required to frequently visit the hospital for the next two to three months so that the specialists can monitor the progress and detect and treat complications early. Afterward, the follow-up visits are usually less frequent, provided you follow all the necessary precautions and procedures advised by your surgeon.
In general, after your lung transplant, you will need to make several long-term adjustments, including:
- Taking immunosuppressants to suppress your immune system and prevent rejection of the donor lung or lungs.
- Taking care of the lifelong care plan including the medications, lifestyle changes, and therapies
- Living a healthy lifestyle to sustaining your new lung. That includes following a nutritious diet and prohibit the use of tobacco products and alcohol.
- Regular exercise is a crucial part of your lung transplant recovery. Your doctor will ask you to begin it within just a few days after the surgery.
- Emotional support. Talk to your doctor if you’re feeling stressed or overwhelmed
Risk of lung transplant
Lung transplantation is one of the major and complicated surgeries, and it comes with some risks, which include failure of the donated lung, failure of other organs, infection, profuse bleeding, and in rare cases, death.
The major risk of this surgery is organ rejection. In this case, your immune system attacks the donor’s lung, and this might fail the donor’s lung. Another risk arises from immunosuppressant drugs. These drugs help in reducing the response of the immune system by which the chances of rejection of the donor’s lung is lowered. However, these immunosuppressant chances of infection are increased as the immunity is low.
Thus before opting for a lung transplant, you should go for a diagnosis and consult with your doctor about its procedure, risk, and other related issues.
A lung transplant can improve the quality of life significantly. The first year after the transplant is the most critical time as the chances for surgical complications, rejection, and infection are high. But with proper care, you can lead a healthy life.
If you are thinking of undergoing lung transplant surgery, Midland Healthcare now has the facility. Midland, in association with Gleneagles Global Hospitals, Chennai, has brought the Lung Transplantation facility for people living with severe lung disease in or around Lucknow. Gleneagles is trusted for more than 100 successful lung transplants and backed by the best pulmonologists and infrastructure at the Midland, the lung transplant facility is now more accessible as well as affordable to people in Lucknow.
You can consult with the specialist from Gleneagles Global Hospitals every second Thursday of the month to know more about the procedure.