Author: City Today News (City today.media)

The complex lung transplant offered fresh lease of life to 57-year-old Bengalurean suffering from chronic lung disease and days oway from succumbing to it

Bengaluru, June 06, 2023 Apollo Hospitals, Bangalore, Department of Pulmonology have successfully performed a unique lung transplant on a 57-year-old patient from Bangalore. This ground-breaking procedure required extensive skill, precision, teamwork, and tremendous effort from the medical professionals involved

Meenakshi (name changed), 57, from Bengaluru, was initially presented to Apollo Hospitals, Jayanagar about two years ago with increasing breathlessness. She was diagnosed with interstitial lung disease (ILD), a condition characterised by the fibrosis or stiffening of the lungs. Her condition progressed to continuous breathlessness necessitating constant oxygen support at home, Inability to do daily activities on her own and was completely cut off from the normal flow of life.

Recognising the severity of her condition, the medical team at Apollo Hospitals broached the subject of a lung transplant, offering her a potential solution for a better quality of life and longer survival. Although initially hesitant, the patient and her family eventually made the decision to pursue the transplant, following effective counselling sessions by the dedicated team at Apollo Hospitals

The call about a suitable donor was received on the day before Ugadi festival and the patient was quickly admitted to hospital for pre-transplant assessment. A labour of thirty six hours of coordination- during the holiday- finally led to her successful bilateral lung transplant.

Dr. Ravindra Mehta, Senior Consultant, Pulmonology and Interventional Pulmonology at Apollo Hospitals, who led the pulmonology team for the lung transplant, said: “Unusually, on a state holiday, the day arrived when a suitable donor became available. The patient underwent thorough pre-procedure tests, while the donor lungs were meticulously assessed to ensure compatibility. On the day of the surgery, the dedicated team of pulmonologists, surgeons, anesthesiologists, and critical care physicians came together and the surgeons performed the complex procedure, which lasted for 13 hours from patient arrival in the operating theatre to ICU admission. Fortunately, the donor was an in-house patient at Apollo Hospitals, hence there was less ischaemia time for the donor organs, and no requirement of a transport green corridor.”

The impact of this lung transplant on the patient’s life has been remarkable. Previously dependent on continuous high flow oxygen support and restricted to her home, she is now completely off oxygen and has regained her freedom. With the support of the entire medical team, including physiotherapists, counsellors and dieticians, she has progressed from lying in bed to walking without support. Her recovery has been holistic and inspiring, allowing her to enjoy activities with her grandchildren.

The success of this procedure highlights the importance of a well-coordinated and multidisciplinary approach to lung transplantation. The pulmonology team, led by Dr. Ravindra Mehta and assisted by Dr Sameer Bansal, Dr Hariprasad, Dr Srikant (Apollo Hospitals) and transplant physician Dr. Srinivas Rajagopala from Kauvery Hospital Chennai along with the cardiac, thoracic, and vascular surgical (CTVS) team led by Dr. Kumud Dhital and Dr. Anand Subramanyam. The dedicated efforts of Dr. Pradeep Kumar, Dr. Srinivas Dhulipala, who led the anaesthetic and intensive care teams, were also instrumental in the patient’s successful recovery. (Dr Dhital, Dr Kumar, and Mr Das (Clinical Perfusion) are seconded from Marengo Asia Hospital, Faridabad, Haryana; and Dr Rajagopala and Dr Sujith V (organ retrieval surgeon) from Kauvery Hospital, Chennai, under collaborative MoU with Apollo Hospitals in Bangalore)

Lung transplantation also necessitates a well-equipped infrastructure and a committed team of medical professionals. Apollo Hospitals Bangalore provided state of-the-art facilities, including specialised recovery rooms with stringent sterile precautions and negative pressure isolation.

Dr. Kumud Dhital, Lung Transplant Surgeon, Marengo Asia Hospitals says, “In the realm of solid organ transplantation, lung transplants are the most complex. Not only from the technical surgical aspects, but more importantly from the simple facts that the lung is more susceptible to infection being open to the atmosphere, but also unlike other organs, is also more prone to stronger immunological responses and therefore at greater risk of rejection. The success of lung transplantation following surgery and thereafter into long-term survivorship of both graft and recipient relies entirely on multidisciplinary expertise comprising close collaboration between the surgeon, anesthetist, intensivist, transplant pulmonologist, infectious disease and physiotherapy specialist, pathologist, immunologist, psychologist, rehabilitation. Our responsibility to the recipient through stringent surveillance is therefore life-long.

This collaborative program with Karnataka between Apollo Hospitals and Marengo Asia Hospitals exemplifies and ensures this very necessary multi-disciplinary expertise. However, despite increased community awareness of the importance of our lungs following the COVID pandemic, and professional knowledge about the massive burden of lung disease in India, it is unfortunate that deceased donation rates remain very low in India, and patients continue to be referred too late into their disease”

Dr. Manish Mattoo – Chief Executive Officer – Karnataka Region, Apollo Hospitals said: This procedure is a testament to the advancement of medical science and the incredible skills of the medical professionals involved. Lung transplantation is a highly complex surgery that demands meticulous attention to detail and specialised expertise. By successfully completing this procedure, Apollo Hospitals Bangalore demonstrated their commitment to pushing the boundaries of medical innovation and providing life-changing solutions to patients suffering from similar conditions. It has been a privilege for Apollo Hospitals to witness this breakthrough lung transplant procedure, saving life and giving new hope to the 57 yr old. We wish to continue doing the same and giving a fresh lease of life to many more.”

When the medical cosmos against all odds brings heaven and earth together in an impossible situation, in a life-threatening crisis, to make a difference like never before!

Unique aspects of the lung transplant:

1. A last- minute save for a patient on 15L of oxygen, with imminent demise staring in the face

2. An organ which comes on a holiday- a story of 36 hours of relentless effort, culminating in successful transplant

3. The fruit of our labour comes from the power of integration- ABAPS (Apollo Bangalore Advanced Pulmonology Services)- which includes all the Pulmonology departments of Apollo hospitals Bangalore- Jayanagar, Bannerghatta and Seshadripuram, all under one umbrella

4. A unique collaborative effort between different hospitals to ensure convergence of clinical expertise and infrastructure to ensure best patient outcome.

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