Lung Transplant in Delhi, India

Early symptoms of lung failure include:

• Shortness of breath: Difficulty breathing or shortness of breath, especially during physical activities or even at rest, in more severe cases.
• Persistent cough: A chronic cough that doesn't go away and may produce mucus.

• Wheezing: A whistling or rattling sound in the chest, especially when exhaling.
• Fatigue: Increased tiredness and lack of energy may be more pronounced during physical exertion.
• Chest discomfort or pain: Feeling of tightness or pain in the chest, which can be a sign of lung distress.
• Frequent respiratory infections: An increased susceptibility to infections like bronchitis or pneumonia.
• Changes in mucus production: An increase in the amount or change in mucus colour.
• Swelling: Swelling in the ankles, feet, or legs can indicate that the lungs are not effectively removing carbon dioxide from the body, leading to fluid retention.
• Change in breathing pattern: An alteration in the breathing pattern, like more shallow breaths, can indicate lung distress.
• Cyanosis: Bluish colouration of the lips or fingernails due to low oxygen levels in the blood.

Eligibility Factors for a Lung Transplant:

• Severe lung disease diagnosis: The patient must have a diagnosis of a lung disease that is severe enough to necessitate a transplant, confirmed through comprehensive medical assessments, usually termed “End Stage Lung Disease”.
• Suitability for surgery: The patient's overall physical condition should be stable enough to withstand the rigours of transplant surgery.
• Absence of other untreatable conditions: Patients must not have other untreatable medical conditions that could complicate the transplant or recovery process.
• Commitment and understanding: A willingness to undergo transplantation and understanding and acceptance of the responsibilities involved in pre- and post-transplant care are essential.
• Age and physical fitness: While no absolute age limit exists, candidates are typically evaluated on their physiological and physical fitness rather than chronological age. In terms of numbers, age above 70 years is considered a relative contraindication for lung transplant.
• Absence of substance abuse: Candidates should have no history of alcohol or substance abuse, as these can affect both the eligibility and the success of the transplant.
• Adherence to medical regimen: A history of following medical advice and treatment plans is important, as post-transplant life involves strict adherence to a medication regimen and follow-up appointments.
• Healthy body weight: Maintaining a body weight within a healthy range for the patient's height and age, as obesity or being underweight, can impact surgical outcomes and recovery.
• No recent history of cancer: Patients typically should not have a recent history of cancer, as the immunosuppressive drugs required post-transplant can increase the risk of cancer recurrence.

Before a lung transplant, comprehensive tests and evaluations are conducted to assess the patient's overall health and suitability for the procedure. These tests are crucial to ensure the patient is a good candidate for a transplant and identify potential risks or complications. Common tests include:

• Blood tests: To determine blood group, which is needed in order to find a suitable donor. The donor needs to be of a compatible blood group. Blood tests to measure kidney and liver function, and to check for infectious diseases such as HIV, hepatitis, and others. Also blood tests to check for any antibodies in the blood that might make it harder to receive a transplant. Antibodies to tissues that are not one’s own can be formed in the setting of a previous blood transfusion, pregnancy or transplant.
• Pulmonary function tests: These tests measure how well the lungs are working, including how much air the lungs can hold and how quickly air moves in and out of the lungs.
• Chest X-ray: To examine the lungs, heart, and chest cavity. Measurements of the various dimensions of lungs on a Chest X-ray also helps in size matching with a prospective donor as size matching is very vital in lung transplant.
• Computed Tomography (CT) scan: Provides detailed images of the lungs and helps assess the extent of lung disease.
• Electrocardiogram (ECG or EKG): Records the heart's electrical activity to identify any heart-related issues.
• Echocardiogram: Uses sound waves to create images of the heart, helping doctors see how well the heart functions.
• Cardiopulmonary exercise test: Assesses the heart and lung function during exercise, which helps to determine the patient's exercise capacity and how surgery might affect it.
• Ventilation-Perfusion (V/Q) scan: Checks for any issues in the air and blood flow in the lungs.
• Right heart catheterization: Measures the pressures in the heart and lungs, essential for evaluating pulmonary hypertension.
• ● Bone density test: To check for osteoporosis, which can be a concern due to long-term use of certain medications post-transplant.

After the lungs of a compatible donor become available, the transplant candidate is called immediately to the transplant centre to prepare for the surgery. At the same time, the surgical team examines the deceased donor’s lungs to make sure they are fit for transplant. If they are, surgery on the candidate begins immediately.

Surgeons may perform either a single lung transplant or a double lung transplant. Each option has advantages and disadvantages, and the choice varies with the recipient’s lung disease and other factors. The lung transplant cost also depends on the type of procedure chosen.

A Lung Transplant surgeon makes a large incision on the chest, which varies by the type of lung transplant:

• In the case of single lung transplants, the cut is made on the side of the chest where the lung is transplanted. The duration of this surgery is about 4 to 8 hours. In most cases, the lung with the worst condition is removed.
• In the case of double lung transplants, the cut is made below the breast and reaches both sides of the chest. The worse functioning lung is removed first, and a new lung is transplanted. This is followed by removal of the other lung and then implantation of the second lung. It is called a sequential double lung transplant. The duration of this operation is about 6 to 12 hours.

Complete unconsciousness is maintained throughout the whole procedure with the help of general anaesthesia. Specific lung transplant candidates are required to go on ECMO (Extra Corporeal Membrane Oxygenation) or cardiopulmonary bypass at the time of the surgery. While on bypass, the blood, instead of the heart and lungs, is pumped and enriched with oxygen with the help of a machine.

The recovery duration of a lung transplant varies from person to person. Some patients may leave the hospital within a week. However, some stay in the hospital for two weeks or longer. The first year after the surgery is the most critical period. At this time, the patient must visit the doctor frequently and get all the chest X-rays and blood tests done in a timely manner.

From the operating room, the patient will be taken to the Intensive Care Unit, where specially trained staff will look after them. Recipients remain in the ICU until their lung function is stable, and they can breathe on their own. This takes, on average, from a few days to a week, but varies with each recipient, and can take several weeks.

Once the transplanted lungs are working fine, the patient can be shifted to the wards, and after a few days of observation and rehabilitation, planning for discharge is undertaken.

The patient and their family will be advised several days before the expected discharge date.

The first year post-transplant is crucial; during this time, the transplant team frequently sees the patient. The patient must also have blood tests, Chest X-rays and lung functions often during this period. They must strictly adhere to the medicine schedule prescribed by the transplant team.

A lung transplant can significantly enhance an individual's quality of life. Many recipients experience profound improvements, often extending their lifespan by ten years or more. This outcome is remarkably achievable when the procedure is performed at one of India's leading lung transplant hospitals.

• Reduced instances of shortness of breath
• Increased energy levels
• Fewer lifestyle restrictions
• Enhanced overall quality of life
• Prolonged life expectancy post-transplant

We recognize the profound impact that lung transplantation can have on the lives of our patients and their families. In line with this understanding, we are committed to providing each patient with the highest quality of care at every stage of the transplantation process. Here are some key aspects that establish us as one of the most reliable lung transplant hospitals in India:

Expert transplant team: Our lung transplant team consists of some of the most distinguished transplant surgeons, pulmonologists, anaesthetists, and support staff, who possess extensive experience in lung transplantation and are renowned for their expertise in their respective fields.

Advanced technology: Max Hospitals is equipped with cutting-edge technology and state-of-the-art facilities designed explicitly for lung transplantation. This includes sophisticated operating rooms, advanced imaging technologies, and a dedicated Intensive Care Unit (ICU), ensuring that our patients receive the best care available.

Comprehensive services: We offer a full range of services necessary for various lung transplants, including those from living and deceased donors, as well as specialised procedures such as paediatric lung transplantation.

Quality care: Our lung transplant program is deeply committed to quality and patient safety. We adhere to strict international standards to ensure the highest level of care throughout the transplant process, from evaluation to post-transplant follow-ups.

Compassionate approach: We understand that lung transplantation involves not only medical challenges but also emotional and psychological ones. Our compassionate approach includes providing support, guidance, and counselling to patients and their families throughout the transplantation journey.

How common are lung transplants?

Lung transplants are relatively uncommon compared to other organ transplants, but they are performed regularly worldwide.

Who is eligible for a lung transplant?

Eligibility for a lung transplant depends on various factors, such as the severity of the lung disease, overall health, and ability to withstand the transplant procedure. A comprehensive evaluation by a transplant team is necessary to determine eligibility.

What are the signs indicative of lung transplant rejection?

Signs may include shortness of breath, decreased lung function, fatigue, and fluid retention. Regular medical check-ups are crucial to monitor for rejection.

What is the average lifespan for a person after a lung transplant?

Lifespan varies, but many recipients lead active lives for many years. Median life span after a lung transplant is close to six years. Success depends on factors like overall health, adherence to medications, and the prevention of complications.

Is there an age limit for individuals seeking a lung transplant?

While age alone is not a strict barrier, eligibility is based on overall health and the ability to withstand the procedure. Each case is assessed individually.

Can a lung transplant cure COPD?

A lung transplant can improve symptoms of Chronic obstructive pulmonary disease (COPD), but it may not cure the underlying disease. Lung transplant is the only intervention that can substantially improve long-term outcomes in COPD patients with very advanced disease. Success depends on various factors, and not everyone with COPD is eligible for a transplant.

How long will I need to be in the hospital after a lung transplant?

The duration of hospitalisation varies, but it typically lasts for a few weeks. This depends on individual recovery progress and any potential complications.

Will my original lung disease come back after the transplant?

The original lung disease is replaced with the donor organ, so it does not come back after a successful lung transplant.

What is lung transplant recovery like?

Recovery involves a period of rehabilitation, follow-up appointments, and adherence to medications. Physical therapy and lifestyle adjustments may be necessary.

What will be expected of me after a lung transplant?

After a lung transplant, you are expected to adhere to a strict medication regimen, attend regular medical check-ups, and make lifestyle changes to support overall health and prevent complications. Compliance with medical recommendations is crucial for long-term success.

Reviewed by Dr. Kamran Ali, Principal Consultant - Thoracic Surgery, Lung Transplant on 25-Jan-2024.

• Guide for Treating Lung Cancer with a Pill
• Suffering from Lung Cancer-It is not your fault!
• What Are the Stages of Lung Cancer?
• The early symptoms and signs of lung cancer