Lung transplant- A ray of hope

Dr Syed Z Tousheed, Dr Basha J Khan, Dr BV Murali Mohan - Lung Transplant Physicians- Narayana Health City , Bangalore

Respiratory diseases are one of the largest killers across the globe. They rank second, next only to accidents in conditions causing death in the Indian population. Respiratory diseases do not only cause suffering, they also impose a huge economic burden on the nation. The picture is more devastating if the younger population or the earning members of the family are affected with these disorders. Thousands of people of all ages are victims of these terrible conditions such as chronic obstructive pulmonary disease (COPD), fibrotic lung diseases, bronchiectasis (a type of fibrocystic lung disease), or idiopathic pulmonary artery hypertension.

Labelling patients with these diseases used to be like declaring a death sentence, as they progress inexorably with time despite receiving the best available medical treatment. Fortunately, this is no longer true, at least in the developed world as lung transplantation has revolutionized the management of chronic respiratory diseases. Though India has made its mark in other solid organ transplant, lung transplant is still in its infancy . India, despite bearing one of the largest respiratory disease burdens, is lagging far behind in its lung transplant programme. India has performed less than 200 lung transplants so far, where as more than 50 thousand lung transplants have been done across the globe.

How does lung transplantation help?
•      Lung transplantation offers a potential treatment option for highly selected patients with advanced chronic lung disease who continue to deteriorate despite maximal medical therapy. Patients who are not able to do their routine work, and are barely able to walk and are dependent on oxygen therapy for a long time are the candidates who can benefit the most from a transplant.
•      In lung transplantation, the lungs (either one or both) are taken from a deceased organ donor and transplanted into the recipient. The recipient is initially thoroughly assessed for suitability for transplant  and if suitable donor is available ,transplant is performed within a narrow window of six hours after they are harvested.
•       . The lung is an active organ in the immune process, so fairly intensive immunosuppression is needed to ensure that the recipient’s immune system does not reject the transplanted lung/s. As a result of which the recipient is potentially exposed to infective organisms through the air we breathe.
•      Lung transplant not only involves expertise from the medical aspect but also requires tremendous support and commitment from the family.
Though it was a big challenge to start the lung transplant program and is going to be a challenge to sustain in the existing conditions in Karnataka and our country, Narayana Hrudayalaya has taken this giant step to help patients who suffer from relentlessly progressive lung disease and have no treatment alternatives.