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From undertaking the initial Lung Transplant in India, what has changed more than a decade?

All the healthcare and surgical advances have led to improved, more quickly and speedier recovery for patients who obtain Lung Transplantations

“Lung transplantation is the definitive treatment for end-stage Lung disease but it took several decades of experimental studies and clinical attempts to reach this success.” Said Dr. Jnanesh Thacker, Program &amp Surgical Director – Heart, Lung, Heart &amp Lung Transplantation &amp Assist Devices, Yashoda Hospitals Hyderabad.

Jayshree Mehta, a 41 year old homemaker from Vile Parle, Mumbai was the initial Indian to get the First Lung Transplant in India effectively on 11th July 2012, and this surgery was completed by Dr. Jnanesh Thacker, also identified as the Pioneer of Lung Transplantation in India. This occasion served as a catalyst to start the development of Lung Transplantation applications in the nation. Back then, the main challenge was that there have been quite handful of organ donations. In Mumbai in the year 2008, there have been only 31 donations in the preceding 15 years, whereas in Tamilnadu there have been 496 donations in the last 5 years, which is 16 instances more in comparison to Mumbai and any other State in India.



In 2008 The British Medical Journal carried a caricature column wherein a medical professional though advising a patient stated, ‘You need a Kidney transplant? Go to Madras, it is the kidney market of the world’. And as a result started an outrage amidst senior officials of the government in Tamilnadu. In a 3-day conference with all healthcare administrators and selection makers for Transplants, the government addressed the require for a robust Cadaver Transplant Program. Furthermore, the government of Tamilnadu issued 8 government orders (GO’s) to enhance this system. Due to the transparent and equitable distribution of organs, the state managed to raise their Transplants manifold.



What has changed for Lung Transplantations in the last decade?

Medical progress

Several advancements have taken spot to make Lung transplantation a secure operation for patients with finish-stage Lung illness. Medical interventions with progressive improvement in anti-rejection medication have enabled physicians and surgeons to assure an uncomplicated recovery post-surgery. Better intensive care monitoring technologies, such as Cardiac output monitor which measures the quantity of blood pumped by the heart Pulse oximeter aids to have improved solutions to measure oxygen implants sophisticated blood gas machines to measure oxygen, carbon-dioxide, acid and alkalinity of blood.

Surgical progress

Not only Medical but Surgical advancements have occurred in the last decade, for instance the introduction of Extra corporeal oxygenation membrane (Artificial Lung). It assists in keeping oxygenation when the transplanted Lungs are recovering from an injury, or when the patient’s breathing collapses (i.e. Lung failure).

Hospitals have access to improved preservative options to preserve the donated Lung with a new answer named Perfedex (a Dextran based answer, a substance which has greater osmotic stress i.e. greater concentration answer).

Technology progress

There has been an improvement in the top quality of sutures like polypropylene which can stay inert with no causing any reaction in the body for duration of one hundred years. With advance in surgical procedures surgeons are in a position to tailor the lung to match the size of the chest cavity. Hence, this has led to the usage of stapler made of Titanium in triple rows of varying depth for improved preservation of the blood provide to the reduce-edges of the Lungs. Recent advance of Double-Lung transplantation has shown enhanced 5-year survival, because prior to the last decade about the early 2000’s surgeons have been replacing only single lungs for fibrotic ailments. But today, Double Lung Transplants patients are in a position to survive beyond 5 years with fantastic ease.

Recovery price progress

Recovery price is accelerated by improved surgical procedures, and improved post-operative care which is prevalent only in the existing decade. All the healthcare and surgical advances have led to improved, more quickly and speedier recovery for patients who obtain Lung Transplantations.

Survival with no a Lung Transplant

Dr. Jnanesh Thacker explains, “Most patients coming to me ask me if they can be managed medically instead of having a Lung Transplant. The fact is that these patients with End-stage Lung disease have only 10% chance of being alive for 1 year as compared to 10% chance of being alive for 20 years with a Lung Transplant operation.”

Emergence of Air Ambulance for Lung Transplants

In the COVID era the spotlight has shifted to the urgent require for Lung Transplants and ECMO i.e. Extra corporeal membrane oxygenation (Artificial Lung). There are a handful of Lung Transplant applications in the nation, which are mostly restricted to Maharashtra, Tamilnadu and Telangana. Hence, patients from unique geographies in India are airlifted and transported to these Lung Transplant centres. Similarly organs also require to be transferred from unique places to these centres for effective Lung Transplantations. This burden has improved and the require of the hour is to have chartered planes and helicopters for such Transplant emergencies.

What desires to transform to execute more Lung Transplants in the future?

The field of Lung Transplantation has made various important advances in the last 9 years, ever because the initial Lung Transplant in India on an Indian patient in 2012. Despite these advancements, the morbidity and mortality price continue to stay higher for Lungs as compared to other strong organ transplants. Challenges pertaining to donor shortage continue to prevail and should be prioritised, which demands people today education to accept organ donation as a norm, and this can take spot with generating awareness amongst the citizens of the nation by permitting organ life beyond death. Organ awareness applications should be introduced in communities, religious institutions, schools, colleges, and all associations of the lay and the discovered. Such modifications inside our society will deem to have a important influence on shaping the field of Lung Transplantation in the post-Covid era.

(The author is Program &amp Surgical Director – Heart, Lung, Heart &amp Lung Transplantation &amp Assist Devices, Yashoda Hospitals, Hyderabad. The write-up is for informational purposes only. Please seek the advice of wellness specialists and healthcare pros ahead of beginning any therapy or medication. Views expressed are individual and do not reflect the official position or policy of the TheSpuzz Online.)



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