Lung Transplantation is the last option meant to be considered for End-stage Lung diseases when the patient goes into irreversible persistent lung failure and become oxygen dependent.
Extensive Interstitial Lung Fibrosis (ILF), Late Stage COPD/Emphysema are two of the most crippling late-stage Lung diseases for which Lung Transplant has been employed worldwide with gratifying results. Quality of life improves considerably. One, five and ten years mortality indices post Lung transplant have also steadily improved over the past couple of decades; one-year mortality has improved over 85%, five years over 55%-60%—longest living Lung Transplant survivor is almost 30 years.
Other Lung diseases where successful LTx is being performed are:
The traditional age group for Lung Transplant is 65 yeas. However, much older patients have been subjected to successful LTx. In most conditions, double Lung transplant is preferred but sometimes we have to make do with a single Lung transplant in certain select conditions with almost equally good results with almost similar quality of life.
Like in all organ transplants, rejection and infection are the two most important post-operative complications and the dedicated transplant critical Care team has to continually watch out for them. The immunosuppressive drug levels also have to be monitored very carefully and repeatedly.
The technique of Lung Transplant has been adopted in India, also much the same way as North America and Europe and the results have been good. Deceased organ availability has been an issue. The registries for end-stage Lung decease cases have also not been upto the mark in various states of India. There is a need for improvement in co-ordination so that maximum available organs ( lungs ) are utilized well in time when they are available, and the families of the deceased have given the consent for organ transplantation.
We go for detailed pre-operative workup of the patient to see if he/she is too early or too late a candidate for lung transplant. Initial workup and if needed rehabilitation is started to see if the candidate is good for listing for lung transplant. Getting listed is the first step to fall in queue as a possible donor recipient.
Dr. Kanwar received his training for lung transplant at Toronto which is famous for doing the maximum successful lung transplant cases in the world.