Importance of Lungs and What is Lung Transplant

‘Hey, relax. Just breathe in and breathe out.’ All of us have said or heard this at some stage of our lives. Breathing is considered to be a relatively easy activity and rightly so, for you don’t have to teach it to even an infant. However, there is a mighty power-house behind this seemingly easy activity. Lungs are the core of the human respiratory system. They are responsible for inhaling fresh air into the body while exhaling bad gases in parallel. Oxygen enters the body through the trachea and goes down to the lungs. Each cell in the body exchanges its waste gas carbon dioxide for oxygen. The lungs are also responsible for removing this carbon dioxide from the blood.

If the importance of lungs were to be explained in 4 words, those would be: ‘No breath, no life’. It is said that when you own your breath, nobody can steal your peace. However, what happens when you no longer own your breath, when the functioning of its core is beyond your control and the sync that your body had with it since birth doesn’t exist anymore?  Advancements in medicine have helped address this concern via a concept known as ‘Lung Transplant’. It is a surgical procedure done to replace a diseased or failing lung with a healthy lung, usually from a deceased donor. Like any other organ transplant, lung transplant is considered to be the last resort for a failing lung and is only suggested after all possible treatments and lifestyle changes have failed to bring about any significant improvement. Depending on the medical condition, a lung transplant may involve replacing one or both the lungs.

When is a Lung Transplant needed?

Typical cases that demand a lung transplant include:

• Chronic obstructive pulmonary disease (COPD)

• Scarring of the lungs

• Pulmonary hypertension

• Cystic fibrosis

• Sarcoidosis

• Severe bronchiectasis

Apart from the above obvious conditions that warrant an urgent solution, lung transplant is recommended when the patient has an acceptable health/ nutrition/mental health status and would suffer from a drastically limited life expectancy in the absence of the transplant.

Eligibility for Lung Transplant

All lung transplant applications are scrutinized in detail since it may not be the most beneficial/applicable therapy in all cases. Numerous tests such as chest CT scan, pulmonary function tests and cardiac stress tests are performed during a lung transplant evaluation. A lung transplant application may be considered ineligible if you:

• Are unwilling or unable to make lifestyle changes necessary to keep your donor lung healthy, such as not drinking alcohol and/ or not smoking

• Are greater than 60/65 years of age

• Have a recent personal medical history of cancer

• Have serious life-threatening systemic diseases such as kidney, liver or heart diseases

• Don’t have a good support system

Types of Lung Transplants

• Single lung: Transplant of one lung

• Double lung: Transplant of both lungs

• Bilateral sequential/ Bilateral single: Transplant of both lungs, done one at a time

• Heart-lung transplant: Transplant of both lungs and the heart taken from a single donor

Most lungs that are transplanted come from deceased organ donors (cadaveric transplant). Living transplant includes donation of a part of the lung (called lobe) from healthy, non-smoking adults who are a good match. People who donate a lung lobe can live in a good physical shape with the remaining lungs.

Preparing for Lung Transplant

Although the emotional toll of waiting for the patient’s health to improve which desperately waiting for a transplant can be daunting and exhausting, tests suggested by the doctor should be performed at suggested frequencies and a positive, optimistic attitude must be maintained. When a suitable match is identified basis matching of blood group, lung dimensions and other parameters, the patient will be immediately called in for the surgery. The surgery includes incisions in the chest to replace the lung. Basis the complexity, this surgery lasts from anywhere between 6 to 12 hours.

Post-surgery risks

Like any other big surgery, lung transplant comes with its own share of risks. Although science has advanced vastly over the past decades, complete mastery over the human body’s functioning is something mankind has still not been able to achieve. The biggest risk of a lung transplant surgery is organ rejection. This occurs when the immune system believes that the new lung is a foreign body and considers it to be a disease. Severe rejection could lead to failure of the donated lung.

Other risks include:

• Bleeding and infection

• Cancer and malignancies due to immunosuppressants

• Kidney damage

• Severe pulmonary edema (fluid in the lung)

It is thus paramount that the patient and his/her family put utmost faith in trained and experienced medical professionals and follow their instructions with utmost care. The patient should also strictly avoid skipping any medications prescribed by the doctor pre and post surgery.

Why FORTIS?

Fortis has the highest survival rate among institutes in India that perform lung transplant surgeries. They are not wary of complex cases and consistently push their boundaries to develop their expertise and deliver better.  Since the surface area of a patient’s lungs is constantly exposed to potential airborne pathogens, it becomes more complex to extend post-surgery care to a lung transplant patient. However, at Fortis, a dedicated team of experts works closely with the patient since his/her diagnosis until discharge to ensure that utmost care is extended at all stages especially the recovery stage. The Fortis team leaves no stone unturned in keeping all up to speed by doing the right diagnosis, having detailed discussions with the patients and their families to explain the procedure in detail and then performing transplants with international standards of accuracy and success rate. Since the inception of the program in X, the Fortis team has performed X single and X double lung transplants. Infact, Fortis’ lung transplant outcomes compare favorably with not just the national average, but the global overage.