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This Hospital Completes India’s First Double Lung Transplant During COVID-19 Pandemic
The Apollo Hospitals successfully carried out the first Double Lung Transplant during the COVID pandemic in India. The Apollo Hospitals Group today demonstrated its leadership in the field of organ transplants with the announcement of the first Double Lung Transplant during the COVID pandemic in India. The patient was put on ECMO or Extra Corporeal Membrane Oxygenation to support his heart and lungs till the donor's lungs were available.
What Is A Lung Transplant?
A lung transplant is a surgical procedure which involves replacing a diseased or failing lung with a healthy lung, usually from a deceased donor [1]. The transplant is reserved for people who have tried other medications or treatments but have not reported any improvements.
The survival rate for lung transplant patients has improved in recent years, in comparison to 20 years ago. However, the survival rates vary by facility, pointing out the need to ask about the facility's survival rates [2].
Who Requires A Lung Transplant?
An unhealthy or damaged lung can make it difficult for your body to get the oxygen it needs to survive. Certain health conditions and diseases can damage your lungs and hinder their ability to function normally and virtually [3]. Conditions that can damage the lungs are as follows [4]:
•
Chronic
obstructive
pulmonary
disease
(COPD)
•
Scarring
of
the
lungs
(pulmonary
fibrosis)
•
High
blood
pressure
in
the
lungs
(pulmonary
hypertension)
•
Cystic
fibrosis
•
Emphysema
•
Sarcoidosis
In most cases, lung damage can be treated with medication or with special breathing devices [5]. In the event of these failing and posing a life-threatening risk, the individual will be directed to a transplant, where the doctor might suggest a single-lung transplant or a double-lung transplant.
A typical single-lung procedure can take between 4 and 8 hours. A double-lung transfer can take up to 12 hours [6]. In some cases, people with severe heart and lung conditions may need a combined heart-lung transplant.
What Are The Risks Involved In A Lung Transplant?
Lung transplant, being a major surgery involves certain risks. Some of the risks involved in a lung transplant are as follows [7]:
•
Organ
rejection,
which
happens
when
your
immune
system
attacks
your
donor's
lung
•
Serious
complications
can
arise
from
immunosuppressants
used
to
prevent
rejection
•
Immunosuppressants
can
raise
your
risk
of
infections,
as
your
body
has
very
low
immunity
[8]
•
Bleeding
and
blood
clots
•
Cancer
and
malignancies
due
to
immunosuppressants
[9]
•
Diabetes
•
Kidney
damage
•
Stomach
problems
•
Thinning
of
bones
(osteoporosis)
Therefore, in the case of the patient admitted in Apollo, the risks were extremely high due to the COVID-19 pandemic.
Successful Double Lung Transplant Amidst The COVID Pandemic
The double lung transplant during COVID times is an exemplary achievement. It has only been possible due to careful and cautious action from the group of doctors at the Apollo hospital, Chennai. The latest medical advances and technology has indeed contributed to the continued success of the surgery [10].
Dr T Sunder, Senior Consultant Cardiothoracic Heart and Lung Transplant Surgeon said, "Performing a transplant surgery during a pandemic presents many medical and logistic challenges to ensure the safety of recipients, family members and healthcare personnel. Safety is ensured safety via strict protocols that mandate all transplant patients to be received and managed only in dedicated areas that do not have any COVID patients."
Speaking on the critical need to be extra cautious, due to the risk of infections, the surgeon continued, "The staff looking after them are assigned to only the transplant patients, and all are checked for COVID status. Post-operatively, all parameters of the recipients are passed on to the treating doctors in real-time via encrypted software and only if a physical examination is mandated is access to a patient given. A dedicated post-operative transplant care medical team does not cross over and examine other patients, further ensuring safety. Limiting physical contact with the recipient has been a feature of our transplant team since the inception of the transplant program."
How Does ECMO Help With A Lung Transplant?
The
successful
transplant
and
recovery
also
bring
into
focus
the
success
on
the
use
of
ECMO
to
support
the
heart
and
lungs
until
transplant
or
recovery.
Recent
technical
improvements
in
ECMO
have
been
able
to
expand
the
role
of
ECMO
during
lung
transplantation
[11].
Likewise,
ECMO
is
a
treatment
that
uses
a
pump
to
circulate
blood
through
an
artificial
lung
back
into
the
bloodstream
[12].
The
number
of
patients
waiting
for
a
lifesaving
organ
transplant
far
exceeds
the
number
of
available
donor
organs,
and
the
need
for
organ
transplants
is
increasing.
When
the
patient
condition
deteriorates
while
waiting
for
a
donor
organ,
ECMO,
or
Extra
Corporeal
Membrane
Oxygenation
comes
to
the
rescue.
Similar to the heart-lung bypass machine used in open-heart surgery, the ECMO machine pumps and oxygenates a patient's blood outside the body, giving rest to the heart and lungs. ECMO acts as a bridge to recovery and bridge to transplant.
On A Final Note…
The intricate surgery shines a light on the transformations in the medical field in the event of the new normal. With hospitals and authorities standing tall against the minacious pandemic, there is hope.
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