Introduction To Lung Transplantation

Lung Transplant is a surgical procedure in which diseased lungs are partially or fully replaced from those of a donor. It is done to enhance the quality of life and to treat chronic lung conditions. Depending on your medical condition, the procedure may involve the replacement of either of your lungs or both of them. There are cases when the lungs may be transplanted along with a donor’s heart.

What Health Conditions Require Lung Transplantation?

Lungs are the primary and vital organs of the respiratory system. Unhealthy lungs make it difficult for the body to get the amount of oxygen it needs for survival. There are various conditions that can damage your lungs and do not let them function effectively. They are:

• Sarcoidosis: Tiny collections of inflammatory cells form in the lungs leading to breathing difficulties.
• Chronic obstructive pulmonary disease (COPD): A chronic lung disease that blocks the airflow in the lungs making it difficult to breathe.
• Pulmonary Hypertension: It is a type of blood pressure that blocks arteries in the lungs.
• Pulmonary fibrosis: A group of lung diseases that is characterized by scarring of the lungs and affects the respiratory system.
• Cystic Fibrosis: An inherited, life-threatening disorder that causes damage to the lungs, digestive system as well as other organs of the body.

Types Of Lung Transplant — Organ Transplantation

• Single Lung Transplant: This process involves the transplant of either of the damaged lungs.
• Double Lung Transplant: This is a case when both lungs are damaged and need a transplant of lungs.
• Bilateral Sequential Transplant: This process is also called a bilateral single process which involves the transplant of both lungs, done one at a time.
• Heart-Lung Transplant: This is a case of transplant of the lungs and heart from a single donor.

When the lungs transplanted come from a deceased organ donor, then the process is called a cadaveric transplant. Healthy and non-smoking adults are also good donors and can donate a part of their lungs which is called a lobe. This transplant is called a living transplant.

What Are The Factors That May Affect Your Eligibility For A Lung Transplant?

A lung transplant isn’t an appropriate treatment for every candidate who has lung disease. There are certain factors that may not allow you from being an eligible candidate for undergoing a lung transplant such as:

• An ongoing infection
• Family history of cancer
• Having other serious diseases such as heart or liver diseases
• Not willing to switch to a healthy lifestyle and adopt healthy habits

Legal Requirements For Lung Transplant!

• The donor and recipient would have to stay in India for 2–3 weeks. The process starts with an authorization committee interviewing both the donor and recipient before giving final approval for the transplant.
• The donor and recipient must carry their affidavits, No Objection Certificate, or a consent letter from their Embassy in India with a statement that the donor is donating the organ voluntarily and there is no exchange or compensation for the transaction.

Note: The above cost of pre and post-transplant logistics will be carried by the patient/attendant.

How To Prepare For A Lung Transplant in India: Taking The First Steps!

If your doctor recommends you lung transplant, then there are certain things to consider and they are:

• You will likely start with selecting an appropriate transplant center that comes under your insurance plan.
• Check how many transplants the center performs annually and its success rate.
• Check whether the center provides additional services such as nearby accommodation for your recovery period, travel arrangements, and other information as per convenience.

Once you have made your mind about undergoing a lung transplant, you will likely go through a rigorous evaluation process such as:

• Diagnostic Tests and Procedures: This includes X-rays, CT scans, ultrasound, lung biopsy, pulmonary function tests, dental exams to examine the overall health and lungs status. Women are likely to undergo Pap tests, mammograms, and gynecology evaluations.
• Blood Tests: These tests are performed to find an appropriate match. This improves the chances of organ acceptance.
• Quit Smoking: If you smoke, then you have to quit smoking as soon as you can.
• Other Evaluation Tests: Lung transplant is a complex process and this includes stress and financial issues. There should be thorough support from the family and friends to avoid any negative outcome on this transplant.
• Other Additional Preparations: Proper dose of immunization to lessen the chance of infections that can impact the transplanted lung.

Waiting For A Lung Donor

The next step is the transplant center registers your name on a waiting list. It is unfortunate that the number of people waiting for a donor far exceeds the number of donors available and people die before the turn comes.

While your name is registered, your transplant team closely monitors your overall health at regular intervals and treats you with alternate medications. You may need to follow a healthy lifestyle, intake of healthy diet, avoiding tobacco, quit smoking, and do regular workouts. You may also participate in a pulmonary rehabilitation program that helps to enhance your breathing difficulties.

What To Do When You Find A Donor

When a donor is available, the specific criterion is to be followed for the best outcomes. This includes:

• Blood type
• Organ size compared with the chest cavity
• Recipient’s overall health
• Where the donor is from

What Happens During The Lung Transplant Procedure

Before the transplant process begins, the team will explain the process either to you or your family member and answer your queries if you might have any. Your doctor will ask you not to eat or drink for eight hours before the surgery. Below is the usual procedure explained which is followed by the transplant team:

Step 1: General Anesthesia: As lung transplant is a complex surgical procedure, the doctor injects general anesthesia so that you will not sense anything or awake throughout the surgery.

Step 2: Ventilator Support: Lungs are the vital organs in the respiratory system and in this case, they are being treated. Therefore, your doctor will put you on ventilator support to help breathe, medicate you for other bodily functions.

Step 3: Incision: The surgeon now cuts and opens the chest along with the main airway and blood vessels.

Step 4: The Removal Step: Now, the surgeon removes the diseased lung.

Step 5: The Actual Step: The doctor connects the healthy organ, reconnects the blood vessels, and stitches the cut.

Lung Transplant Process: Postoperative Complications Associated With The Transplantation!

Like every major surgery, a lung transplant also has its share of complications. This may include:

• Bleeding
• Infection
• Fluid accumulated in the lungs, severe pulmonary edema
• Formation of blood clots
• Organ rejection
• Blocked airways
• Blocked blood vessels to the transplanted lung

Post-Lung Transplant Surgery: What To Follow

After the surgery, you will be shifted to the intensive care unit (ICU). The doctor will put you on a mechanical ventilator and tubes in your chest that help drain the accumulated fluid from around your lungs and heart.

As your health improves, the doctor will remove the ventilator and you can breathe on your own. The stay in the ICU and the hospital room may vary according to the recovery period.

Once you start recovering, the doctor may discharge you. However, the doctor will closely monitor your health and you have to visit the transplant center for regular follow-ups. During this period, you will have to stay near to the center. After your visits become less frequent, you may travel back and forth from your original place for follow-up visits.

The follow-up visits include chest X-rays, pulmonary function tests, electrocardiogram (ECG), and lung biopsy to check how much you have recovered.

Your doctor may also recommend joining a pulmonary rehabilitation program for improving your breathing effects.

Resuming Life After Lung Transplant

• Regular Follow-up Visits: You will likely visit for the next three months for regular check-ups and monitoring as instructed by the transplant team.
• Immunosuppressants: There are chances that your body may take a transplanted lung as a foreign body and attack it. To avoid such conditions, the doctor prescribes immunosuppressants for the rest of your life.
• Healthy Lifestyle: Following a healthy lifestyle, practicing hygiene, no-smoking rules, and adopting healthy eating habits become a part of your routine after a lung transplant.

Success Rate And Life Expectancy After Lung Transplantation

• The ratio of medicine progression is directly proportional to the life expectancy of patients after lung transplant. In other words, as the patient makes a quicker recovery, the life expectancy becomes more.
• The success rate after undergoing lung transplantation is approximately 87%.
• The one-year survival rate is believed to be around 80% while the five-year survival rate is up to 50%.

What Is The Average Cost Of Lung Transplant In India?

Procedure

Hospital Stay

Cost

Pre-transplant procedure — Recipient

5–7 days

USD 9,000 or depends on the patient’s overall condition

Initial workup for the donors

On OPD basis

USD 3,000 per donor

Live Lung Transplantation — Recipient

Upto 21 days

USD 60,000

Transplant cost for the donors

Upto 6 days

USD 11,000 — USD 13,000

Post-transplant follow-up care

On OP basis actuals

USD 1,000 — USD 2,000 actuals

Note:

1. The above-estimated cost of lung transplants in India may change as per the patient’s condition.
2. The pre-transplant procedure includes the patient’s admission to the hospital, room rent, pharmacy charges, doctors’ fees, tests, and diagnostic procedures.

What Are The Factors Affecting The Cost Of Lung Transplant In India?

The Cost of Lung transplants in India is comparatively less as compared to other developed countries across the world. Patients should check with their insurance companies whether they have coverage plans for organ transplantation. The cost of a lung transplant depends on the following factors:

• Patient’s overall condition
• Hospital infrastructure
• Recovery procedure and Rehabilitation
• Hospital stay and type of room selected
• Surgeons’ fees, their teams, and nursing personnel
• Postoperative follow-up visits
• Medications

Patients who have traveled from another city or country need to consider the cost of stay in the new city. Most patients and their family members find accommodation near to the hospital. This also adds up to the total cost.

Why Opt For Lung Transplant In India?

Medical Tourism in India is booming due to reduced treatment costs, availability of the latest medical technologies, qualitative health care meeting international standards, highly trained medical personnel. One of the best factors is doctors are well-trained in western countries and therefore, international medical tourists do not face a language barrier in India. Medserg Health communicates with patients and bridges the gap between them and medical staff by providing information right from traveling to treatment and assisting throughout their medical journey.