Lung transplantation is a viable option for patients with chronic lung diseases which continue to progress despite optimal medical management. However, it is a big decision and is recommended by the doctor after complete evaluation and assessment, which comprises of, conducting a battery of tests (Blood, diagnostic, scans, social, financial, and psychological evaluation, etc) and consulting a multidisciplinary team of doctors depending on the condition of the patient. Basis this, transplant is recommended and explained to the patient and his/her family thoroughly to make an informed decision. Once they opt for it, the financials are discussed and are placed on a waitlist (Jeevandan/Jeevansarthakathe/TRANSTAN /NOTTO). On receiving a suitable donor and post asserting it through various tests, documentation and consent are taken followed by anesthesia and then transplant. Generally, Lung transplants can be done across people of all ages up to 65-70 years.
Dr. Sunil Kumar K
Lead Consultant - Interventional Pulmonology
MBBS, MD, DM (Pulmonary & Critical Care Medicine)
Dr. Sunil Kumar K is an established clinician and researcher in the field of Pulmonology (Chest diseases), Critical care (Intensive Care) and Sleep Medicine with over 10 years of experience in the fields. He has had extensive academic training and professional experience, in India, Germany and the USA. He practices and believes in delivering evidence-based medicine for the best care, and keeps up-to-date with the latest advances in the field. Dr. Sunil Kumar has also established a state-of-the-art Interventional Pulmonary Program at Aster CMI, Bangalore which is widely regarded as one of the best programs in the country. This has led to ground-breaking work in Interventional Pulmonology, which has been presented in various international meetings.
Dr. Sunil Kumar K did his MBBS from the JJM Medical College (Davangere), followed by MD in Internal Medicine (General Medicine) from MS Ramaiah Medical College, Bangalore.
As the fields of Critical Care and Interventional Pulmonology always fascinated him, he decided to pursue a career in the field of Pulmonology and Critical Care Medicine and completed his D.M (Pulmonology and Critical Care Medicine) from the prestigious Amrita Institute of Medical Sciences, Kochi. He has received extensive training in Pleural, Diagnostic, and Therapeutic Bronchoscopy under world-renowned interventional pulmonologists. He has also trained in Interventional Pulmonology Under stalwarts at Cleveland Clinic, Ohio, USA and Thoraxklinik, Heidelberg, Germany.
Dr. Srivatsa Lokeshwaran
Consultant - Interventional Pulmonology
MBBS, MD, FRCCM (NUH, Singapore), FCCP (USA), Fellowship in Respiratory endoscopy (NCC, Japan)
Dr. Srivatsa Lokeshwaran has over nine years of experience in the field of pulmonology. His special interest lies in airway diseases, sleep medicine and interventional pulmonology. Dr. Lokeshwaran has expertise in interventional Pulmonology and has trained with world-renowned interventional pulmonologists at Singapore in the advanced airway and pleural procedures like thoracoscopy, EBUS (Endobronchial ultrasound) and Tumor debulking and stenting and Bronchial Thermoplasty.
He has also trained at National Cancer Center (NCC) Japan, in navigation, mapping and early cancer diagnosis like radial EBUS, electromagnetic navigation and other navigation systems.
He also had a stint at Serdang Hospital, Malaysia in advanced interventions like rigid bronchoscopy, complex central airway pathologies, cryotherapy, laser and endobronchial valves. He ran asthma and airway disease clinic at National University Hospital (NUH), Singapore along with experts and has been running an asthma clinic in asthma phenotyping and advanced therapies for asthma-like targeted therapy and Bronchial thermoplasty.
Dr. Lokeshwaran is also running a state-of-the-art Interstitial lung disease clinic, one of the very few in the country to have a comprehensive ILD (Interstitial Lung Disease) multidisciplinary group. He conducts regular academic activities in ILD of national interest every year. He is also an expert in sleep medicine.
Dr. Lokeshwaran completed his undergraduate training at KIMS, Bengaluru, followed by his training in M.D. (Pulmonary medicine) from the AIMS (Kochi). He then went on to complete his Fellowship in Respiratory and Critical Care medicine from the world-renowned National University Hospital, Singapore.
He received training in advance bronchoscopy and pleural procedures under world-renowned interventional pulmonologists. He holds the distinction of being the first international fellow in respiratory and critical care medicine from NUH, Singapore. He also completed his Fellowship in Respiratory Endoscopy from the National Cancer Center, Japan, one of the premier institutes of advanced cancer management and research for the country with training in CT mapping, convex EBUS, radial EBUS, autofluorescence, photodynamic therapy, electromagnetic navigation and other advanced diagnostics and therapeutic airway and pleural interventions. The experienced doctor believes in delivering evidence-based medicine and keeping abreast of newer advances. He has worked with other leading hospitals in Bangalore carrying with his rich experience.
When your lung is not functioning well and no medicine or treatment is helping, then your doctor may recommend a single or double lung transplant basis your condition. Also, if you are suffering from serious medical condition, transplant may be advised accordingly.
The common conditions for which lung transplant is recommended include:
- Chronic obstructive pulmonary disease
- Idiopathic pulmonary fibrosis
- Cystic fibrosis
- Pulmonary arterial hypertension
- Certain hereditary conditions that affect the lung
Factors that may affect your eligibility for a Lung transplant adversely.
- Suffering from an infection
- Medical history of cancer
- Addiction to alcohol or smoking
- Serious health condition like liver, heart, or kidney disease
Maintaining a healthy lifestyle, avoid substance abuse & smoking, exercising and pulmonary rehabilitation.
For lung transplant, hospitalization ranges from 10-20 days depending on the patient condition. However, it will take few months to completely recover. First three months you are monitored for any signs of rejection, immunosuppressant’s side effects, complications, infections, and lung function. Thus, you would need to visit the doctor frequently for check-ups, scans, tests, therapy, and rehabilitation. Also, physiotherapists will be needed to chart out your exercise schedule. In addition, you need to maintain a strict diet, take medications on time, exercise, lead a healthy lifestyle and refrain from smoking and alcohol. In case you develop fever, feel pain or breathlessness you should consult your doctor immediately.
Transplant will improve your health and quality of life considerably. However, the first year will be critical due to risk of having infection, rejection, or any other complications.
If your eligible for a transplant, on completion of your evaluation and interviews, your name is listed on the regional/national organ recipient list. Based on how long the patient can live without transplant and life expectancy after transplant, a score is allocated to each patient. People with higher score are given first preference once the donor organs are attainable. It may take weeks to months to get a suitable donor.
Once the donor lung is made available, you will be intimated and soon prepared for surgery. Anaesthesia will be administered, and a tube will be inserted in the windpipe and another in the nose to empty the stomach. Catheter will be inserted to empty your bladder and you will be put on heart-lung machine to control your blood-oxygen levels. A large incision will be made in your chest and your damaged lung will be replaced by a donor lung. Once your lungs are functioning you will be moved to ICU for further monitoring. A single-lung transplant can take 5-8 hours and double-lung up to 12 hours. Once you are stable, you will be shifted to ward and put-on liquids to start with and thereafter on solid diet.
Since lung transplant is a major operation, it poses some risks. Some of them are:
- Rejection: Your body may not accept the donor lung and thus your immune system will reject it. Therefore, you need to take antirejection drugs to avoid the same.
- Infection: With medicines such as immunosuppressants there is a high possibility of developing infections.