Lung Transplant

A Lung Transplant is a surgical intervention performed to substitute a damaged or failing lung with a healthy one, typically sourced from a deceased donor. This procedure is typically considered for individuals who have previously attempted medications or alternative therapies without achieving significant improvement in their conditions.

Depending on the individual's medical status, the transplant may entail the replacement of either one lung or both lungs. In certain cases, the transplantation of lungs may occur simultaneously with a donor heart.

While a lung transplant is a major surgical procedure associated with several potential complications, it has the potential to substantially enhance both your health and overall quality of life. When you are with the decision of undergoing the transplant, it is essential to familiarize yourself with the whole process, the surgical procedure itself, potential risks involved, and the necessary post-operative care.

Why is Lung Transplant needed?

Unhealthy or impaired lungs can hinder your bodys ability to obtain the necessary oxygen for survival. In many instances, lung damage can be managed through medication or specialized respiratory devices. However, when these interventions are no longer effective or when your lung function reaches a critical, life-threatening stage, your healthcare provider may recommend either a single-lung transplant or a double-lung transplant. In certain cases, individuals with severe heart and lung conditions may necessitate a combined Heart-Lung Transplant.

The primary causes that necessitate Lung Transplant are:

• Chronic obstructive pulmonary disease (COPD), which includes emphysema
• Scarring of the lungs, known as pulmonary fibrosis
• Cystic fibrosis
• Elevated blood pressure within the lungs, referred to as pulmonary hypertension
• Severe coronary artery disease to restore blood flow to a blocked or narrowed artery in the heart, in addition to a lung transplant.

Prior to undergoing a Lung Transplant, you will undergo a comprehensive pre-transplant assessment, which serves as the initial step in determining the suitability of your treatment. This assessment may include:

• Your overall examination to ensure physical well-being to undergo transplant
• Your family's medical history recording
• Medication history, particularly for blood thinners
• Recent computed tomography (CT) scans and chest X-rays
• Blood examinations
• Tissue typing, which ensures compatibility between your body tissues and those of the lung donor
• Pulmonary function assessments
• Ventilation-perfusion scans, measuring blood flow to your lungs and the distribution of air in each lung
• Cardiac evaluations, encompassing electrocardiograms, echocardiograms, and cardiac catheterization
• Sigmoidoscopy or colonoscopy
• Bone density assessments (DEXA scan)
• For women and individuals assigned female at birth (AFAB), Pap smears and mammograms will be conducted, while men and individuals assigned male at birth (AMAB) will undergo a prostate examination

Upon confirmation by your healthcare providers that you meet the criteria for a lung transplant, you will be placed on a national lung transplant waiting list. However, the considerable number of individuals awaiting lung transplants, your placement on the waiting list may extend for several months or even years. To be matched with a suitable donor, the following factors must align:

• Blood type
• Similar lung size

During Lung Transplant, you may expect following:

• Anesthesia: Your doctor will insert an intravenous (IV) line into a vein in your arm or hand. This IV will administer anesthesia to ensure you are unconscious and pain-free during the procedure. Concurrently, they will monitor your heart and blood pressure using an electrocardiogram (EKG).
• Body Positioning: The positioning on the operating table may vary depending on the type of transplant required. For single lung transplants, you may lie on your back or side, whereas double lung transplants or heart-lung transplants typically involve lying on your back.
• Preparation for Transplant: Once you are under anesthesia, your healthcare team will connect you to a mechanical ventilator to assist with breathing. Additionally, they will insert a urinary catheter into your bladder to collect urine produced during the procedure. In some cases, your procedure may necessitate the use of a miniature heart-lung machine known as ECMO (extracorporeal membrane oxygenation). ECMO facilitates bypassing blood flow to your heart and lungs, pumping blood throughout your body, and effectively replacing carbon dioxide with oxygen to maintain tissue health.To prepare the surgical area, your healthcare providers may shave your chest and disinfect your skin with an antiseptic to eliminate bacteria.
• Incisions: For a single lung transplant, your healthcare provider will make an incision on the side of your chest containing the damaged lung using a sterile scalpel. In certain instances, a single lung transplant may be performed through an incision in your breastbone, similar to heart surgery. In the case of a double lung transplant, a horizontal incision will be made across your entire chest, beneath your breast tissue, using a scalpel. Alternatively, a sternotomy incision, like that used in heart surgery, can also be employed for a double lung transplant.
• Transplantation: Your healthcare team will remove the diseased or damaged lung and replace it with the donor's lung. They will connect your blood vessels and airways using precise surgical techniques, ensuring proper blood flow (vascularization) to the transplanted lung to sustain tissue viability.
• Drainage: Once your healthcare providers have confirmed adequate blood flow and air passage to the transplanted lung, they will insert small silicone tubes in the surgical sites to drain excess blood, fluids, and air from your chest. These drainage tubes also assist in the full expansion of your new lungs.
• Closure of Incisions: Subsequently, any equipment used during the surgery will be disconnected, although the mechanical ventilator and catheter will remain in place. Finally, your incision will be sutured closed, and bandages will be applied to the surgical areas.

A Lung Transplant carries several potential risks, which encompass:

• Surgical risks: Like all surgeries, it also presents inherent risks, including complications related to anesthesia, excessive bleeding, blood clot formation, unfavorable scarring, infection, and, in rare cases, even mortality.
• Transplant rejection: Your immune systems primary role is to protect your body from harmful foreign invaders such as bacteria, viruses, parasites, and fungi. Transplant rejection occurs when your immune system mistakenly identifies the transplanted lungs as foreign invaders and mounts an attack against them. This form of rejection, known as acute rejection, is most common within the first 12 months following surgery. Fortunately, acute rejection can typically be reversed with additional immunosuppressive medications. However, there is another type of rejection, chronic rejection, which can affect some individuals more than three years post-transplant. Chronic rejection is challenging to treat and can lead to severe complications, including death or the need for a repeat transplant. Consequently, lifelong immunosuppressive drug therapy is necessary to reduce the risk of your immune system attacking the newly transplanted lung.
• Infection: Although immunosuppressive drugs are essential to prevent rejection of the transplanted lung, these drugs also weaken your immune system's ability to defend against infections. Consequently, you face an elevated risk of developing potentially severe infections affecting the blood, skin, respiratory system, and other areas while on immunosuppressive medication.

After the Lung Transplant procedure, you may expect following:

• ICU Care: Following the surgery, you will undergo an initial recovery period within the hospital's intensive care unit (ICU). During this phase, a mechanical ventilator will assist your breathing for a few days, while tubes in your chest will drain fluids from around your lungs and heart. Pain management and prevention of lung rejection will be facilitated through a vein-delivered regimen of potent medications immediately after the surgery.
• In-Hospital Care: As your condition progresses positively, you will no longer require the mechanical ventilator, and you will be relocated from the ICU. The duration of your hospital stay during the recovery period typically ranges from one to three weeks, although this stay may vary according to circumstances.
• Post-Discharge Monitoring: Upon discharge from the hospital, you will need to undergo approximately three months of frequent monitoring by the lung transplant team. This is crucial for the early detection, prevention, and treatment of potential complications, as well as for the assessment of your lung function. During this initial monitoring phase, it is generally advisable to remain in proximity to the transplant center.
• Follow-Up Plan: Subsequently, follow-up visits tend to become less frequent, allowing for travel back and forth as needed. These follow-up appointments may encompass a range of evaluations, including laboratory tests, chest X-rays, electrocardiograms (ECGs), lung function assessments, and periodic lung biopsies. A lung biopsy, conducted during a bronchoscopy, involves the removal of small lung tissue samples to examine for signs of rejection and infection.
• Complication Monitoring: Your transplant team will closely monitor your progress and assist you in managing any side effects associated with immunosuppressive medications. Vigilance for infections will also be a priority, with potential prescription of antibiotics, antiviral drugs, or antifungal medications to mitigate infection risks. Furthermore, your transplant team will offer guidance on infection prevention practices to adopt at home. Additionally, continuous surveillance for signs or symptoms of rejection, such as shortness of breath, fever, coughing, and chest congestion, will be an integral part of your post-transplant care.

After your Lung Transplant, you will typically need to make enduring adjustments, including:

• Uninterrupted Intake of Immunosuppressants: It will be necessary to take immunosuppressive medications throughout your life to suppress your immune system and prevent rejection of the transplanted lung or lungs.
• Lifelong Care Plan: Your doctor will provide you with post-transplant instructions to adhere to. It is crucial to strictly follow these instructions, including taking all prescribed medications as directed. Regularly monitoring your lung function at home as per your provider's guidance is essential. Additionally, attending scheduled follow-up appointments and adhering to a lifelong care plan is of utmost importance.
• Healthy Lifestyle: Adopting and maintaining a healthy lifestyle is pivotal for the well-being of your newly transplanted lung. Your healthcare provider may advise you to abstain from using tobacco products and limit alcohol consumption. Incorporating a nutritious diet into your routine can also contribute to your overall health.
• Physical exercise: It is a crucial aspect of your rehabilitation following the transplant and should commence within days of the surgery. Your healthcare team will collaborate with you to tailor an exercise regimen suitable for your needs. Furthermore, your doctor might recommend pulmonary rehabilitation, which combines exercise and education to potentially enhance your breathing and daily functionality after the transplant.
• Emotional Support: The introduction of new medical therapies and the stress associated with a lung transplant may lead to feelings of overwhelm. Many individuals who undergo such treatments experience these emotions. If you find yourself feeling stressed or overwhelmed, it is advisable to confide in your healthcare provider. Transplant centers often offer support groups and additional resources to assist you in managing your emotional well-being alongside your medical condition.

A Lung Transplant brings about significant improvements in your overall quality of life. Following facts exhibit how successful this procedure is for lung patients:

• Extended Lifespan: This procedure substantially increases your life expectancy. Approximately 55% of lung transplant recipients exhibit a survival rate of at least five years post-transplant, with some individuals continuing to thrive for up to 10 or even 20 years.
• Enhanced Vitality: Many recipients experience a notable boost in their energy levels, enabling them to engage more actively in daily activities. These activities may encompass exercises and various physical pursuits.
• Ability to conceive: After this procedure, it is safe to consider pregnancy. Numerous women and individuals assigned female at birth (AFAB) have reported an enhancement in their fertility following the transplant.

The cost of Lung Transplant in India are quite affordable than many Western nations, while still maintaining world-class quality. The approximate price of this procedure in India ranges from ₹12,31,841 - ₹27,43,075 ($15,458 to $34,422).

Comparison of cost of Lung Transplant with other western countries:

Following are the factors affecting cost of Lung Transplant in India:

• Out of pocket expense
• Health insurance coverage
• Consultation fees
• Pre-Surgical expenses
• Severity of lung damage
• Surgery cost
• Hospital fees
• Doctor fees
• Patients age
• Type of procedure
• Overall health status of the patients
• Complications involved after the surgery
• City where hospital is located

The cost for diagnostic tests and evaluations linked to lung transplant can fluctuate due to several factors. These factors include the particular tests needed, your choice of healthcare facility or clinic, and your geographical location. The following is the approximate diagnostic cost split for this surgery: 

MedFlick, your trusted healthcare companion, is dedicated to ensuring that your medical journey goes as smoothly and successfully as possible.

• Individualized Guidance: Personalized guidance throughout your medical journey.
• Access to a broad network of prominent hospitals, top doctors, and skilled surgeons.
• Transparent and Competitive Pricing: A full breakdown of treatment costs that eliminates surprises and offers you cost-effective solutions.
• MedFlick provides everything from travel arrangements to hotel and visa help to lodging.
• Multilingual Support: Breaking down language barriers to allow patients and medical professionals to communicate more effectively.
• The road to a successful Lung Transplant is long and challenging, full of hope, resilience, and the promise of a brighter future. With MedFlick as your guide, navigating this life-changing adventure becomes simple and liberating.