Lung Transplant Program

You have arrived at this page as you have been referred to Lotus Hospital for either a lung or heart-lung transplantation. Lung Transplantation is a gift of life made possible by the altruistic donation of lungs from brain-dead patients by their relatives despite their immense grief at the loss of their loved one at that time. Our mission at Lotus Hospitals is to treat each donation as a precious chance of life and maximize the chance that this opportunity provides at a second chance for another person. For people with end-stage lung disease, a lung transplant offers better hope of survival and long-term quality of life to the recipient. In this procedure, one or both healthy lungs taken from the body of a brain-dead person is transplanted into the recipient’s body.

Lotus Hospitals, one of the leading Hospital chains in South India, have been at the forefront of high-quality, modern therapies and treatments, and has a strong research orientation. Patients from across India who are undergoing sophisticated procedures such as a Lung Transplant can benefit from the experience and expertise that our dedicated panel of experts bring to the area of Transplant and post-transplant care.

Once the patient has made a choice in the favor of transplant, it is a life-long commitment to take good care of the new lungs and overall health. Lotus Hospital will be with you at every step in helping you achieve this. This booklet is the first step in addressing some of your concerns and the Transplant team will be discussing most of the relevant issues with you in detail during the evaluation and listing process.

Lung Transplant Hospital in Erode – The Lung Transplant Team

Lung Transplant is a sophisticated procedure that requires a team of specialists to orchestrate the entire process right from the time the patient walks into our hospital, to the rehabilitation post-transplant and thereafter. Our Transplant team at Lotus includes:

• Transplant Pulmonologist: He is the expert who specializes in lung disease and lung transplantation. He will conduct the various tests required, evaluate the results, review your past medical history, and then conclude if a transplant is the best option for you. Post-transplant, he will provide most of the follow-up care
• Transplant Surgeons: As the name implies, these are specialists who will actually perform the transplant surgery. Before the procedure, they will educate you on the procedure and the risks involved, to help you decide if a transplant is the best option for you.
• Transplant Coordinator: Acting as a single point of contact for you and your family, the Transplant coordinator is involved right from the evaluation process, educating you on the test results, the transplant schedule, the surgery and recovery processes. He will coordinate all care, before and after the transplant.
• Transplant Medical Secretary: She is required for seamless communication between you and transplant team. She will answer and prioritize phone calls from both parties and ensure lab results are shared with the concerned members of the team.
• Medical Psychologist: As the name implies, this person specializes in human behavior. She will assess how well you understand the transplant process and its impact on your life, your past history of use/abuse of substances and all those factors that can affect a successful outcome. She will also suggest therapy before and after transplant if the need is felt.
• Transplant Physiotherapists: These specialists will assess your musculoskeletal system and your ability to exercise. This is crucial as an inability to perform rehabilitation prior to transplant will disqualify you from transplant unless we can make some progress. Their role post-transplant is to recover the loss of muscle and energy related to surgery and get you as strong as possible once your new lungs start working. They will also suggest structured, ambulatory in-hospital observed rehabilitation program and coordinate home-exercises for you that will increase your strength and endurance in order to prepare you for the transplant. Post-transplant, they will monitor your activity and make suggestions as needed.
• Transplant Dietitians: They will address your nutritional needs before and after transplant. This is important as a healthy weight at the time of transplant is crucial for a positive outcome. Low or high weight relative to your height can be reasons to decline a transplant till your goals are met.

The Transplant Team at Lotus Hospital will work closely with you and your family to ensure a positive outcome. You are free to ask them any query at any time.

Why is a lung transplant required?

Oxygen is the life-force that supports us and is present in the air that we breathe-in. The lungs take in oxygen from the air and give up carbon di-oxide. Blood acts as a carrier transporting oxygen-rich blood from the lungs to the rest of the body. In people with lung disease, this gas-exchange begins to deteriorate. When medication cannot cure the condition causing lung disease, the lung(s) can fail, and this is usually life-threatening. The following conditions are common causes of irreversible lung failure in some patients:

Transplant Medical Secretary: She is required for seamless communication between you and transplant team. She will answer and prioritize phone calls from both parties and ensure lab results are shared with the concerned members of the team.

• Chronic obstructive pulmonary disease (COPD)
• Idiopathic pulmonary fibrosis and Familial Lung fibrosis
• Progressive Pulmonary fibrosis caused by connective tissue disorders and hypersensitivity pneumonitis
• Bronchiectasis: Airways in the lungs get damaged, making it hard to empty mucous and is associated with repeated infections and blood in sputum
• Pulmonary hypertension, or high pressure in the lungs
• Sarcoidosis

Types of Lung Transplant

The Transplant team will evaluate which of the following is most suitable for you:

• Single lung: Generally, one healthy lung is enough to live a normal life. In some patients, we choose to transplant either one of your diseased lungs. This choice is often made for medical reasons
• Double lung / Bilateral: This is increasingly the choice in younger patients with end-stage lung disease
• Bilateral sequential: Bilateral lung transplantation (discussed above) is done one at a time. An ECMO which provides artificial lung-support may be used during the procedure to support oxygen in the blood while the lungs are being attached to your heart.
• Heart-Lung transplant: In this, both the lungs and the heart from the same donor are transplanted into the recipient. This is done for very specific medical reasons.

Based on Donor type

• Cadaveric: The lung(s) is/are donated from a person who is brain-dead and his/her family have altruistically offered his/her lungs for another’s second shot at life. The process of lung allocation is done by the government.
• Living: Healthy, non-smoking adults who are a good match can donate a part of one of their lungs, and still live a healthy life afterwards. Generally, two people are needed for one person and this is less commonly done.

Preparing for the Transplant Evaluation

By now, all preliminary discussions about the eligibility of transplant would have been discussed with the patient and the transplant team would have decided that there is no medical therapy available for your lung disease. Next the Transplant team will need to decide whether you have any conditions that can cause problems during transplantation and whether you need a single, bilateral or heart-lung transplantation.

This is accomplished during your transplant evaluation. At this stage, it is important to prepare logistics:

• Choosing a date for the Evaluation tests: The medical secretary and social worker will work with you and plan an admission for four working days
• How many and who among your family members to be involved
• Compiling and bringing all your medical records, including CT scan images
• Planning the Travel: You need to coordinate with our medical secretary to confirm availability of beds as per your desired date of travel and freeze the travel schedule accordingly
• Planning for Oxygen Needs: Oxygen supply must be adequate for your entire travel to our Hospital. If you are planning to stay locally after your evaluation till the transplant, the logistics of continuing oxygen supply and accommodation will be coordinated by the MSW
• How many and who among your family members to be involved.