57-year-old taken off oxygen support after successful lung transplant

The incidence of lung fibrosis has gone up by 15% in the last five years

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Vijay Soman (57) can now breathe and move around, without oxygen support equipment attached to his body. After a successful lung transplant at Global Hospitals, Mumbai, Soman who was suffering from interstitial lung disease, took his first steps without oxygen support.

A multidisciplinary team led by Dr Samir Garde, successfully performed the transplant on Soman and he is now able to walk 600 metres without oxygen support with ease.

Interstitial lung disease is a debilitating disease that leads to scarring of lung tissue causing the lungs to fibrose and become stiff. He was diagnosed with Idiopathic Pulmonary Fibrosis and was advised home based oxygen therapy to relieve his symptoms.

Idiopathic Pulmonary fibrosis is a rare subset of interstitial lung disease and the only definitive treatment is lung transplant.

As per doctors, Soman needed oxygen support. Due to lung fibrosis, he developed pulmonary hypertension causing the blood pressure of the lungs to go up. In such a condition, when the right side of the heart gets affected and it can even cause failure. Soman would get breathless with the slightest amount of exertion, leading to de-saturation as the oxygen level dropped.

The incidence of lung fibrosis has gone up by 15% in the last five years and the cause for it could be attributed to pollution. Soman registered with the hospital for a transplant in the month of May and was lucky to receive a donor in time for the transplant. He recovered well and could even complete a stretch of 600 metres without stopping and oxygen support post-surgery before being discharged.

In addition to all other measures that transplant recipients take, he will have to be extra cautious as lungs are directly exposed to the atmosphere, say doctors.

Dr Chandrashekhar Kulkarni, Senior Consultant CVTS and lead Heart & Lung Transplant Surgeon at Global Hospitals, Mumbai said, “Pulmonary diseases like interstitial lung disease can affect the heart if present for a longer term. We initiated a VA ECMO during the surgery to reduce the load on the heart and it helped in a faster recovery. At the time of discharge, Soman could walk unaided and without oxygen support which is significant improvement and he will recover soon.”

Since 2021, says Soman, his breathing troubles and inability to walk greatly impacted his work concentration. "Despite fear, I remained resolute in pursuing a transplant for an improved quality of life. Given the cutting-edge advancements in the medical field, one should confidently opt for a transplant without hesitation as timely treatment options are now accessible."

As per a report on the burden of chronic respiratory disease in India in the Lancet Global Health, it can be said that India has a disproportionately higher burden (32% of the global chronic respiratory disease burden), while contributing to only 17.8% of global population.

Doctors whom THE WEEK spoke to agree that lung transplantation has come of age in India. From 1999, when it first began in India to now, in a period of 22 years, we, as a nation have come a long way. Even as Covid posed a challenge for organ donation, post Covid, 25 lung transplants have been carried out in India for Covid affected lungs as per the Indian journal of thoracic and cardiovascular surgery. This includes patients whose previously normal lungs were ravaged by Covid and patients with end-stage lung disease which worsened with Covid infection.

As per research conducted by Sandeep Attawar, from the Institute of Heart and Lung transplant, Krishna Institute of medical sciences, Hyderabad, lung transplantation is gaining widespread acceptance as the preferred therapeutic option for selected cases of end-stage lung disease in India. The indications of lung transplantation are increasing with better post-operative survival, including the Covid affected lung.

The national acceptance of expanded criteria in lung donation, streamlining of the process of lung transplantation by governmental, and non-governmental organizations and significant increase in the number of organ donations in India have strengthened the lung transplantation program within the country. As per doctors, lung transplantation is still the only option that can be offered to the majority of selected end-stage lung disease patients. "However, it is a lengthy process with most of the recommendations based on International Society for Heart and Lung Transplant. Further streamlining of recipient selection will ensure better outcomes," says Attawar in his report.