Department of Lung Transplant, BGS Gleneagles Global Hospitalss Mumabai
Lung transplant is a surgical procedure for replacing a diseased or failing lung with a healthy one, generally coming from a deceased owner. BGS Gleneagles Global Hospitals is one of the best hospitals for lung transplant in Bangalore.
It is a dedicated centre for different procedures in lung transplantation. Lung transplant is specifically for people whose condition doesn't improve despite medication. It involves replacing one lung or, sometimes, both the lungs. Sometimes, the lungs are transplanted along with the donor's heart.
Unhealthy or damaged lungs can lead to difficulties in the everyday functioning of the body, because of lack of oxygen. Some of the issues that can cause severe damage to the lungs to include:
- Chronic pulmonary obstructive disease (COPD), including emphysema
- Scars in the lungs
- High blood pressure in the lungs
- Cystic fibrosis
Usually, lung damage can be cured with the help of medication or special breathing devices. However, if these measures fail, the patient will be in need of single lung transplantation or double lung transplantation. This could be considered the broad classification of the types of lung transplantation.
The hospital is well-equipped with world-class infrastructure and highly experienced surgeons to provide a smooth transplant experience for the patients. The doctors guide patients through every step of the surgery, from initial assessment to diagnosis and treatment. This makes them amongst the best lung transplant specialists in Bangalore.
Why choose BGS Gleneagles Global Hospitals Bangalore for treatment of Lung Failure
The hospital specializes in providing extensive care catered to individual needs.
BGS Gleneagles Global Hospitals is-
- a centre for leading procedures and advanced surgical care
- a centre for utilizing the power of technology for optimum patient care
- a centre for delivering positive and sensitive patient experiences
- a centre for mastering the need for early detection and holistic treatment
We commit to improve patient outcomes and quality of life.
For achieving our goal, we commit to
- utilization of advanced technology
- world-class quality standards
- inventing new treatment methods
- employing the best talent
Diagonsis of Lung Failure
We believe in providing a relaxed and worry-free experience, right from consultation to recovery. We begin by taking a thorough note of the patient's medical history, understanding the symptoms to produce an accurate diagnosis.
The symptoms of end-stage lung failure depend on the underlying cause and the amount of oxygen and carbon dioxide in the bloodstream. Diseases like COPD and emphysema cause wheezing, whereas pulmonary fibrosis leads to a chronic dry cough, which ultimately ends up being some of the causes of end-stage lung failure. Patients having cystic fibrosis tend to cough up thick mucus and have repeated occurring infections. Decreased levels of oxygen in the blood because of end-stage lung failure can cause shortness of breath and fatigue. This limit walking and other physical activities. When severe, it leads to darkening of skin, lips, and fingernails into a bluish colour. High levels of carbon dioxide in the blood causes rapid breathing and confusion.
A physical examination is done to get a complete hold of the problem. In some cases, patients require a more extensive diagnosis done through chest X-ray, chest CT scan, pulmonary functions test, etc. The hospital provides specialized diagnostic and therapeutic procedures and services to provide a more accurate depiction of the patient's condition. One way of diagnosing pulmonary fibrosis is chest CT. If it is not diagnostic, a lung biopsy done by bronchoscopy may be required. If the doctor suspects pulmonary hypertension, an echocardiogram may be performed. Cystic fibrosis can be confirmed with the help of sweat test and genetic testing.
We provide the best diagnosis of lung failure to the patient to initiate the treatment as quickly as possible. One of the possible treatment plans for end-stage lung failure is oxygen therapy. It helps in pushing oxygen to the lungs by inserting a small plastic tube in the nostrils or a mask. Another option available is a mechanical ventilator, for additional breathing support. When all the options fail, the patient will require a lung transplant. The hospital is equipped with world-class infrastructure and one of the best team of lung transplant surgeons in Bangalore to provide accurate diagnosis and treatment plan.
Treatment for Lung Failure
Surgical treatments associated with lung transplant is performed by our team of pulmonary surgeons. The team begins with initial investigations and tries to alleviate the condition with medicines/drugs. But when all the treatments and machines fail to provide adequate oxygen to the lungs, a lung transplant is needed.
Waiting for the donor
Once the transplant list determines the patient as a candidate for the transplant, the transplant centre registers him/her and adds the name to the waiting list. The number of people that require lung transplants far exceeds the number of lungs available for performing the procedure. There are chances that people may die waiting for a transplant.
While the patient is on the list, the team at GGH BGS hospital closely monitors his/her condition and alters the treatment as needed. The doctors recommend healthy lifestyle changes like eating a healthy diet, getting regular exercise, and avoiding tobacco.
It is recommended for the patients to join the pulmonary rehabilitation program while waiting for the donor’s lung. Rehabilitation programs help to improve the health and ability to function every day before and after the transplant.
When the donor organ is finally available, the donor-recipient matching system administered by United Networks for Organ Sharing (UNOS) looks for a match based on a specific criterion, which includes:
- Blood type
- The measure of the organ compared to the chest cavity
- Geographic distance between donor lung and the recipient
- Level of the recipient’s lung disease
- Recipient’s overall health
- Chances for the success of the transplant
Lungs are usually donated by deceased people. If the donor is a living person, the transplant can take place at a planned time. The potential donor will have a compatible blood type, with good health. Psychological tests will be performed on the donor to ensure that she/he agrees with the decision.
Indications for a lung transplant
Indication of single or double lung transplant includes chronic obstructive pulmonary disease (COPD), including emphysema, scarring of the lungs called pulmonary fibrosis, severe bronchiectasis, high blood pressure in the lungs called pulmonary hypertension, cystic fibrosis, etc. The most important reason for a lung transplant is when any other medication or treatment fails to deliver the required oxygen to the lungs.
Indications for heart and lung transplantation include end-stage heart failure and end-stage lung failure. The failure is a result of complex congenital heart disease with Eisenmenger syndrome or right ventricular failure with evidence of right ventricular fibrosis or infarction or refractory left ventricular failure. Any of these conditions mandate lung transplant for the patient.
Preparing for a lung transplant
Patients begin to prepare for a lung transplant before the surgery is scheduled. One can begin preparing for a lung transplant week, months, or even years before receiving a donor lung, depending upon the respective waiting transplant waiting time.
If the doctor suggests a lung transplant for your condition, you are likely to be referred to a transplant centre for evaluation. The patient can select the transplant centre on his/her own.
When evaluating a transplant centre:
- You must check with the health insurance provider to see the centre covered by your plan.
- Take into consideration the number of transplants a centre performs each year and transplant recipient survival rate.
- You must check the extra services provided by a transplant centre, like support groups, assistance with travel arrangements, etc.
Once the center for a lung transplant is determined, the patient needs to have an evaluation for seeing his/her eligibility for the transplant. During the evaluation, the doctors and the transplant team can review your medical history, conduct physical examinations, ask for other tests, and evaluate mental and emotional health. The tests performed on the patient include different types of blood tests, chest X-Ray scan, pulmonary function tests, ventilation-perfusion scan, computed tomography scan (CT scan), etc.
After the pre-transplant evaluation, the Lung Transplant Team meets together to discuss if the transplant is appropriate for the patient. The transplant coordinator then notifies the patient about the team’s decision. The goal of the whole procedure is to determine the patient’s ability to undergo the transplant and its recovery without any complications. If the patient is approved, he/she is placed on the transplant list.
The patients are also provided with a lung allocation score. It is a number which the United Nation of Organ Sharing (UNOS) uses to assign relative priority for distribution of lungs for transplant in the USA. It takes into account the different measures of patients’ health for directing donated organs towards the patients best suitable for the lung transplant.
Lung Transplant Surgery
The procedure is conducted with general anesthesia, so the patient will not feel any pain. A tube will be guided through the patient's mouth and the windpipe for his/her to breathe. The surgeons will cut the chest and remove the diseased lung. The main airway and the blood vessels with lungs and heart will then be connected to the donor's lung. Some lung transplants require a heart-lung bypass. For this, the patients will be connected to the machine, which will circulate blood in the patient's body during the process.
What happens after the surgery?
Immediate days after surgery are spent in the hospital's Intensive Care Unit (ICU). The patient will breathe with the help of a mechanical ventilator for a few days, and the tubes in the chest will drain fluids around the lungs and heart.
A tube in a vein will send strong medication to control pain and to prevent rejection of the new lung. As the condition of the patient improves, they will no longer require a mechanical ventilator and will be moved out of ICU. Recovery generally involves 1-3 weeks of stay in the hospital.
After leaving the hospital, the patient will need approximately three months of frequent monitoring by the transplant team to prevent, detect, and treat complications and to evaluate the liver function. During this time, the patient should stay close to the transplant center. When the follow-up visits are less frequent, it is easier for the patient to travel back home and come back for follow-ups. The follow-up visits can involve laboratory tests, chest X-rays, ECG, lung function tests, etc.
Lung Transplant Specialists, Doctors and Surgeons
The lung transplant team at BGS Gleneagles Global Hospitals consists of an expert panel that is experienced and committed to bringing compassionate care for patients with end-stage lung failure. The team walks the journey with you from evaluation to transplant to post-transplant recovery. An initial evaluation assesses the patient’s need & qualification for a transplant; following with a transplant team helps the patient and caregivers understand the transplant procedure, the wait time and pre-transplant care.
As the patient moves through the transplant journey, from evaluation to actual transplant to post-surgery care and rehabilitation, our team of pulmonologists, intensivist & anaesthetist, lung transplant surgeons, lung transplant co-coordinators, nurses, care managers, physiotherapist, dietitians and other clinicians will work together to manage your care at every stage. The single-minded focus and goal of the lung transplant team is to help you return to a full and productive life post the lung transplantation.
Learn more about the team members who will support you during the transplant process and beyond.
Dr Sandeep Attawar
MBBS, MS Gen Surgery, M.Ch (Cardiac Surgery)
Director & Chair of Heart & Lung Transplant Program