India has become one of a handful of nations including the US and Canada where a “breathing lung transplant” can be conducted – a huge advantage as there is a growing list of those waiting to get new lungs and Coronavirus only increased the critical cases of lung failure.
This cutting edge process helps increase the time available between the harvest of the organ and the transplant. It also increases the recipient body’s ability to accept the organ more easily by removing infection and reducing “wastage” of donated lungs. The first process was conducted in Hyderabad’s Krishna Institute of Medical Sciences on Saturday.
“Wastage” is when a donated lung cannot be used because of infection and collapse of internal parts, explained Program Director Dr Sandeep Attawar. In fact, because of these reasons, more than half the available lungs cannot be used for patients who need a transplant- a dire situation with the number of people needing a transplant shooting up by the day.
A donated lung becomes “breathing” when it is put into a hermetically sealed machine called the “organ reconditioning box” and treated with a nutrient solution containing antibiotics and other necessary fluids that flush out the infection.
Then it is made to breathe artificially through a ventilator that invigorates collapsed portions. Air passages are cleaned out through bronchoscopy and several tests can be done simultaneously to further assess and enhance the performance of the lung. The whole process is monitored closely by a team of various specialists who also take note of how well the lung is functioning.
When the transplant finally happens, the patient gets an organ in a better condition that helps the body accept it smoothly and makes it durable in the long term.
This process increases the number of usable organs by 30 per cent, said Dr Attawar, whose team of 50 specialists has been working for the last six months to perfect this technology.
The idea of “breathing lung” is to run the lungs through a device that cools the organ while it breathes, nourishes it with a substrate enriched solution that has antibiotics which wipe out small traces of infection.
Dr Vigil Rahulan, chief of transplant pulmonology at the hospital said the nutrient solutions and antibiotics reduce injury to lung from cold ischemic transport in an icebox. It is also used to condition the lung with growth factors to enhance lung fuction and to reduce edema of the lung.
Dr Attawar said the process is part of “organ regeneration concept” and can provide “best results in the long term”.
“Only a select few transplant institutions in the United States, Canada, and Austria take this approach to enhance lung transplant outcomes,” he added.
Hyderabad is emerging as the lung transplant capital for the nation with 80 per cent of the transplants of the country happening here.
“By performing a highly complex procedure, they once again proved this is the best transplant team not just in India, but possibly in the whole of Asia,” added Dr Abhinay Bollineni, Chief Executive Officer, KIMS Hospitals.