When the air becomes breath: Region’s First Double Lung Transplant for Pulmonary Alveolar Microlithiasis
Hyderabad, 5thJan 2022: Doctors of Yashoda Hospitals which is one of the largest super specialty hospitals in Hyderabad, successfully performed the region’s first double Lung Transplant for Pulmonary Alveolar Microlithiasis. The patient was Venkatasha Rao, a 52-year-old priest from Kakinada. Double-lung transplants are performed by Dr. Jnanesh Thacker, Program & Surgical Director – Heart, Lung, Heart & Lung Transplantation & Assist Devices, Dr. Apar Jindal, Director – Advanced Lung Failure, Transplant Pulmonologist. Co-Director – LungFailure Unit and his team.
Mr.Venkatasha Rao was on constant oxygen support. Every day he needed 5 to 7-liter/min oxygen to maintain saturation of more than 90%. He was still not able to carry out his day-to-day activity without a drop in his oxygen level in blood. Post assessment by a multidisciplinary team, he was posted for a double lung transplant. After a short waiting period, he underwent an ABO compatible lung transplant. After double lung transplantation, he was discharged without supplemental oxygen. He is now in a better position and now off oxygen totally and leading a normal, healthy, and productive life.
“This is a milestone for lung transplantation”, says Dr. Jnanesh Thacker, Senior Consultant Cardiothoracic Surgeon Surgical Director – Lung, Heart, Heart-Lung Transplantation and Mechanical Circulatory Support, who performed the procedure. “Pulmonary Alvealar Microlithiasis is a very rare and complex disease. Most of the people in our country do it by using ECMO. We have successfully done the surgery without ECMO, on beating heart, without a single blood transfusion. This is the safest for the patient. Therefore, he could walk on the fourth postoperative day, and could be discharged on the eleventh post-operation day from the hospital. We are proud of our team with their focus knowing that they are the best and that they have the faith in themselves.”
Explaining the challenges and complexities involved, Dr. Apar Jindal, Director – Advance Lung Failure, Transplant Pulmonologist. Co-Director – Lung Failure Unit says, “Venkatesh Rao was a very typical, unique and difficult case. The disease that he had Pulmonary Alveolar Microlithiasis is characterized by the formation of micro-stones which are basically calcium depositions in the lungs. Therefore, the entire lungs become hard like a rock and therefore non-collapsable. Venkateshwara Rao had lost his lung function. He was in Advanced Lung Failure. It was a surgical challenge but our expert team is well experienced to handle such challenges. A successful lung transplant can give a new lease on life, a second-inning in your life. That is the satisfaction and wonder of this procedure.”
Venkateshwar had a normal, uncomplicated; post-surgical convalescence and was discharged on Day 11.
Further explaining about double lung transplantation, Dr.Ravi Kanth, Anesthesiologist, Yashoda Hospitals Hyderabad said, “Lung transplantation nowadays is a well-accepted and routine treatment for selected, assessed patients with terminal respiratory illness. Perioperative management of these patients is challenging, Anesthesiologist require expertise in several areas including cardiac, Thoracic anesthesia, TOE, immunology, and transplant medicine. Postoperative care also plays a major role in the outcome. These patients require a coordinated response from an Anesthesiologist, surgeons, and perfusionists. Most of the transplants are performed off-pump with the exception of severe PAH, Rv dysfunction, They are monitored using PA cath with cardiac output, TEE, Bronchoscopy intraoperatively.”
