Lung Transplantation for End-stage Lung

An end-stage lung condition is defined as lung destruction leading to extensive respiratory disability and a state of crippling. Such a patient is completely bed-ridden and continuous oxygen dependent. The patients get severely malnourished, lose muscle mass and weight. In recent times, there is a significant increase in prevalence of end-stage lung problems and oxygen dependence especially after the COVID pandemic. Such a condition frequently results from some of the following common conditions:

1.      Extensive post-COVID lung fibrosis

2.      Progressive fibrosing illnesses of the lungs due to interstitial lung diseases

3.      Chronic obstructive pulmonary disease

4.      Vascular Lung Disease,  Primary pulmonary hypertension

5.      Other chronic diseases: Suppurative Lung Disease, Cystic fibrosis,  Bronchiectasis

Patients with end-stage lungs can be helped with several modalities besides the routine drug treatment such as the Respiratory Rehabilitation; Yoga and pranayama therapy; Breathing exercises; Nutrition support and muscle building; Psychological supports

Lung transplantation: Lung transplantation is offered as a last hope for some of such patients available at a few select centres, mostly in South India. Lung transplantation requires a large infra-structure and plan for availability of the organs besides the expertise and the costs.

Patients who are fit for lung transplant need to be carefully selected and undergo preoperative pulmonary physiotherapy and RR so that they can get best results from the transplant

These patients also need a long term post operative physiotherapy and rehabilitation program so that the advantages of transplant can be maintained. They also require regular surveillance for early signs of rejection and other complications with help of blood investigations, radiology, bronchoscopy and biopsies.