Hyderabad Yashoda docs perform India’s first successful bilateral double lung transplantation

Hyderabad: A rare double-lung transplant was successfully conducted on a 23-year-old man at a corporate hospital in the city.

The man, a patient with pulmonary fibrosis, was battling for his life for more than a month after he consumed poison, which had damaged both his lungs along with the kidneys and liver. The poison chemical known as paraquat is widely used as a highly toxic contact herbicide. The lungs were the main targets damaged by the active accumulation of paraquat, which resulted in irreversible pulmonary fibrosis. Respiratory failure is the main cause of death in the late phase of paraquat intoxication.

Said to be the first successful double-lung transplant survivor in India, the young patient from Mahabubabad district near Warangal was admitted to Yashoda Hospitals where he was placed on mechanical ventilator and thereafter to extracorporeal membrane oxygenation support (ECMO). Paraquat-induced multi-organ injury warranted multiple organ support including dialysis and ECMO.

“The patient was supported on ECMO for more than 15 days, and when there was no improvement, he was considered for a lung transplant. After ensuring that no poison remained in the body, bilateral lung transplantation was done by a team of senior pulmonologists, thoracic and lung transplant surgeons at Yashoda Hospitals in Secunderabad,” said Dr Pavan Gorukanti, the director of Yashoda Group of hospitals.

“This sort of double lung transplantation was performed successfully in India for the first time for the above condition and there are only four cases worldwide where such bilateral lung transplantation was done. We feel that our case is unique in many ways as there was a limitation in the test availability to know in detail the residual amount of poison remaining in the body before the transplant and he was on ECMO for nearly a month and had multiple bloodstream and respiratory infections before the transplant. He was almost in bed for nearly one month prior to the transplant,” informed Dr Hari Kishan Gonuguntla, senior interventional pulmonologist at the hospital.

The patient received the donor lungs from a cadaveric brain-dead donor as part of the state-run Jeevandan organ donation initiative. The procedure was carried out by the team led by senior interventional pulmonologist Dr Hari Kishan Gonuguntla along with thoracic and lung transplant surgeons Dr KR Balasubramoniam, Dr Manjunath Bale, Dr Chetan, Dr Sricharan, Dr Vimi Vargehese and team.

The patient was discharged recently and currently, he does not require external oxygen support and is able to do his routine activities without difficulty. He is doing well after discharge and the lung transplant team is following up on his case regularly, said doctors.