Woman with auto-immune disease undergoes bilateral lung transplant

A 53-year-old woman with interstitial lung disease underwent bilateral lung transplant in a city hospital.

The woman had scleroderma, a common auto-immune disease that causes inflammation of various parts of the body. She was diagnosed with ILD five years ago and was on medication. Pulmonary function tests and CT scans showed that her lung function had worsened. A thorough evaluation was done for transplant but owing to scleroderma she had to be reviewed by a rheumatologist and gastroenterologist as well. After clearance she was registered for organ transplant for nine months by which time, she needed eight litres of oxygen at rest during day and home ventilator support at night.

Srinivas Rajagopala, senior consultant in pulmonology and director of transplant pulmonology and lung failure unit said, the transplant was medically complex and required optimisation and careful planning. “Several centres abroad do not accept scleroderma patients because of the concern of aspiration due to poor movement of the oesophagus which can cause permanent damage to the lung graft,” he said.

The patient also had severe pulmonary hypertension and had antibodies against potential donor lungs that could lead to rejection of the transplanted organ, Dr. Srinivas said.

Though donor lungs were available her condition prevented transplantation. Programme director Kumud Kumar Dhital performed the transplant with central ECMO support. The patient was weaned off ventilator support within a day and oxygen support by the fourth day post-transplant. Ten days later she was able to walk normally and use the stairs. She was discharged 12 days post-transplant.

The doctors said her lung function was improving and had resumed independent daily activities.

Co-founder and executive director of Kauvery Hospital Aravindan Selvaraj said the hospital’s transplant unit team, along with state-of-the-art infrastructure, provide comprehensive and life-long care to transplant patients.