Challenges, experiences, and postoperative outcomes in setting up first successful lung transplant unit in India

Vijil Rahulan, Unmil Shah, Pavan Yadav, Srinivasa Ravipathy, Apar Jindal, S. Suresh, H. Sandeepa, Pradeep Kumar, Anoop Mohandas, Sharanya Kumar, Shivaprakash Shivanna, Santosh Kori, Prabhat Dutta, Prem Anand, B. Mahesh, N. Madhusudana, B. Bhaskar, G. Balasubramani, Sandeep Attawar

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Lung transplantation (LT) has emerged as a definitive cure for a plethora of end-stage lung diseases (ESLDs). With improvements in immune-suppression protocols, the posttransplantation survival rates have gone up. Aim: The study reported the initial experience of the India's single largest lung transplant program on clinicopathological profile, procedures, challenges encountered, and outcomes. Settings and Design: A retrospective analysis was done from data available at three centers of Institute of Heart and Lung Transplant, Gleneagles Global Hospitals across Chennai, Bengaluru, and Mumbai. Materials and Methods: A total of 132 patients underwent lung (single or bilateral) or combined heart and lung transplant between April 2017 and March 2020. All the participants had 30 days' follow-up. Postoperative complications, graft rejection, and 30-day mortality were reported. Kaplan-Meier survival analysis and logistic regression analysis were performed. Statistical Analysis Used: Kaplan-Meier survival and binary logistic regression was performed. Results: Interstitial lung diseases, 65.91%, were the most common diagnosis. Bilateral LT (81.3%) was the most common type of LT performed. Grade III primary graft dysfunction was observed in 16 (12.1%). Distal airway stenosis (21.97%) was the most common complication followed by anastomotic stenosis (14.30%). Gram-negative bacterial sepsis (52%) was the leading cause of death. Cumulative probability of survival at 1 month was 0.85 (95% confidence interval [CI] 0.80-0.92), and at 1 year, it was 0.78 (95% CI, 0.72-0.86). Conclusion: This study establishes the fact that despite multiple challenges, LT is a viable option for selected patients with ESLDs in India and should encourage early referrals to a transplant center.

Original languageEnglish (US)
Pages (from-to)216-222
Number of pages7
JournalLung India
Volume38
Issue number3
DOIs
StatePublished - May 1 2021

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

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