A private hospital in Bengaluru has performed a double-lung transplant on a Covid-recovered patient, said to be a first for Karnataka.
Dr Sanath Kumar S G, a 30-year-old anaesthetist at Prakriya Hospitals, Nagasandra, contracted Covid in the course of his work during the second wave, which eventually damaged his lungs, requiring urgent transplant.
At Aster CMI Hospitals, he was put on ECMO support for about four weeks. (It's a technique of providing prolonged cardiac and respiratory support to people whose heart and lungs are unable to provide an adequate amount of gas exchange)
But there was no improvement in his lungs, and he was advised double-lung transplant. Three and a half months later, he has recovered and was discharged from the hospital recently.
This year, Karnataka has reported at least seven lung transplants (not all are Covid-cured patients), including one heart and lung transplant. Three pairs of harvested lungs were sent out of the state as there were no matching recipients here. Forty-two more patients are still on the waiting list for lungs.
Jeevasarthakathe, the state government agency which conducts the deceased donor transplant programme, says patients whose lungs are worsened by Covid are moved up the waiting list if they are in an emergency situation.
"Covid or not, if the patient is in an emergency condition, we move them up the list. Most lung transplants are double-lung transplants," said Lijamol Joseph, Chief Transplant Coordinator, Jeevasarthakathe.
Dr Bhaskar B V, Consultant, Cardiothoracic Vascular Surgery, Heart and Lung Transplant Surgery, who is on the lung advisory committee of Jeevasarthakathe, explained the treatment in patients with severe Covid.
If the patient has been in the ICU for more than a month, and ventilator support does not improve their oxygenation, they are subjected to ECMO. But if the patient does not recover even after that, a CT scan is done to establish if there's an irreversible damage due to Covid. If hospital-acquired infections like UTI or bloodstream infection are ruled out, and the patient is neurologically intact, lung transplant is an option, he said.
Dr Murali Mohan B V, Pulmonologist, Narayana Health, said there had been only four or five lung transplants in Covid-cured patients in India.
"Normally, we have time to do other evaluations and put the patient on pulmonary rehabilitation programme, take care of their nutrition and get a psychologist to counsel the patient because it is quite traumatic. But we can't do all these preparations if the patient has had Covid. If they are strong enough to undergo a transplant and don't have an active infection, they can sustain the surgery," he added.
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