Lung Transplant in India – Dr Bala Subramoniam’s Perspective

Lung Transplant in India – Dr Bala Subramoniam’s Perspective

Lung Transplant in India – Dr Bala Subramoniam’s Perspective reflects my clinical experience as a lung transplant surgeon caring for patients who continue to experience severe breathlessness despite optimal medical treatment. In advanced stages of lung disease, medications and long-term oxygen therapy may no longer provide adequate relief. For carefully selected patients, lung transplantation can provide a meaningful opportunity to improve survival, restore lung function, and enhance overall quality of life.

Lung transplant surgery is one of the most complex procedures in modern thoracic care. Its success depends on careful patient selection, structured evaluation, experienced surgical expertise, and lifelong follow-up. When performed at the appropriate stage of disease, lung transplantation can significantly improve functional capacity and daily living.

What Is a Lung Transplant?

A lung transplant is a surgical procedure in which one or both diseased lungs are replaced with healthy donor lungs. The primary objective is to restore effective lung function, improve oxygen delivery, and reduce disabling symptoms such as breathlessness and fatigue.

Depending on the underlying condition and overall health, the procedure may involve:

• Single lung transplant
• Double (bilateral) lung transplant

The decision is individualized and based on clinical evaluation rather than a one-size-fits-all approach.

When Is Lung Transplant Recommended?

In my clinical practice, lung transplantation is considered when:

• Lung disease has progressed to an advanced or end stage
• Symptoms persist despite maximum medical therapy
• Quality of life is significantly impaired
• Long-term prognosis without transplant is limited

Early referral to a thoracic surgeon allows timely evaluation and improves the chances of a successful outcome.

Conditions That May Require Lung Transplant

Patients may be evaluated for Lung Transplantation if they are diagnosed with:

• End-stage Chronic Obstructive Pulmonary Disease (COPD)
• Idiopathic Pulmonary Fibrosis (IPF)
• Advanced interstitial lung disease
• Pulmonary hypertension
• Cystic fibrosis
• Severe, irreversible lung damage following infections

Not all patients with lung disease are candidates for transplant; eligibility is determined through comprehensive assessment.

Evaluation Before Lung Transplant

Before listing a patient for Lung Transplant in India, a structured evaluation is essential. This typically includes:

• Lung function tests and imaging studies
• Cardiac and kidney function assessment
• Infection screening and blood investigations
• Nutritional and psychological evaluation

This process ensures that the patient is medically fit for surgery and capable of managing long-term post-transplant care.

Lung Transplant Surgery and Recovery

Lung transplant surgery is performed under general anesthesia by a specialized thoracic surgery and transplant team. The procedure requires advanced intraoperative and intensive care support.

Following surgery, patients are monitored closely in the ICU. Recovery involves:

• Lifelong immunosuppressive therapy
• Regular follow-up and monitoring
• Pulmonary rehabilitation
• Lifestyle modifications to reduce infection risk

With appropriate adherence to treatment, many patients experience significant improvement in breathing capacity and overall quality of life.

Risks and Long-Term Considerations

Lung transplantation carries certain risks, including:

• Acute or chronic organ rejection
• Infections
• Side effects related to long-term medications

Ongoing monitoring and early intervention are critical to managing these risks and achieving long-term success.

Lung Transplant vs Conventional Treatment – Key Differences

My Approach to Lung Transplant Care

As a thoracic surgeon practicing in Hyderabad, I view lung transplantation as a long-term partnership rather than a single surgical event. Clear communication, ethical decision-making, and patient education are central to my approach.

Each recommendation is based on:

• Evidence-based clinical guidelines
• Individual patient assessment
• Multidisciplinary team discussion

The focus remains on patient safety, realistic expectations, and sustained long-term outcomes.

FAQs

1. When is lung transplant advised?
When lung disease no longer responds to medical therapy and significantly affects survival and quality of life.

2. Is lung transplant available in India?
Yes. Lung Transplant Surgery is available in India at select specialized centers with experienced transplant teams.

3. Who is eligible for lung transplant surgery?
Eligibility depends on disease severity, overall health, organ function, absence of active infection or malignancy, and ability to follow lifelong treatment.

4. How long does recovery take after lung transplant?
Initial recovery may take several weeks, while full rehabilitation often takes several months. Lifelong follow-up is required.

5. Can patients live a normal life after lung transplant?
Many patients return to daily activities, including work and travel, with proper medical care    and adherence to follow-up.

6. How long do transplanted lungs last?
Outcomes vary among individuals. Advances in surgical techniques and post-transplant care continue to improve long-term survival.

About the Author

I am Dr Balasubramoniam (Dr Bala), a consultant thoracic surgeon based in Hyderabad. I specialize in advanced chest surgery, minimally invasive thoracic procedures, and lung transplantation. I am actively involved in evaluating and surgically managing complex lung diseases, always following evidence-based protocols to ensure patient safety and the best possible outcomes