Anaesthetist, who contracted COVID-19, undergoes double lung transplant
Doctors say this is the first ever post-COVID-19 double lung transplant on a COVID-19 warrior who is also a medical professional
A 30-year-old anaesthetist and intensivist, who contracted COVID-19 on duty during the second wave and suffered acute lung damage, got a new lease of life after a team of doctors at Aster CMI Hospital performed a bilateral lung transplant.
The team claims that this is the first ever post-COVID-19 double lung transplant on a COVID-19 warrior, who is also a medical professional.
Sanath Kumar, the intensivist who was treating critical COVID-19 patients in the ICU of Prakriya Hospital since the beginning of the pandemic, tested positive for COVID-19 on May 8. He was admitted to Prakriya Hospital. The disease progressed to a severe stage causing acute lung damage and he needed mechanical ventilation. As he showed no sign of improvement, he was moved to Aster CMI hospital and put on ECMO and also on the national transplant list. Doctors said he was not vaccinated.
He was fortunate to get a matching donor. A team of critical care consultants, pulmonologists and lung transplant surgeons at Aster CMI Hospital in Bengaluru and KIMS Heart and Lung Transplant Institute in Hyderabad performed the transplant after four weeks on ECMO. Aster has a tie-up with KIMS for lung transplants.
The transplant was conducted on June 21. After treatment of three-and-a-half months, Dr. Sanath Kumar was discharged from the hospital. However, he needs to stay indoors in a secure environment to minimise risk of catching an infection again, doctors said.
Explaining the challenges and complexities involved, Sandeep Attawar, Chair and Director of Thoracic Organ Transplants and Assist Devices at KIMS Heart and Lung Transplant Institute in Hyderabad, who led the transplant team, said, “A double lung transplant is a grueling surgery but was the only solution for Dr. Sanath Kumar, who experienced a life-threatening combination of lung damage caused by the COVID-19 virus, an exaggerated immune response, and the body’s failure to properly repair the injury.
“Eventually, in the self-repair phase, the deposition of yellow fibrotic scar tissue creates a liver-like densification that makes the lungs completely solid. This process of misdirected and inappropriate self-repair, irreversibly destroys the tiny alveolar air sacs through which gas exchange happens. Patients only survive up to the fibrotic stage if they are intubated and at times transitioned to ECMO support. This harmful scarring can occur within a couple of weeks of viral pneumonia.”
V. Arun, Lead Consultant – Anaesthesia and Critical Care at Aster CMI Hospital, said Dr. Sanath Kuamr’s case was both emotionally and clinically challenging. “Being from the same fraternity working with COVID-19 patients, it was difficult to see a colleague suffer so much lung damage. When he was referred to Aster CMI, he was intubated and was on 100% oxygen support, but barely had enough oxygen in his bloodstream to survive. Within half an hour of his arrival, we initiated ECMO support to help him oxygenate the rest of his body,” he said.
Sunil Kumar K., Lead and Senior Consultant – Interventional Pulmonology and Transplant Physician at Aster CMI Hospital, said despite being on ECMO, Dr. Sanath Kumar’s lungs continued to deteriorate. “Long term ECMO with a bleak outlook was a difficult period for him and his family. A transplant was the last option. Luckily, he remained stable over the next few weeks while we waited for a suitable donor match for him. We were able to find a suitable match after four weeks, and he underwent a lung transplant,” the doctor said.
As post-transplant infections and rejections are the major roadblocks for a transplant, Dr. Sanath Kumar’s condition was closely monitored for a few weeks, he said.
Thanking the doctors, Dr. Sanath Kumar said, “When I tested positive and started taking medicines, I thought I would recover soon. I had never imagined that my health would deteriorate so much and end up having a lung transplant.”