CHENNAI:Standing at a little over five feet, swaddled in oversized clothes and a surgical mask, 30-year-old Anita Devi can easily pass for a lanky teenager — the kind who’s yet to hit her growth phase. While being petite is the new cool, it got her doctors really steamed up. Diagnosed with Interstitial Lung Disease and Scleoderma, the only way she could possibly live to see the turn of the decade was by getting a lung transplant.
And that’s where her petiteness got in the way. “She is hardly 5’1. Her lungs are really small and to get lungs that size we needed it from someone who’s 4’6 or something,” explained Dr Rahul Chandola, Heart and Lung Transplant Surgeon at Global Health City. As if a lung transplant wasn’t hard enough, they now needed lungs either from a dwarf or a child. Neither seemed possible. “We don’t get organs from children here and we had to refuse most of the lungs that were offered because they were too large to fit in her chest,” he added, showing CT scan images of her narrow cavity.
Instead, the surgical team decided to attempt something that hadn’t been done in the country, but had been honed in select surgical centres abroad over the last 15 years: cutting portions of the lung off to make it small enough to enter the chest cavity or Lung Reduction Transplantation. “She was deteriorating because of the high oxygen flow (she needed 4 litres a day) and finally we accepted a donor lung from a 42-year-old smoker who was 166 cm — much taller than her,” said Dr Vijil Rahulan, the attending pulmonologist.
Given that the lung was a lot larger than her chest cavity, they began to use specialised staplers to cut lung lobes on the sides and the middle, “We resected nearly 25 per cent of her middle and lower lobes, very anatomically, taking care that we took just enough off so that it would be capable of sufficient oxygenation. Normally, there are risks of leaks and tears in the organ wall, but this time it went off smoothly,” said Dr Chandola.
The resection was done after the lung was harvested and taken out of the cold case. After some sections were cut, it was put into Anita’s body and then minor resections and cuts needed to be made to ensure that it fit her well. Only after that was the pulmonary function gradually restored. “Normally, the lung has a high decay rate and is a very sensitive organ. We have only four to five hours in which to harvest and transplant it and it takes over an hour to do the resection, so if it had been brought in from another hospital we may have been cutting it fine,” said Dr Govini Balasubramani, Heart and Lung Transplant Surgeon.
Today, 45 days after the nerve-wracking six-hour surgery, all of them are breathing a whole lot easier. But none of them as much as Anita Devi. She’s showing off her new lungs with elan.
Breath of Life
How does Lung Reduction work?