Step-by-step guidance through our coordinated care pathway, from initial symptoms to long-term post-operative recovery.
Before undergoing lung transplantation, patients are assessed by a pulmonologist and must complete a series of tests to determine their eligibility for the procedure. These evaluations may consist of blood tests, imaging studies, lung function tests, and various other assessments.
Evaluating clinical safety checks and overall patient strength to guarantee surgical readiness.
High-precision diagnostics, cutting-edge medical technologies, and evidence-based treatment pathways tailored for individual patient outcomes.
Lung transplantation is the ultimate life-saving therapeutic intervention for patients suffering from irreversible, progressive end-stage respiratory failure who have exhausted all medical, surgical, and interventional therapies. Successful transplantation replaces failing, diseased lungs with healthy donor organs, restoring physiological gas exchange, eliminating supplemental oxygen dependence, and offering patients a renewed lease on active life.
The Lung Transplant Evaluation Program provides end-to-end assessment for advanced end-stage pulmonary diseases: multi-organ recipient phenotyping, cardiovascular and nutritional optimization, standardized Lung Allocation Score (LAS) urgency matching, pulmonary pre-habilitation, and mechanical ECMO bridging to donor transplant alongside specialized thoracic transplant teams.
Recognizing clinical signs and diagnostic triggers that indicate the need for specialized pulmonary review.
Any patient diagnosed with IPF or fibrotic ILD showing FVC decline > 10% in 6 months, DLCO < 40%, or requiring supplemental oxygen should be referred immediately upon diagnosis.
Patients with BODE index score > 5, FEV1 < 25% predicted, refractory hypercapnia (PaCO2 > 50 mmHg), or recurrent hospital admissions for acute respiratory exacerbations.
Persistent severe airflow obstruction with rapid FEV1 deterioration, frequent intensive care admissions, massive recurrent hemoptysis, or development of secondary pulmonary hypertension.
Patients in NYHA Functional Class III or IV despite dual or triple combination pulmonary vasodilator therapy, with cardiac index < 2 L/min/m2 or severe right ventricular failure.
Patients unable to be weaned from mechanical ventilation or prolonged veno-venous ECMO support with documented non-recovering, destroyed lung architecture.
Inability to perform basic daily activities without profound desaturation (< 88% SpO2), marked weight loss, or inability to walk more than 200 meters in a 6-minute walk test.
Advanced medical and surgical equipment providing high-yield diagnostic precision and life-saving therapeutic interventions.
A multi-organ physiologic screening protocol assessing cardiac reserve, renal and hepatic function, active infectious screens, bone mineral density, dental hygiene, and psycho-social family support systems.
Registration with the State Organ and Tissue Transplant Organization (SOTTO Karnataka) and NOTTO national registry, optimizing candidate urgency scores based on survival benefit algorithms.
When candidates experience catastrophic acute deterioration while awaiting organs, veno-venous ECMO provides extracorporeal oxygenation without deep sedation, allowing the patient to remain awake, mobile, and conditioned for surgery.
Pioneering technology where retrieved marginal donor lungs are placed on an isolated ex-vivo perfusion circuit, warmed to body temperature, ventilated, treated with medications, and physiologically tested prior to final implantation.
Surgical excision of diseased lungs via clamshell incision (bilateral) or anterolateral thoracotomy (single) under cardiopulmonary bypass or ECMO support, followed by precision bronchial, pulmonary artery, and left atrial anastomoses.
Structured cardiopulmonary exercise training, nutritional optimization (target BMI 18-30), breathing retraining, and psychologic counseling to ensure maximum physical resilience for surgery.
How we guide every patient from initial assessment to definitive treatment and long-term functional recovery.
Dr. Yadav reviews all clinical records, serial CT scans, echocardiograms, and oxygen requirements to establish preliminary transplant candidacy.
3-to-5 day comprehensive evaluation covering cardiac catheterization, full blood panels, infectious serologies, malignancy screening, and social evaluation.
Multidisciplinary transplant board discussion (pulmonologists, transplant surgeons, intensivists, coordinators). Formal statutory listing on the Karnataka organ waitlist.
Continuous monitoring, ongoing physical prehab, and 24/7 readiness. When matching donor lungs are allocated, immediate admission for surgical transplantation.
Clear, clinically accurate answers to common patient questions regarding this pulmonary specialty.
Referral should occur early rather than late. For interstitial lung diseases (such as IPF), referral should happen at the time of diagnosis or when oxygen is first required. For COPD and bronchiectasis, referral is indicated when hospital admissions increase or FEV1 drops below 25-30%. Early workup allows full candidacy clearance before critical decompensation.
While historically limited to age 65, physiological age and overall functional fitness matter more than chronological age. Highly conditioned candidates up to age 70 without significant coronary artery disease, renal failure, or active malignancy are routinely evaluated and successfully transplanted.
Wait times vary widely depending on blood group, recipient height/thoracic cavity dimensions, and donor organ availability in Karnataka and neighboring states. A typical wait period ranges from a few weeks to several months, during which candidates must remain actively engaged in pulmonary rehabilitation.
Absolute contraindications include active malignancy within the past 2 to 5 years, untreated chronic infection (e.g., active tuberculosis, active HIV with uncontrolled viral load), severe irreversible dysfunction of other major organ systems (kidneys or liver), active substance abuse, and lack of reliable family social support.
Modern international and institutional data show 1-year survival rates exceeding 85-90% and 5-year survival rates between 60-70%. Quality of life improvements are dramatic: most recipients return to independent walking, working, traveling, and an active family life completely free of supplemental oxygen.
Consultation Specialty: Lung Transplant Evaluation
