First lung transplant recipient of Indian armed forces

Abstract

In 2010, a 22-year-old female presented with progressive breathlessness and multiple joint pain in bilateral knee and wrist joints. She was diagnosed with rheumatoid arthritis (RA) based on the clinical as well as serological criteria, and her breathlessness was attributable to RA-associated interstitial lung disease. Despite being on immunosuppressants, her lung involvement continued to progress as she got dependent on oxygen at home for 2011 and required domiciliary noninvasive ventilatory support for 2017. The prognosis was grave as the disease continued to affect her lungs relentlessly despite all possible medical therapies. Our experience with lung transplants in service hospitals was nonexistent as it was not a common practice to refer patients for lung transplant because of inadequate data of its success in our country and the mammoth cost involved. However, in view of the emerging reports of successful lung transplantation and the risk benefit ratio favoring the patient, she was referred to a lung transplant center. The patient chose to have the lung transplantation at a hospital in Chennai. On May 22, 2018, the patient underwent a successful bilateral lung transplant. She is being managed with triple immunosuppression and antimicrobial prophylaxis at her home. Over the past 1½ year, the patient has developed one episode of bacterial pneumonia which was successfully managed with antibiotics. The patient continues regular visit at our hospital as she is able to work independently of any ventilatory support. We intend to narrate the experience of first-lung transplant recipient among our clientele.