Covid infected J’khand minister fine after rare lung transplant
CHENNAI: Jharkhand’s education minister Jagarnath Mahto, who was airlifted from Ranchi to Chennai’s MGM Healthcare on life support with little hope of recovery on October 19 last year and later underwent a bilateral lung transplant after his lungs were completely damaged by Covid-19, was on Thursday declared fit to be discharged by his doctors.
Only a few lung transplants on Covid-19 patients have been performed across the world.
“This is different from a regular lung transplant, as these are the sickest of patients who have been on a ventilator for months,” said Dr K R Balakrishnan, who performed the surgery and is director of the heart and lung transplant, MGM Healthcare. “The patients are on ECMO (extracorporeal membrane oxygenation) and have been given tons of steroids, several drugs and sedation. They have profound muscle weakness where they haven’t even moved their fingertips. Even if we change the lung; it takes a long time to rehabilitate them.”
Mahto, sitting inside his hospital room, spoke to reporters via video. “I’m well and wish to come back soon to serve the people of Jharkhand,” Mahto said, speaking in Hindi.
The 54-year-old minister was infected by the coronavirus in October last year and admitted to a Ranchi hospital where he was on ventilator. Mahto also had comorbidities of hypertension, diabetes and coronary artery disease.
The Jharkhand government contacted the Chennai hospital which flew a team and put him on ECMO and brought him to Chennai in an isolated air ambulance. He was on ECMO for 23 days.
ECMO is a treatment that uses a pump to circulate blood through an artificial lung back into the bloodstream.
“He was unconscious for a week,” said Dr Balakrishanan.
The fibrosis had severely damaged the cells of his lungs to the extent that there was no gas exchange possible. When his CT scan did not show any improvement, he was enlisted under the lung transplant programme. “This patient was kept alive for more than a month by an external machine and because Tamil Nadu has such an excellent system of organ donation and distribution, he fortunately received a good pair of lungs.”
Mahto underwent a bilateral lung transplant on November 10.
On the following day, he was shifted to the ICU and taken off the ventilator. “The transplanted lungs were functioning normally and he started breathing spontaneously,” said Dr Suresh Rao, co-director, heart and lung transplantation.
Mahto met guidelines prescribed for lung transplants in Covid-19 patients, which is to be under the age of 65, fully conscious and no other organ should have been affected.
The hospital has done bilateral lung transplants on eight other Covid-19 patients.
As the virus affects both sides, a single lung transplant isn’t done.
The surgery is done while the patient is on ECMO. Both the chest cavities are opened, the old lungs are taken out and replaced one by one with the donor lungs.
“Technically, the lung transplant is a straightforward operation though the Covid situation makes it challenging because the lungs are badly stuck so they tend to bleed a lot more,” said Balakrishnan. “Managing the patients is more complicated.”
From being Covid positive to getting back to normal had taken almost four months for Mahto.
This is different from a regular lung transplant as these are the sickest of patients who have been on a ventilator for months
DR K R BALAKRISHNAN, Doctor at MGM Healthcare