Covid-19: Jharkhand minister recovers after double lung transplant in Chennai

Only a few lung transplants on Covid-19 patients have been performed across the world and the minister’s critical condition necessitated the procedure.

Jharkhand education minister Jagarnath Mahto, who was airlifted from Ranchi to a Chennai hospital, underwent a bilateral lung transplant after the organs were completely damaged by Covid-19 and has recovered well, doctors treating him said. On Thursday, the doctors said he was fit to be discharged.

Jharkhand education minister Jagarnath Mahto(Pic: Sourced)

Only a few lung transplants on Covid-19 patients have been performed across the world and the minister’s critical condition necessitated the procedure.

“This is different from a regular lung transplant, which is commonly done, as these are the sickest of patients who have been on a ventilator for months,” said Dr KR Balakrishnan, who performed the surgery and is chairman-director, cardiac sciences and 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,” he added.

Sitting in his hospital room, Mahto spoke to reporters via video link, “I’m well and wish to come back soon to serve the people of Jharkhand.”

The 54-year-old minister was infected by the coronavirus in October and was 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 who flew a team that brought him to Chennai in an air ambulance. “He was unconscious for a week,” said Dr Balakrishanan. Mahto was tracheostomized on October 28 last year. The fibrosis had severely damaged the cells of his lungs that there was no gas exchange possible. When his CT scan did not show any improvement, he was enlisted under the lung transplant program. “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,” said Dr Balakrishnan.

Mahto underwent a bilateral lung transplant on November 10.

“The transplanted lungs were functioning normally and he started breathing spontaneously,” said Dr Suresh Rao, co-director, heart and lung transplantation. “After the lung transplant, a bronchoscopy was done to check if anastomosis was perfect.”

Mahto met guidelines prescribed for lung transplants in Covid-19 patients - which is the person should 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 was done while the patient was on an extracorporeal membrane oxygenation (ECMO) machine. Both the chest cavities were opened, the old lungs were 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.”