In death, man helped Covid patient get new lungs, arms for accident victim

CHENNAI/MUMBAI: When a 48-year-old man from Ghaziabad, whose lungs were totally damaged following Covid-19 infection, was wheeled into a Chennai-based hospital on Friday, he had just a thin hope of survival.
About a few hours later, in faraway Mumbai, Monika More’s dream of having her hands, which had got severed in a train accident seven years ago, back came true with a double hand transplant.
And, they both had one man and his family to thank — the organs came from a 34-year-old man, who was declared brain dead by doctors at the Gleneagles Global Hospital in Chennai after intracerebral haemorrhage on Thursday.
His wife agreed to donate his organs and they were allotted to various hospitals. While Global Hospital’s Chennai branch, where he died, retained the liver, the heart and lungs went to two patients in MGM Healthcare, kidneys to two patients at Gem hospital, skin to SIMS and hands to Monika at the Global Hospital in Mumbai.
A heart transplant surgery was also performed at the Chennai hospital, the donor being the same man.
Monika’s transplant has been in planning stage for over eight months now, but forearm donations are rare. On Thursday, Monika’s family heard from the Chennai hospital about the donor. The cross-match between the donor and recipient came late in the evening, with the donated arms being flown to Mumbai in a special charter flight around 10.50pm. The organs were wheeled into the operation theatre around 2am on Friday and the transplant was declared complete around 5.30pm.
Monika, a resident of Kurla in Mumbai, had lost her hands at the Ghatkopar station and on Friday, became the first in Mumbai to undergo a hand transplant.
“Monika is stable and has been moved to the ICU,” said plastic surgeon Nilesh Satbhai, who led the 15-hour transplant operation at Global Hospital. Monika didn’t suffer hyperacute rejection as blood flowed through the transplanted arm.
Monika, who had prosthetic arms and had joined a Kurla hospital as a social worker six months ago, intends to pursue a professional career. The family is now raising funds for the surgery and the long rehabilitation ahead.
In Chennai, the eight-hour-long transplant surgery on the Covid patient with damaged lungs ended at 7am on Friday. The Ghaziabad businessman had suffered severe respiratory failure due to Covid-19, doctors at MGM healthcare said. He was tested positive for the virus in June.
“The patient is on a ventilator, but is awake. He met his family members,” said Dr Suresh Rao, co-director, Institute of Heart and Lung Transplant and Mechanical Circulatory Support. He was a part of the transplant team. “After being rigid in bed for nearly two months, the patient moved his fingers and limbs,” he said.
Minutes after they replaced his lung, doctors removed the extracorporeal membrane oxygenation (ECMO) he was connected to for more than a month.
The recovery, however, may take a long time. “Twelve hours after surgery, the patient is able to do well without ECMO. His new lungs are healthy. He has no other comorbid conditions or illness. But he is still on a ventilator because he is weak. Recovery will take time as his chest muscles are weak now,” said transplant pulmonologist Dr Apar Jindal.
“The infection was severe, and the lung they removed did not look like anything doctors have seen before. A lung is spongy. The one we removed was as hard as a liver. It was inflamed and was plastered to the chest wall,” he said.
The patient was tested positive for Covid-19 on June 8 and admitted to a hospital in Delhi in a critical condition. On June 20, doctors there put him on a ventilator. A month later, he was airlifted and brought to MGM healthcare. His oxygen saturation was just 60% (normal is above 95%). Five days later, on July 25, a day after he was put on the waitlist for lung transplant, doctors plugged him on to a veno-venous ECMO to support lung function. The machine then pumped blood out through one channel and back into the body through the other.
On Thursday, when the hospital received a call from the state transplant authority about a possible donor, the team was prepared.
The team carried out the two transplant surgeries — heart and lung — simultaneously on two patients. “Transplant was not an easy decision. We debated about it several times. But the patient was a healthy, young patient. If we could reverse the lung damage, we knew he had better chances to lead a long happy life,” said senior transplant surgeon Dr K R Balakrishnan.
The Covid-affected lungs doctors have retrieved holds valuable information. “We are examining the diseased organ under an electron microscope. We want to study how and how much the novel virus has invaded the lungs,” he said.