Mumbai: A 46-year-old woman from Seychelles has been breathing easy for the last one month after being on oxygen therapy for around five years.
Elaine Desnousse, a finance professional, was diagnosed with a genetic disorder called cystic fibrosis, developed pulmonary hypertension and had a rare anomaly in the structure of her blood vessels. Despite all these challenges, both her lungs were replaced with those received from an Indian donor.
Desnousse got in touch with doctors at Parel-based Global Hospital early last year and has been living in Mumbai since June. Her primary concern was fibrosis, a genetic condition that makes a person prone to several lung infections which get progressively worse with time. The only solution was lung transplant.
While the woman was undergoing basic screening before the procedure, the doctors noticed she had a rare birth defect wherein both her lungs had a single vein connecting them to the heart. Known as anomalous pulmonary venous connection, it is seen among 2.5% children with congenital heart defects, which affects one in 1,000 live births.
“While the anomaly itself is not life threatening, it certainly made the transplant difficult. And the genetic difference between the donor and recipient was the other challenge,” Dr Samir Garde, director of interventional pulmonology and lung transplant department of the hospital, said.
Once Desnousse was in India, she was registered as a recipient with the Zonal Transplant Coordination Committee (ZTCC). It took six months to find a pair of lungs for her as the committee puts Indian nationals needing an organ higher up on the waiting list of recipients of an organ transplantation. A pair of lungs was flown in from Ahmedabad.
Dr Chandrashekhar Kulkarni, lead lung transplant surgeon of the hospital, said that the first order of business was to prevent organ rejection. “As the patient had fought many infections earlier, her antibody profile had to be cleansed. We scavenged all antibodies in her system through plasma therapy. We took an antibody profile of the donor and ensured that the two of them were compatible,” he said.
The final surgery took place on December 18. While Desnousse had only one pulmonary vein, the donor had two veins. To resolve this, the doctors had to create a funnel-like system with the help of tissue enhancers while also increasing the width of the area where the vein connected with the heart.
Being able to move around freely, albeit with an N95 mask, Desnousse is looking forward to trekking again, a hobby she had to let go of due to her health condition. “I am grateful to the doctors and the family of the donor. The surgery seems nothing short of a miracle to me,” she added. She is still getting used to her strict diet post-surgery as well as readapting to the daily routine.
“We ensured that the patient received support from a multidisciplinary team of specialists in pulmonology, cardiovascular and thoracic surgery, immunology, infectious diseases, dedicated nursing staff and other support staff,” Dr Vivek Talaulikar, chief executive officer, Global Hospital, said.
Cardiac transplant surgeon from Fortis Hospital, Dr Sanjeev Jadhav, applauded the team for managing the complications in the case, given the rarity of the congenital defect.
