Challenges in expanding lung transplantation in India | Jindal Chest Clinic

Presentation on the topic "Challenges in expanding lung transplantation in India"

1. Challenges in expanding lung transplantation in India Dr. Aditya Jindal Interventional Pulmonologist & Intensivist Jindal Clinics, SCO 21, Sec 20D, Chandigarh DM Pulmonary and Critical Care Medicine (PGI Chandigarh), FCCP

2. Introduction Scope of lung disease Indian transplant framework Challenges At donor level At recipient level At doctor level At society level Logistics

3. Chronic respiratory diseases The third leading cause of death 4.0 million deaths (95% UI 3.6–4.3) Prevalence of 454.6 million cases (417.4–499.1) globally Total deaths and prevalence have increased by 28.5% and 39.8% from 1990 to 2019 COPD - 212.3 million (200.4–225.1) cases primary cause of deaths [3.3 million (2.9–3.6 UI)] Asthma - 262.4 million (224.1–309.5) cases

4. Lancet Glob Health 2018

5. Lancet Glob Health 2018

6. https://notto.mohfw.gov.in

7. https://notto.mohfw.gov.in

8. https://notto.mohfw.gov.in

9. NOTTO  National Organ and Tissue Transplant Organization ROTTO  Regional Organ and Tissue Transplant Organization SOTTO  State Organ and Tissue Transplant Organization Transplant hospital Transplantation of Human Organs and Tissues Act

10. Challenges Donor level Ideal donor/ donor lung Wait-list mortality 12.8% per year (USA) and 21% per year (UK)

11. Challenges Recipient level Late referral Referral Evaluation Pulmonary rehabilitation Nutrition Waiting time Lack of official scoring system Lung allocation score (LAS)

12. Challenges Society/ infrastructure level Separate floor/ facility Need for ECMO/ negative pressure rooms Expertise Awareness/ organ donation Transport/ crowding Cost Team building Post transplant challenges Surveillance biopsies Recurrent infections/ rejections Local expertise?

13. Summary