Second opinion on lung disease and transplant decisions

What a second opinion actually gives you

A second opinion is not a polite formality and it is not a challenge to your current doctor. It is a re-reading of your evidence by someone who was not present when the first conclusion was reached. In advanced lung disease it tends to answer four specific questions.

• Does the diagnosis fit the images? Fibrosis is a pattern, not a cause, and patients labelled idiopathic sometimes turn out to have a treatable cause that was not looked for.
• Has treatment been optimised? Antifibrotic therapy not started, pulmonary hypertension not assessed, oxygen not prescribed for exertional drops, reflux or sleep apnoea untreated. Each of these changes symptoms and none requires surgery.
• Is transplant genuinely indicated, and is the timing right? This is the question most patients come with. The answer is sometimes yes, sometimes not yet, and sometimes no.
• What happens if you do nothing for now? A realistic picture of the likely course, so a decision can be made on information rather than on fear.

When it is worth asking for one

You do not need a reason beyond wanting to be sure. That said, these situations make a second opinion particularly worthwhile.

• You have been told you need a lung transplant, or told you are not a candidate for one.
• You have a fibrosis or interstitial lung disease diagnosis and nobody has explained which subtype you have or why.
• Your breathlessness is getting worse on treatment that is supposedly correct.
• A surgical lung biopsy has been recommended and you want to know whether it is necessary.
• You have been offered an airway stent, a procedure or a major intervention and want the indication confirmed.
• Two doctors have already told you different things.
• A relative is in intensive care and decisions about ventilation, ECMO or transfer are being discussed.

How it works

1. Send your reports on WhatsApp

   Use the builder below or simply message +91 79937 41199 directly. Send the images themselves where you can, not only the typed reports.

2. The material is reviewed

   Dr. Manjunath re-reads the imaging and the function tests against the clinical story. If something essential is missing, you will be told exactly what to obtain rather than being asked to repeat everything.

3. You receive a written opinion

   Covering the diagnosis, whether treatment is optimised, where you stand on transplantation, and what the next step should be. Written so you can share it with your current team.

4. Optional video consultation

   Booked and paid in advance, available between 9 AM and 9 PM, for when you want to talk the opinion through. Many patients stop here and continue treatment locally with the written opinion in hand.

What to send

The more complete the material, the more definite the opinion can be.

• HRCT chest images, the scan files themselves rather than only the report. If you have scans from more than one date, send them all.
• Pulmonary function test including DLCO, and every previous one you have, because the trend matters more than any single result.
• Echocardiogram report, which is how pulmonary hypertension is first picked up.
• Recent blood work, including the autoimmune panel if it has been done.
• Any biopsy, bronchoscopy or catheterisation report.
• Current medication list with doses, including oxygen and how many hours a day you use it.
• A short note in your own words on your symptoms, when they started and how they have changed.

What Dr. Manjunath reviews second opinions on

The practice is concentrated in advanced lung disease, so opinions are most useful in these areas rather than across general medicine.

• Lung transplant candidacy, whether transplant is indicated, whether it is too early or too late, and what would need to change. See lung transplantation and who needs a lung transplant.
• Interstitial lung disease and fibrosis, re-reading the HRCT pattern and checking whether treatable causes were excluded. See interstitial lung disease and pulmonary fibrosis and IPF.
• Pulmonary hypertension, which of the five groups a patient belongs to and whether the treatment matches the group. See pulmonary hypertension.
• Airway problems, central airway obstruction, stenting decisions and post-transplant airway complications. See rigid bronchoscopy.
• ECMO decisions, whether a patient in respiratory failure is a candidate, and whether the goal is recovery or a bridge to transplant. See ECMO.
• Post-transplant problems, rejection, chronic allograft dysfunction and infection. See life after a lung transplant.

Who is giving the opinion

Dr. Manjunath M Negigoudara is a transplant pulmonologist at KIMS Hospital, Electronic City, Bengaluru. MBBS Gold Medalist from Bangalore Medical College, MD in Pulmonary Medicine from JSS Medical College, DNB in Respiratory Medicine, and Fellowship in Interventional Pulmonology from Manipal Hospitals. KMC registration 116911.

He has personally managed 250+ lung transplant cases within the KIMS Institute of Heart and Lung Transplant, which has completed 780+ thoracic transplants. He has published in the European Respiratory Journal and the Journal of Heart and Lung Transplantation, and presented India's first redo double lung transplant at the ESOT 2025 Congress in London. See publications and talks and the full clinical profile.

For patients from Bangalore, across India, and abroad

Bengaluru and Electronic City

Local patients often prefer to come in person rather than send files, and that is entirely reasonable. KIMS Hospital is on Hosur Road opposite the PES University EC Campus, about 15 minutes from Silk Board via the elevated expressway, and consulting hours are Monday to Saturday, 9 AM to 5 PM. Patients attend from HSR Layout, Koramangala, Sarjapur Road, BTM Layout, Jayanagar, JP Nagar, Bannerghatta Road, Whitefield and Marathahalli, and from Bommasandra, Anekal, Chandapura and along Hosur Road.

Across India

Remote second opinions are requested from Mysuru, Mangaluru, Hubballi-Dharwad, Belagavi, Kalaburagi, Shivamogga, Tumakuru, Davangere and Ballari within Karnataka, and from Chennai, Coimbatore, Madurai, Tiruchirappalli, Salem, Hyderabad, Warangal, Vijayawada, Visakhapatnam, Tirupati, Guntur, Kochi, Thiruvananthapuram, Kozhikode, Kannur, Goa, Mumbai, Pune, Nagpur, Ahmedabad, Delhi NCR, Kolkata, Bhubaneswar, Guwahati, Chandigarh, Lucknow, Patna, Ranchi and Raipur. This is the single most useful service for patients outside the major transplant centres, because it answers the question of whether travelling is necessary at all. Kempegowda International Airport is about 45 km from the hospital for those who do need to come.

International patients

Opinions are issued for patients in Bangladesh, Nepal, Sri Lanka, the Maldives and Bhutan, in Oman, the UAE, Saudi Arabia, Iraq, Yemen, Kuwait, Bahrain and Qatar, in Kenya, Tanzania, Ethiopia, Uganda, Rwanda, Sudan, Nigeria and Ghana, and in Myanmar, Indonesia and Malaysia. The written opinion can be used to support a medical visa application where travel to India is recommended. Video consultations are available between 9 AM and 9 PM India time, booked and paid in advance, which covers most of these time zones comfortably.

Related reading

• Who needs a lung transplant, the referral and listing criteria
• Lung transplant cost in Bangalore
• Lung transplant cost in India, the full breakdown
• Conditions treated and airway procedures
• Contact and directions