New Delhi: Doctors at Fortis Escorts Heart Institute here on Wednesday said they have successfully transplanted the heart of a 58-year-old man, who had suffered a brain haemorrhage, in a 23-year-old girl suffering from end stage heart disease. The transplant was conducted by Dr Z S Meharwal, director, cardiovascular surgery, Fortis Escorts Heart Institute, New Delhi and his team.
According to Dr Meharwal, the donor, a 58-year-old man, suffered a brain haemorrhage and was referred by a local hospital to Fortis Memorial Research Institute (FMRI), Gurgaon. The patient was declared brain dead by the FMRI doctors when he could not be revived after extensive efforts. The patient’s family was counselled about saving several lives and they agreed to donate his organs.
To make the transportation of the live beating heart seamlessly to the hospital where the recipient was admitted, a green corridor with the help of traffic police was created between Fortis Memorial Research Institute (FMRI), Gurgaon and Fortis Escorts Heart Institute, New Delhi — a distance of 32 kilometres. The convoy of ambulances, carrying the live beating heart, covered this distance in just 27 minutes 56 seconds. The surgical procedure for the heart transplant took four hours for the completion.
The recipient, Oshin Goyal, a young girl at 23 years of age, had been suffering from restrictive cardiomyopathy for nine years. The first symptoms she was presented with were swelling of her feet and legs, abdomen and face. Small activities would leave her breathless and she would experience extreme fatigue and tiredness every now and then, unable to go through her regular day-to-day schedule. Further tests revealed that she suffered from a condition called the restrictive cardiomyopathy.
Restrictive cardiomyopathy is a rare form of cardiomyopathy, a condition in which the walls of the lower chambers of the heart (the ventricles) are abnormally rigid and lack the flexibility to expand as the ventricles fill with blood. The heart is, therefore, restricted from stretching and filling with blood properly, eventually, leading to a heart failure. As a consequence of poor pumping of the heart, adequate amount of oxygen does not reach the various body parts and the body begins retaining high levels of water. Organs like lungs, abdomen and veins fill up with water that leads to an unconditional swelling of the body.
“When the patient was brought to us we had a huge challenge on our hands as she had been bed-ridden for the last four months and had an extremely weak heart. Whether her body would be able to withstand the surgery put a big responsibility in our hands. The tissues were frayed in this patient due to excess water retention in her body and would not be able to withstand the pressure of sutures,” said Dr Meharwal.
He further said, “The discrepancy in the sizes of the donor’s heart from that of the recipient’s heart chamber presented added challenges. Not only was the donor’s heart larger than the chamber of this patient, the aorta of the donor was also bigger than that of the recipient. A special technique had to be used to suture donor’s aorta to recipient’s smaller aorta.”
Dr Vishal Rastogi, head, heart failure programme, Fortis Escorts Heart Institute, said, “The condition of this young patient who has undergone the transplant had progressed to the extent that she had very little time to live. Despite the optimum levels of heart management that we were extending, transplant was the only option that was possible. There was no other treatment that could have been applied here as this heart condition eliminates every other option that can be applied to other types of heart diseases.”
This is the second heart transplant surgery successfully conducted at Fortis Escorts Heart Institute, New Delhi. The first heart transplant surgery by doctors at FEHI, New Delhi was successfully performed on January 3, 2015 on a 16-year-old boy.
Dr Ashok Seth, chairman, Fortis Escorts Heart Institute, said, “With our second successful heart transplant on an extremely ill young lady who had only days to live, we have established ourselves as one of the very few heart transplant centres in India providing end to end advanced care for failing hearts.”
“We hope that this transplant in a young lady at death’s door awakens numerous people to be able to pledge for organ donation and save numerous lives,” added Dr Seth.
Heart transplantation has made great strides over the years. Today, more than 85 percent of heart recipients will live at least an additional year and more than 70 percent will live five more years. However, patients continue to face a lengthy waiting list to receive a donor heart. There is a huge disparity between the number of patients needing transplants and the number of procedures being performed. This has sharply brought into focus the need for creating more awareness on the noble act of donating organs.
India enjoys the dubious reputation of having the maximum number of road accidents annually in the world. According to a survey by the World Health Organisation, 60 percent of the deaths in road accidents are of people in the age group of 15–44 years. This constitutes young and healthy people and organ donation by their family members can go a long way in bridging the gap between the organs required and organs received.
Thanking the doctors and the donor’s family, the father of the young girl said, “We are really grateful to the (donor’s) family for taking such a noble decision and in being instrumental in restoring life to our daughter. I have seen her suffering and had almost lost hope that my wife and I will be able to spend more years watching her grow. But the doctors have made our impossible hope a living dream.”
Dr Somesh Mittal, zonal director, Fortis Escorts Heart Institute, said, “India is witnessing over three million deaths in a year due to cardiovascular diseases making India a likely ‘Heart Disease Capital of the World’.”