Patients with heart failure with poor effort tolerance with maximum medications are the candidates who require heart transplant. PGI is performing heart transplants since 2013. The reason for less number of transplants is the non-availability of the suitable donors and the matching recipients. Presently Dr. Ajay Bahl is heading the heart failure clinic where the heart failure patients are screened for checking the eligibility for heart transplant. Those patients with heart failure whose expected survival is less than 10% at one year are worked up for possible heart transplant and included in the transplant waiting list. The patients’ organs functions are minutely assessed as some of these patients may have liver and kidney dysfunctions. The psychological aspect of the receipeint are also assessed and the patients are counseled by the psychologists. After careful evaluation of the patients status by the Heart and Lung Transplant Committee these patients are put on transplant waiting list, if found suitable. Whenever there is a brain dead patient at PGI, a team of cardiac anaesthesiologists, cardiologists and cardiac surgeons closely assess as well as monitor patients suitability for donation of heart and if they are found fit for donation and a compatible recipient is available on the waiting list, the donor’s heart is taken up. It takes 3-4 hours of surgery to harvest the organs like liver, kidney, pancreas, heart for transplant in various departments. After explantation the heart is evaluated and then transplanted into the recipient. Prospective recipient of heart failure patients have compromised heart functions which makes the work of the anaesthesiologists as well as intensivists very important to ensure the patient’s survival during the perioperative period. It takes 4-6 hours and sometimes few days for the transplanted heart to return to normal function after surgery. Till that time the patient is supported in the ICU by anaesthesiologists, intensivists and nursing officers. These patients are put on immunosuppressents to prevent rejection of the transplanted organ and blood level of these drugs are closely monitored and once they have acceptable blood levels, patients are discharged home under follow up. These patients have higher risk of getting infection so they are advised to take adequate isolation at home and maintain hygiene by putting masks.
Prof. Ajay Bahal, Prof. Sourav Mehrotra from the Department of Cardiology, Professor Shyam KST from CTVS, Prof. G.D. Puri, Prof. Bhupesh Kumar and Prof. Banashree Mandal from Cardiac Anaesthesia interacted with the Press. Prof. Sourav Mehrotra briefed about our journey of heart transplant at Cardiac Centre which involved successful transplant of six patients out of seven transplants done between 2014 to 2022. The current patient Deepak Rai and an old operated patient Mohit also attended the meeting.
Prof. Bahal and Prof. Puri elaborated the financial assistance given by the Government, PGIMER, Chandigarh from poor free patient funds and the donations by the doctors themselves for successful execution of the heart transplant programme till now. It is notable that the current patient did not have to spend anything from his pocket for the transplant. All the money has been spend by the PGI as well as through Ayushmaan.
All the six patients are healthy till now and Mohit currently 18 years of age is working as a Hospital Attendant in the Biomedical Hub at PGIMER, Chandigarh which indicates the return of patient into full functionality and the commitment of the transplant team to take this programme to greater heights. Prof. Shyam KST discussed about the surgical aspect of the transplant surgery.
Prof. Puri stressed on the need of a team work between the Departments of Cardiology, Cardiac Surgery, Cardiac Anaesthesia, Transplant Coordinators and the timely availability of eligible donors for such a success of our cardiac transplant programme at PGI. Even during the Covid times this team has performed two successful heart transplants one in the year 2020 in a thirteen years old boy Krishan and now in April, 2022 in a 32 years old male Deepak Rai.
