The Ukraine-based couple knew the odds were against them. Their 27-year-old daughter, who suffered a rare pregnancy-associated heart failure last year, did not recover from a double valve repair. With her heart sinking rapidly, India now seemed the best place for a transplant.
Barely five days since she landed in the country and was admitted to Fortis Hospital in Mumbai that she suffered a medical emergency on Saturday and was shifted immediately to the ICU where doctors revived her. On Sunday, the heart transplant team at Fortis Hospital was informed about the availability of a donor heart from Surat.
As luck would have it, from among all the 116 waitlisted patients in Mumbai, it was the 27-year-old Ukrainian’s blood group and other tests that matched perfectly with that of the 22-year-old banker from Surat . He had died in a road traffic accident and was declared brain dead.
For the Zonal Transplant Coordination Centre (ZTCC) in Mumbai, the donor heart may have matched with that of the Ukrainian woman, but the preference had to be given to the waitlisted patients across Maharashtra and then in the country, Dr S K Mathur, vice-president of ZTCC in Mumbai, told The Indian Express. He said the organ distribution being a dynamic process, the procedures had to be well coordinated till the last minute.
“We found there were no eligible Indian patients in the same blood group who were available at that time in Maharashtra. The ZTCC in Pune and Aurangabad did not have any eligible Indian patient in the same blood group and hence the heart was then offered to the National Organ and Tissue Transplant Organisation (NOTTO). “Sometimes, the recipients are so ill that they cannot undergo a heart transplant. At other times, the patient on the waiting list is not available,” Mathur explained.
“It was only after we got a written assurance from NOTTO that no eligible recipient was immediately available than we decided to go ahead with the heart to be transplanted in the Ukrainian woman,” Dr Mathur told The Indian Express. On Monday, the first international heart transplant was performed where the 27-year-old Ukrainian got an Indian heart
Dr Gustad Davar, ZTCC Mumbai president, told The Indian Express that the centre had registered 56 heart transplants in Mumbai. “Our donor pool is also increasing. According to the guidelines, preference is always given to local patients on the waiting list and the second criterion is medical necessity,” Davar said. He said that despite over 100 patients on the waiting list, it is not always easy to get a compatible match with the donor heart.
According to cardiac surgeons, apart from blood group match, the size of the heart, the weight of the patient and other tests are required to ensure that there is no rejection once the heart is transplanted from the donor to the recipient. The 27-year-old had suffered a medical emergency while in the ward at Fortis Hospital and had become critical, according to the doctors. “She suffered a minor cardiac arrest, had difficulty in breathing and was shifted to the ICU,” doctors at Fortis Hospital said.
While she was stabilised, on Sunday, the heart transplant team, headed by Dr Anvay Mulay, head of Cardiac Transplant Team, Fortis Hospital, Mulund, who was informed about the availability of a donor heart at Surat, left Mumbai in the wee hours of Monday (at 12.30 a m) and reached Surat at 6 am by road. While Mulay and his team began the procedure to remove the donor’s heart, in Mumbai, the team, headed by Pune- based cardiac surgeon Dr Sanjeev Jadhav, started the procedure on the 27-year-old to dissect her heart and put her on heart lung machine. Dr Jadhav, who is attached to Pune’s Jehangir Hospital and Mumbai’s Fortis hospital told The Indian Express that several investigations had to be done to ensure compatibility.
Harvesting of the heart took place at Unity Hospital in Surat. It was transported in 1hour and 32 minutes, covering a distance of 317 km, in a chartered flight. The retrieval and transplant surgery was conducted by Dr Anvay Mulay, head of Cardiac Transplant Team at Fortis Hospital, Mulund, and his team, including Dr Sanjeev Jadhav, CVTS Surgeon. Jadhav told The Indian Express the operation on the 27-year-old was risky. “The woman had suffered postpartum cardiomyopathy – or pregnancy-associated heart failure – a rare condition – last year. She had undergone a double valve repair in February this year in Ukraine and was on blood thinning agents. It was redo operation and the chances of bleeding and entering into her chest were high,” Jadhav said.
Nilesh Mandlewala, founder and president of Donate Life, an NGO, counselled the family of the patient. The patient’s father agreed to donate his heart, liver, pancreas, corneas and kidneys. Dr Mulay said: “The donor family’s contribution to the waitlisted patients is unmatched; they’ve saved and enriched the lives of seven recipients through their young son. The surgery has been concluded and the recipient is now stable. We will continue to monitor her in the ICU for the next 48 to 72 hours.”
Dr S. Narayani, zonal director, Fortis Hospital, Mulund, said: “This achievement is the fruition of efforts put in by all stakeholders who worked in tandem to breathe new life into our patient and six other deserving patients. We extend our humble appreciation to the donor family; it is because of them that our clinicians have managed to save this young lady.”