Four states, one heart transplant

Fingers crossed for 96 hours

By Rith Basu
  • Published 22.05.18
The ambulance (circled) carrying the harvested heart arrives at Fortis Hospital on Monday morning. Pictures by Gautam Bose

Anandapur: A heart harvested from a brain-dead road accident victim in Bangalore on Monday morning was transplanted about four hours later in a man from Jharkhand at a hospital in Calcutta by doctors flown in from Chennai.

Dilchand Singh, 38, the recipient of the heart, is "under strict observation" in an isolation room at Fortis Hospital in Anandapur, off the Bypass. Doctors could only say after 96 hours whether he was "preliminarily out of the critical stage".

Eastern India's first heart transplant was also marked by the first green-channel transportation of a vital organ to Calcutta from another city.

Concerted efforts by multiple agencies resulted in the heart harvested from 21-year-old Varun D.K. at SPARSH Super Speciality Hospital in Bangalore's Yeshwantpur at 7.19am reach the Bypass hospital at 11.29am.

The journey spanning 2,000km could be completed in four hours flat because of green channels police in Bangalore and Calcutta created to facilitate the organ's transit.

The ambulance ferrying the heart took 26 minutes to cover the 32km from the Yeshwantpur hospital to the Bangalore airport, a journey that involved negotiating six major traffic signals.

In Calcutta, the 20km journey from the airport to Fortis hospital was made in 20 minutes.

"We have never tried something like this before," said cardiac surgeon K.R. Balakrishnan of Fortis Malar Hospital in Chennai, who flew down with his team for the surgery.

"Two teams of doctors left Chennai early on Sunday. One reached Bangalore to retrieve the heart and the other came to Calcutta to ready the recipient for the transplant."

The family of Varun, who had met with a road accident and was admitted to SPARSH Super Speciality Hospital, agreed to donate his heart and other organs after he was declared brain dead.

Singh, a para-teacher who had been suffering from dilated cardiomyopathy, was chosen as the recipient after three parameters of Varun - blood group (A positive), body weight and another blood parameter called CDC - matched his.

Ujjwal Das, the ambulance driver
Cardiac surgeon KR Balakrishnan

Dilated cardiomyopathy is a condition in which the heart loses its ability to pump blood because of enlargement of its main pumping chamber, the left ventricle.

Singh, a resident of Jhanjhi village in Jharkhand's Deoghar district, was among the prospective recipients registered with the National Organ and Tissue Transplant Organisation.

A detailed transportation plan was worked out involving multiple agencies of the two cities. The plan focussed on saving as much time as possible because a heart has to be transplanted within four hours - it can be stretched to five - of the harvest.

A seat was reserved on an IndiGo flight for the 20kg white box containing the heart, which was dipped in a solution called cardioplegia. The temperature in the box was maintained between 2 and 4 degrees Celsius.

"This was the first heart transplant in eastern India and we hope it creates awareness here. Many teams of doctors have received training and are equipped to perform heart transplants but such surgeries do not happen in the region because relatives of brain-dead patients do not come forward to donate organs," said Balakrishnan.

Data gleaned from 260 cardiac transplants at Fortis Malar Hospital suggests that 95 per cent of the recipients survive for up to 30 days, 85 per cent survive for up to five years and 70 per cent for up to 10 years.

Transplant coordinators of Fortis. (From left) Dhanraj, Shanmugasundaram and Sandip Sarkar

The team of 15 doctors who conducted the operation included Suresh Rao, chief cardiac anaesthetist of the Chennai hospital. The team members from the Bypass hospital included Tapas Raychaudhury and K.M. Mandana, cardiothoracic and vascular surgeons, and Saikat Bhattacharya, intensivist and cardiac anaesthetist.

Singh's brother Umesh, 29, who was the only one accompanying him, said they received a call from the Calcutta hospital on Sunday morning and left for the city within two hours. "It's a big operation and we knew it was risky but my brother was suffering so much that he decided to go for it," said Umesh.