Know Everything About Heart Transplant In India

The first Heart Transplant in India was carried out at All India Institute of Medical Sciences (AIIMS), New Delhi on August 3, 1994, and the patient lived for 14 years. 

congestive heart failureA heart transplant, or a cardiac transplant, is a complex surgery to replace a diseased heart with a healthy heart from a brain-dead donor. It is performed on patients with end-stage heart failure or where other treatment options fail.  

Why is Heart Transplants performed?

Health conditions that may require a heart transplant are:

Coronary Heart Disease: When fatty substances deposit around the arteries walls resulting in serious left ventricular dysfunction.

Peripartum Cardiomyopathy: A rare type of heart failure that can happen anytime between the last month of pregnancy to five months after delivery.

Congenital Heart Disease:A group of birth defects that affect the normal functioning of a heart, thus causing multiple complications.

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Heart Transplant Procedure: Criteria and Eligibility  

Your doctor suggests heart transplantation when your body stops responding to other treatments. Firstly, heart transplantyour doctor conducts pre-evaluation tests to detect the underlying causes, demanding a transplant and pre-existing health conditions.  Most often, congestive heart failure leading to weakened heart muscles is the main reason for the possibility of a heart transplant. The doctor recommends a heart transplant in India after complete evaluation

Heart Transplant Process: Pre-evaluation and Assessment

Based on the symptoms you’re experiencing, your doctor may perform some pre-evaluation tests to proceed further with the heart transplant. These tests include:

  • Electrocardiogram:  Your doctor places electrodes on your chest to record the heart’s signals and activity. The signals are displayed in the form of waves on the attached screen.
  • VO2 Max Test: This test includes the use of a treadmill connected to a machine that displays the amount of expired air. This test displays how much oxygen you use and consume during walking on the treadmill.
  • Laboratory Tests This includes a series of blood tests to check any signs of pre-existing viral infections.
  • Chest X-ray To check if there is any abnormality in the lungs and the size of the heart.
  • Cath Study This procedure measures the pressure levels in the right area of the heart. The procedure begins with local anesthesia followed by the insertion of a catheter into a vein in the neck or groin to assess the pressure levels in the heart chambers and blood vessels.
  • Pulmonary Function Test To check the functionality of the lungs and their oxygen-carrying abilities.
  • Carotid & Peripheral Doppler Study In this procedure, the doctor uses an ultrasound probe to find out if there is any blockage in the carotid and leg arteries.

What are the legal requirements for a heart transplant in India?

To undergo a Heart Transplant in India one has to follow legal requirements as it is one of the body’s main organs, it can be transplanted only from a brain-dead donor. Following procedures need to be followed in case of heart transplant such as:

Cadaver’s Family Consultation

It is the most important and first step. The transplant coordinator consults the cadaver’s family members to take consent from them for the transplant.

Health Insurance Policy

Heart transplantation is a costlier procedure. It is better if you have health insurance that covers transplant costs.

Doctor’s Certification

The patient needs to carry a doctor’s certification along before admitting to the hospital for surgery.

NOC Certificate

This is for international patients. The patient must carry a NOC certificate from their home country’s embassy.

In case, you are unable to find a donor for yourself or your family member, get yourself registered through the hospital. In this way, when the donor becomes available, the hospital will immediately contact you. 

Heart Transplant Procedure: How it works

The heart transplant process is an open surgery, it may take several hours or longer. Once the donor is available, the surgeon begins with the procedure that includes:

  • The surgeon injects general anesthesia and connects you to a heart-lung machine to facilitate the flow of oxygen-rich blood throughout your body.
  • Now, the surgeon makes an incision in your chest cavity to access your heart.
  • Proceeding further, the surgeon removes the diseased heart, places the donor’s heart, and reconnects blood vessels to the transplanted heart.
  • Most often, the transplanted heart starts beating as soon as it is placed else the surgeon has to provide an electric shock to make the new heart work properly.

After the surgery, you will be kept in ICU for a few days before shifting to your room. You will get fluids and medications through intravenous (IV) tubes. Also, for the first few days, you will breathe through a ventilator and tubes in your chest to drain out fluids accumulated around your heart and lungs. 

Approximately 300 heart transplants take place every other day.

Post-Heart Transplant Procedure & Recovery

  • After the procedure, the transplant team will closely monitor your overall health including pulse rate, weight, heart rate, blood pressure, and temperature. 
  • There are cardiac rehabilitation programs that help in the post-surgery recovery process. The transplant counselor keeps track of at what pace you are recovering. 
  • The team provides details to you about learning the signs of transplanted heart failure, rejection, or infection. 
  • Also, the team organizes a three-month follow-up plan for you to check the status of transplanted heart infection or rejection.

Resuming Life After Heart Transplant 

A successful heart transplant is a new life to you. Therefore, precautions need to be taken even after the transplant. 

Regular follow-up visits: For the first few weeks after the transplant, your doctor will advise you to follow up with the team to monitor your health progress. This will gradually decrease afterward.

Taking immunosuppressants: As there are chances your immune system may attack the new organ. This is why your doctor prescribes immunosuppressants that you will need to take over your lifetime.

Hygiene: Following good hygiene, routine vaccines, and an opting healthy lifestyle are a choice that you need to follow post-surgery.

Complications that may arise after heart transplant

Like every surgery, a heart transplant has its own share of risks and they are:

    • Infection
    • Chances of bleeding during or post-surgery
    • Kidney failure due to immunosuppressants
    • Formation of blood clots that could go in other organs leading to lung problems, stroke, or heart failure
  • Coronary allograft vasculopathy (CAV), a common type of coronary artery disease that could happen after heart transplantation. It could even occur in heart transplant recipients even after 10 years.
  • Even death

To avoid such situations, follow-up visits are mandatory and prescribed medications must be taken. Sometimes, these medications have side effects such as:

  • Repetitive infections
  • Poor blood circulation throughout the body
  • Serious health problems 
  • Chances of development of metastatic cancer
  • Alcohol or drug abuse

Quality of life after Heart Transplant: Success Rate and Life Expectancy

  • The progression of medicine is directly linked to the life expectancy of patients after undergoing a heart transplant. 
  • A successful heart transplant is a ‘gold standard for patients with end-stage heart disease. 
  • The success rate of heart transplants is approximately 95% with lesser risks and complications.
  • Recent studies have shown that nearly 83% of patients survive for one year after transplant and 70% of patients live for nearly five years.

Choosing the Best Heart Transplant Hospital in India

  • India has nearly 40 Joint Commission International (JCI) accredited hospitals. All these hospitals are well-reputed, have lower mortality rates, have technological expertise, and are well-experienced medical professionals.
  • Almost all the hospitals accept insurance coverage as well.
  • These hospitals hold strong experience in living and deceased donor organ transplants.

Following are some of the best heart transplant hospitals in India:

Fortis Hospital, Bangalore: 

Established in 2006, Bangalore’s one of the finest, multi-specialty hospitals has a reputation as one of India’s best heart transplant hospital. Headed by Dr. Manish Mattoo, the hospital has nearly 150 well-experienced, qualified consultants and around 1,500 paramedical staff.

MGM Healthcare, Chennai:

Chennai’s 450-bedded multi-specialty hospital, headed by Dr. Bala Krishnan, is known to have nearly 110 heart transplants annually and around 120 pediatric heart transplants which is the highest record in Asia. The cardiologist team has performed approximately 24,500 cardiac surgeries.

Global Hospital, Chennai: 

Established in 1999 by India’s most sought-after surgeon – Dr. K Ravindranath, it is a NABH, NABL, and HALAL accredited hospital founded. The hospital holds expertise in organ transplants including heart, liver, kidney, and lungs.

KIMS Hospital, Secundrabad:

Founded in 2004 by Bhaskara Rao Bollineni, it is a multi-specialty hospital with a capacity of over 1,000 beds. Spread over a five-acre plot, it is a NABH and ISO 9001:2008 certified hospital. The hospital received certification of Green OT-certified hospital in Andhra Pradesh and Telangana. The hospital has qualified and well-experienced team of cardiologist and cardiovascular surgeons available round the clock.

Fortis Malar Hospital, Chennai:

Founded in 2004 by Bhaskara Rao Bollineni, it is a multi-specialty hospital with a capacity of over 1,000 beds. Spread over a five-acre plot, it is a NABH and ISO 9001:2008 certified hospital. The hospital received certification of Green OT-certified hospital in Andhra Pradesh and Telangana. The hospital has qualified and well-experienced team of cardiologist and cardiovascular surgeons available round the clock.

It is important to have a second opinion from another doctor or patients who have had a heart transplant before choosing it as your treatment. 

Left Ventricular Assist Device (LVAD) – An Overview!

A left ventricular assist device, or LVAD, is a device in the form of a mechanical pump that is surgically implanted inside the chest just below the heart to help function a weakened heart. One end of the device is attached to the left ventricle that helps in carrying oxygen-rich blood from the heart to other body organs and the other end is attached to the main artery, aorta.Left Ventricular Assist Device

Benefits and Risks of LVAD Implantation

LVAD device restores the blood flow by the heart disturbed by a heart disease. It also helps relieve symptoms like fatigue, breathlessness, etc. Furthermore, it also increases an individual’s strength, helps doing physical activities, and improves other organs as well.

Like any surgery, LVAD implantation is an open surgery and has its share of risks and complications. These complications include:

  • Infection
  • Device implantation failure
  • Stroke
  • Heart failure
  • Other organs failure such as kidney or respiratory failure
  • Internal bleeding

Consult and discuss with your cardiology team if LVAD device implantation is appropriate for you. 

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