The miracle of heart transplantation—Dr. Dhiren Shah, Director, Heart & Lung Transplant Programme Marengo CIMS hospital

Ahmedabad : A change of heart changes everything, and let me tell you, this is not just philosophically correct, but also physiologically correct. I’m referring to heart transplantation.

“Heart transplantation is no longer a research procedure (or a non-imp topic for examination).” It is currently the preferred treatment for certain individuals with end-stage cardiac disease. It significantly improves the quality of life for bedridden and terminally sick heart failure patients. And I’ve seen this and had first-hand experience in the 40 heart transplants that I’ve performed,” said Dr Dhiren Shah, Director and Consultant, Cardio Thoracic and Vascular Surgery Department, Director Heart and Lung Transplant Programme, Director Mechanical Circulatory Support Programme, Marengo CIMS Hospital.

My favourite patient is a 17-year-old chulbuli girl from Amreli who had COVID viral myocarditis and eventually suffered from heart failure with just 15% heart function. She had been in the hospital for about 5 months and was not responding to any medical therapy. She was almost on her deathbed.  Heart transplantation was the only alternative available, and she was released from the hospital on the 14th day. Now, one and a half years later, she is dancing, playing, and attending school, just like any other adolescent. For any doctor, the most rewarding ‘Change of Heart’.

However, this was made feasible when the family of a brain-dead patient agreed to give their loved one’s organs. On that day, a 21-year-old young lad was involved in a car accident, which badly wounded his brain and rendered it irreversible. He was on a ventilator, but his other organ systems were well. His heart, lungs, two kidneys, liver, two eyes, and a set of hands were given, giving fresh life to eight individuals. Aside from the organs listed above, the pancreas, small intestine, and skin may all be given. Anyone from a few days old to 100 years old may donate organs dependent on their organ status.

Brain death is an irreversible disease caused by severe brain damage. The most frequent causes are either accidental injury, brain haemorrhage, or stroke. All of these individuals are generally on a ventilator and cannot breathe without assistance. An artificial support system will keep their crucial processes running.  Such patients are eligible to donate organs.

This is not the same as coma, which is a state of severe unconsciousness caused by brain damage. The brain is still working, and the individual can breathe on his own without the need of a ventilator. There is a possibility of brain recovery.  Such patients are unable to give organs. Patients who have cancer or are in serious condition due to an infection cannot donate organs.

Once we determine that the patient seems to be brain dead, doctors, either neurosurgeons or physicians, will run additional procedures, culminating in an Apnea test to confirm the patient’s brain death. After completing two Apnea tests on the patient, a panel of four physicians, including a neurosurgeon/physician, intensivist, anaesthetist, medical officer, and/or registered medical officer, may declare the individual as brain dead. Following that, the hospital must notify SOTTO of this possible organ donor. SOTTO, a government organisation, will now distribute organs based on the waiting list on the official listing. Once a patient has been confirmed brain dead, the organs must be removed within 24-48 hours.

Another prevalent method of organ donation is via living donors, in which any surviving close relative may give one of their kidneys or a portion of their liver to their blood relations.

Organs are harvested in the operating room, just like any other procedure. The body is not disfigured as a result of organ harvesting. After an organ is harvested from a donor, it may be used for recipients within 4 hours for the heart, 5-6 hours for the lungs, 12 hours for the liver, pancreas, and small intestine, and 24 hours for the kidney.

A person’s gift of organ donation may provide a decade or more of normal and flourishing life to someone suffering from heart failure, kidney failure, or liver failure who would not have survived even 3-5 years otherwise.

It is infinitely better to transplant a heart than to burn or Bury a heart to be devoured by worms. –Dr Christian Bernard