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Indraprastha Apollo Hospitals, Delhi has successfully performed heart transplantation on a 5-month-old infant suffering from dilated cardiomyopathy.

Date: 16 Feb 21

A 5-month-old infant became the youngest child to undergo a successful heart transplant at Indraprastha Apollo Hospitals on 13th January 2021. At birth, the baby was diagnosed with poor heart function (dilated cardiomyopathy) due to multiple holes in the left chamber of the heart. Consequently, the blood that was supposed to reach the heart was getting drained out, hampering its smooth functioning.

The baby was brought to the Emergency with no pulse and BP. He was resuscitated successfully after 4 hours of continuous efforts by the Emergency team and then his condition was stabilized in the NICU. Since the baby required a heart transplant, he was registered with NOTTO on the very day of his admission and the child received a heart from a 20-month-old cadaver donor.

A team of experts led by Dr Bhaba Nand Das, Senior Consultant, Pediatric Cardiology (Surgical) and his team comprising of Dr Rajesh Sharma, Senior Consultant, Pediatric Cardiology and Cardio Thoracic Surgery, Dr Mukesh Goel, Senior Consultant, Cardio Thoracic Surgery, Dr Deepa Sarkar & Dr Vikas Anesthesiologists, Dr Manisha Chakraborty, Cardiologist, Dr Muthu Jothi, Senior Consultant, Pediatric Cardiology and Dr Reetesh Gupta, Paediatric Cardiac Intensivist, conducted this transplant procedure and the process of procuring the organ.

Dr Bhaba Nand Das, Senior Consultant, Cardio Thoracic Surgery, Indraprastha Apollo Hospitals, said, “A human body requires a heart transplant as a definitive treatment in case of an end stage heart failure, where medical therapies and external supports are not able to control and revive heart function. Generally, all transplants are done with a matching blood group donor, including heart transplant. But in case of children where it is very difficult to get organs in the first place, getting a matching blood group donor is extremely rare. Therefore, for children we do accept mismatched blood group transplants.”

“Like in the case of this child, his blood group was O+ and the donor child was AB+. While most of the times no complication arises, but in case of any, there are certain modalities and therapies like plasma exchange that we do, if such a situation arises.”

Dr Mukesh Goel, Senior Consultant, Cardio Thoracic Surgery, Indraprastha Apollo Hospitals said, “All the organs harvested from the donor should be transplanted into the recipient within a specific time duration. For the heart, it is 4 hours, because once the organ is taken out of a body, it stops getting oxygen, blood supply and other nutrients and consequently the cells of the organ start dying. Therefore, in case of heart transplant, if it is transplanted into another person after 4 hours, the organ may not function properly. Post that depending on the patient’s condition many of them may require temporary ECMO support till the organ regains full function on its own.”

Dr Muthu Jothi, Senior Consultant, Pediatric Cardiothoracic Surgery, Interventional Cardiology at Indraprastha Apollo Hospitals, said, “When the child was admitted with us, his heart was unable to function unless on ventilator support. While we knew only a heart transplant could save the child, getting a heart for a child as young as him was very rare and difficult. Nevertheless, on the very first day we had registered him with NOTTO and on 8th January we were notified that parents of a brain dead child (20-month-old) were willing to donate his heart, kidney and liver. A special Green Corridor was created through which the team could bring the organ back to the hospital within 17 minutes and exactly within 2 hours 5 minutes the heart transplant was done successfully.”

The child is under observation and he will be put on anti-rejection therapy to ensure that the heart functions normally.

 

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