The baby with her father Vladislav and mother Evangelina and the doctors of MGM Healthcare, Dr. K.R. Balakrishnan, Director, IHLTMS, Dr. Shahid A. Merchant, Senior Interventional Cardiologist, and Dr. Suresh Rao KG, Co-Director, IHLTMCS
The doctors at Chennai’s leading hospital, MGM Healthcare did a successful heart transplant to provide a new lease of life to a one-and-a-half-year-old child from Bulgaria. What makes this surgery truly rare and tough is that it was an ABO-incompatible paediatric heart transplant, which crossed the barrier caused by a diverse blood group.
The run-up to this operation was full of suspense and uncertainties as the baby suffered cardiac arrests several times before the transplant. This made the team led by Dr. K.R. Balakrishnan and Dr. Suresh Rao KG, Director and Co-Director at Institute of Heart and Lung Transplant and Mechanical Circulatory Support, proceed very cautiously.
Talking to India Narrative, Dr. Rao described the surgery “a miracle and wonder”. “The 18-month-old baby suffered several heart failures before the transplant. The mother had video consultation with us and decided to come to Chennai for treatment. In the air ambulance the child had cardiac arrest and was revived. Flying over Karachi again there was arrest and revival after 40 minutes. Arriving at the hospital, she again had another cardiac arrest and was resuscitated after 45 minutes.”
The baby was in a comatose condition and put on venoarterial-ECMO to support the heart and lung and became conscious after 48 hours. “We were contemplating on implanting artificial or Berlin heart, which is a stop-gap arrangement till transplant is done, when we came to know about the availability of a donor heart from a two-year-old brain dead at Mumbai’s Wadia Children’s Hospital. As there was no suitable Indian recipient available, it was allotted to this baby in Chennai by National Organ & Tissue Transplant Organisation,” Dr. Rao told India Narrative.
While the heart was from a donor with a different and incompatible blood group, the MGM team decided to go ahead. “As the patient has A group and the donor B, we removed anti-B antigens to effect acceptability,” Dr. Rao told India Narrative. The transplant was carried out and the patient was provided ECMO support for pumping and oxygenating the blood to enable the heart to recover completely. The immunosuppression was dealt with and the baby made a complete recovery and is doing well.
Talking about this surgery, Dr. Balakrishnan in a statement said: “ABO-incompatible heart transplants can only be performed on babies and small children since the immune system is immature and there is very little chance of organ rejection response, which can allow for an ABO-mismatch heart to be used. This increases the donor pool and decreases wait-list mortality. This case exemplifies the true potential of medical science when coupled with determination and a collaborative spirit.”
Dr. Rao views the operation as a “pioneering and extraordinary effort”. “It can be a case study for the future and it can help in doing this type of surgery,” he told India Narrative.
Commending medical therapy in the country, Dr. Rao informed India Narrative that “India is in the forefront in providing medical expertise in diverse fields. We have come a long way since 1947. We always had the expertise and now we have infrastructure and equipment. In the years to come the country will emerge as the number one destination for medical tourism.”