Soon, ‘Rehabilitation’ for Injured Hearts Outside Body Before Transplant Surgery
CHENNAI: In the near future, don’t be surprised if heart transplant surgeons agree to take an injured or ‘unviable’ heart and rehabilitate it briefly before they transplant it to a patient that needs the beating organ. Doctors at the Fortis Malar Hospital helmed by cardiac transplant veteran Dr K R Balakrishnan are working on a method to keep a sick or scarred heart alive and beating outside the body using a pump like an LVAD (Left Ventricular Assist Device) or an ECMO (Extra Corporeal Membrane Oxygenation).
“During this time, the heart’s condition can be improved and any trauma can be treated, before the transplant,” explains Dr KR Balakrishnan, Director of Cardiac Sciences at Fortis Malar Hospital. Though Chennai has one of the most well-coordinated transplant systems in the country, plenty of organs still go to waste, “When we harvest and transplant hearts, sometimes we only take 50-60 per cent of the available hearts. This is because they’re either not healthy enough to put into a patient or they’re too far away,” he adds. And quite often, when a sick heart is put into a fitter recipient, there is every likelihood that the heart’s ventricular function and general health state improves drastically.
In fact, the team did a trial run a month ago when they were offered a heart at the SMCH, “Two other hospitals had turned down the heart but we took it as our patient wouldn’t have lasted without it. We fed the heart nutrients and stabilised it before transplanting. To our surprise, she started improving almost immediately,” he adds, as he prepares to do a transplant on 21-year-old Hvovi Minocherchomji.
With time being the critical factor - any heart over 3-4 hours after harvesting not viable for transplant - keeping a heart alive outside the body without an expensive beating-heart carry case could really reduce distance worries, “If we can keep the donor’s heart recuperating for 9-10 hours, we can actually fly a heart from here to Kashmir and do the transplant,” he explains.