40 Year Old Pakistani National Undergoes Complex Heart Transplant At The Centre Of Excellence For Advanced Cardiac Care At Fortis Malar, Chennai.
40 year old man with severely depressed heart function
Pumping efficiency (Ejection Fraction) less than 15%
Hepatitis C infection of the liver, established Renal Failure and Fungal Infection
Difference in the blood group of the donor and recipient, and the recipient was AB+ a rare blood group
Reflecting its commitment to saving and enriching lives beyond boundaries, a team of cardiac experts at the centre of excellence for advanced cardiac care Fortis Malar, Chennai, led by Dr. K R Balakrishnan, Director Cardiac Sciences performed a lifesaving surgery on a Pakistani National who underwent heart transplantation.
40 year old, Moulana Mohammed Zubair Ashmi resident of Tehsil Kharian, District Gujarat, Pakistan, was suffering from a condition called “Dilated Cardiomyopathy”, where the functioning of both the ventricle of the heart is severely depressed. He was repeatedly admitted in several hospitals with breathing difficulty, poor urine output and swelling in the body. Doctors finally diagnosed him as having heart failure and advised his family about heart transplant.
“He had been on medication in Pakistan for more than a year since he was diagnosed with decreased pumping efficiency of the heart of around 10-15 % (Normal being 60 percent) – a condition denoting his poor heart function. When his condition became precarious, he was airlifted from a leading heart hospital in Lahore, Pakistan. Upon his arrival at Fortis Malar, we performed a detailed medical examination, and realised he also had renal failure, had fluid in his lungs and abdomen and was also hepatitis C positive. All this just made his condition extremely difficult to treat” explained Dr. K R Balakrishnan, Director Cardiac Sciences, Fortis Malar.
Despite being on maximal drugs, his cardiac function was deteriorating, leaving doctors at Fortis Malar with the option of either finding a donor heart urgently or fitting him with an artificial heart implant device. His kidney was nearing ‘shut down’ with a serum creatinine of about 3.8mg% (normal < 1mg %) and scanty urine output of less than 150 cc per day. Since his right ventricle was severely dysfunctional, artificial long term artificial heart pump support was ruled out.
Luckily for Zubair, after a wait of approximately 2 months, a suitable Indian donor heart became available even though it was of a different blood group, thanks to the highly efficient organ sharing network system created in the State by the Govt. of Tamil Nadu.
“If the transplant had been delayed by even 2 days, it would have cost him his life. Though most of the transplants are usually done on people with same blood group, in Zubair’s case the donor’s blood group was O+ve and his was AB +ve. The tissue mapping in this case was good and viable. His Hepatitis C was treated with Interferon thereby reducing the viral load and Renal disease was managed with Inotropes to increase the renal blood flow and Immuno suppressants was modified to limit damage to the kidneys” added Dr. Suresh Rao, Chief of Cardiac Anesthesia and Critical Care.
Today Zubair is a happy man and is grateful to God that he was lucky. “I already feel I have got a new lease of life,” he said. Post surgery, he is recuperating well and is able to walk and take food on his own and his kidney function has completely recovered.
“Dr. K R Balakrishan said “There are close to 1.5 million patients diagnosed every year with new onset heart failure in India, and at least a third of them will need advanced therapy to survive.”
“Fortis Malar has one of the best cardiac teams in the country and we look forward to more remarkable milestones in the future” said Mr. Vijayarathna, Zonal Director, Fortis Malar Hospital.
About Dilated Cardiomyopathy
Dilated cardiomyopathy is a condition in which the heart becomes weak, enlarged and cannot pump blood efficiently. It affects the heart’s ventricles and atria. These are the lower and upper chambers of the heart, respectively. The decreased heart function can affect the lungs, liver, and other organs as well. It occurs in people of all ages, including infants and children mostly between the age group of 20 to 60.The disease often starts in the left ventricle, the heart’s main pumping chamber. The heart muscle begins to dilate (stretch and become thinner). This causes the inside of the chamber to enlarge. The problem often spreads to the right ventricle and then to the atria as the disease gets worse.