PUNE: Army Institute of Cardio Thoracic Sciences (AICTS), Pune is a 600 bedded super speciality hospital of the Indian Armed Forces. It is one of oldest centres of Cardio Thoracic Surgery in India. AICTS achieved a major milestone in its glorious history when its first Paediatric Heart Transplant was carried out on 30 May 2022.
Mohd Fardeen Mansoori, 14 years old teenage son of an Army Veteran, first presented to the hospital about two years back with complaints of breathlessness and fatigability. The doctors and parents both suspected him to have some infection which would get cured in week or two. The fate had other plans and little did anybody suspect that the child was harbouring a grave heart disease leading to dilatation of his heart and reduced efficiency.
The child did not have any improvement and would have repeated admissions to cardiac ICU with episodes of heart failure. There was no therapy to cure the disease and seeing the life slowly ebb away from this young boy, he was accepted for heart transplant about 18 months back and included in the list of recipients waiting for same.
The challenge in this particular case was to find a heart which matched this young boy in weight, blood group and was within reasonable distance to enable safe retrieval and transplant. After a long wait of over a year the fateful day arrived on 30 May 22, when the team at AICTS received an alert for a probable heart donor, a 14 years old girl, who had sustained head injury following a road traffic accident. She matched the waiting patient in weight and blood group. Coordination was carried out with Zonal Transplant Coordination Centre (ZTCC), Pune District for explanting the donor heart from Sahyadri Hospital, Pune.
The alert was received late at night and the AICTS swung into action and the process of evaluation of heart for retrieval started almost immediately and a tentative time of 10 AM was fixed for the same. The team from AICTS reached the hospital for retrieval and after the liver and kidneys were harvested, the heart was removed, packed and rushed to AICTS.
The Corps of Military police of HQ Southern Command coordinated with Pune Traffic Police to establish a GREEN CORRIDOR for seamless transport of the donor heart to AICTS, Pune in just 11 minutes.
At AICTS the recipient was already in the operation theatre and the native heart was about to be removed from the patient’s body. Thereafter the whole team worked at a breakneck speed and the heart was transplanted in the mandated time frame. However, the work was not over, and only a part of it had been completed. The surgery was followed by a stormy post operative course with the patient requiring ECMO (Extra Corporeal Membrane Oxygenation) support as the new heart was taking time to find its rhythm and function. It still requires a comprehensive multi-disciplinary team work to return a healthy childhood to the young boy.
The heart transplant as a therapy of end stage heart failure has come a long way since its beginning in the labs of US and South Africa since 1960’s. The importance of transplantation is only now beginning to be understood and accepted by the society. This acceptance is leading to increase in availability of donors. This acceptance still has to overcome social mores and beliefs in a more global manner.
Successful heart transplantation is a culmination of years of training, refining of techniques and smoothening of edges of well-rehearsed protocols. AICTS has successfully started this arduous journey to make this therapy easily and widely available for its dependent clientele.