Heart Transplantation in India

What is a heart transplant?

doctor doing heart operation

A heart transplant is a surgery in which a diseased heart is removed and replaced by a healthy donor heart.

This is a complex process that requires two more experienced medical professionals.  

A heart transplant is mainly required for people with severe heart failure and coronary diseases.

When there is no other treatment option available, or the treatment is not working then the patient will require a heart transplant.  

An end-stage heart failure patient will require a heart transplant to live a normal life. Heart failure is a condition in which a patient ‘s heart does not work properly or efficiently as it should.

It can affect either side of the heart and both at the same time. 

Why does a heart transplant need?

There could be several reasons to transplant a heart. The conditions which could eventually require heart transplant surgery in India are:

 

  • End-Stage Heart Failure – Heart failure occurs when the heart of a person has weakened over time and cannot circulate blood efficiently into the body of a person. People experience end-stage heart failure when medications and other treatments cannot improve the condition of the heart.

 

  • Coronary Heart Disease – It means that a blockage in the arteries caused by the deposition of fatty substances could interrupt the flow of blood in the body.  
  • Cardiomyopathy – Cardiomyopathy is a term used to define the thickening of the wall of the heart which makes it stiff and insufficient to pump blood.  

 

  • Congenital Heart Disease – It refers to the birth defects that affect the functioning of the heart. The word congenital here means present since birth. The reason behind it is still unknown but researchers believe that it could be a result of genetic mutation, medical conditions or some lifestyle factors 
Heart Operation

Who can get a transplant?

Before getting a heart transplant a person must meet some eligibility requirements. Depending upon the patient’s health, age and lifestyle, the doctor will decide if the person should get a risky operation such as a heart transplant. 

There are some factors that a person eligible for a heart transplant: 

  1. If the person is ready to take care of themselves and ensure that the new heart stays healthy. 
  2. If your doctor believes that you can easily recover from a heart transplant surgery. 
  3. When the patient does not have any inherited condition.
  4. If you do not have any health issues that can shorten your lifespan. 
  5. If you do not have any active infection. 

 

These are some of the factors that make a patient eligible for a heart transplant, apart from these, depending upon the current general health condition, age and lifestyle factors, the eligibility for the heart transplant may vary.

How successful is the transplant?

The research for heart transplants started in the late 1950s but it took many years to perform the operation.

In 1967, the first heart transplant took place, but the patient did not live long.

However, the heart transplant was not a big success back then, but it has enormously improved as science and technology advanced.

With multiple research that has been done to get a drug that improved recovery, heart transplants became a new reality.

Nowadays, this experiment has become a treatment that has helped thousands of patients across the world to live longer and healthier lives.

More than 60,000 patients have gone through a heart transplant around the globe.  

The survival rate after one year of transplant is 80%, around 70% after five years and around 50% after 10 years of a heart transplant. 

How does a heart work? 

The heart is an organ made up of muscles. Its sole purpose is to pump blood throughout the body.

The heart has been divided into four chambers, having the upper chambers left and right atria and lower chambers left and right ventricles.

The left side of the heart pumps the oxygen-rich blood to the other organs whereas, the right side collects the deoxygenated blood and pumps it to the lungs.

The oxygenated blood provides nutrition and oxygen to the muscles, skin, brain etc. The other wastes and carbon dioxide is released into the blood and this blood returns to the right chambers.

The right ventricle pushes the blood to the lungs where the blood gets enriched with oxygen again and this cycle repeats continuously. 

How does heart failure affect your health? 

A normal and healthy heart functions properly and pumps blood to the body. Heart failure occurs when the heart could not efficiently pump blood. As a result of it, blood eventually gets collected into the organs.

Hence the patient experiences symptoms such as shortness of breath and swelling in the organs such as hands and feet.

Some people might experience heart failure due to a genetic condition which is an enlarged heart. X-ray helps in these cases to provide an image of the heart and its condition.

As a weak heart struggles to pump blood into the body leads to the stretching of muscle fibres. After a long period, these stretched muscles lead to an enlarged chamber which is weaker.   

Heart Transplant Cost in the world 

Heart transplant cost in the world fluctuates a lot depending upon the country in which the heart transplant surgery is performed. Different countries have distant heart transplant cost and here you can see heart transplant cost India, hence the list:

 

Countries 

Cost 

Cost in USD 

India 

Rs.15,00,000 – Rs.25,00,000 

$18,700 – $31,300

USA 

$1,600,000 – $1,700,000 

$1,600,000 – $1,700,000 

Nigeria 

₦ 9,500,000 – ₦ 9,800,000 

$22,000 – $23,000 

Turkey 

3,000,000 – 4,000,000 Lira 

$160,000 – $220,000 

Other options 

Some people cannot receive heart transplants due to certain reasons. In that case, other treatment options can assist the patient’s heart to function perfectly.

This option includes Ventricular Assist Device (VAD). This machine assists the patient’s weak heart to pump blood efficiently into the body. It gets implanted into the lower chamber of the heart.  

This device can be used for people who are waiting for a heart transplant surgery or people who are not eligible for a heart transplant due to any reason. These types of devices are being used by many patients across the world.  

If that also does work then, an artificial heart is used to support heart failure patients while they wait for a donor. It works as a short-term alternative till a donor’s heart is available.

Risks  

As heart transplant surgery is one of the most complex procedures, it includes many risks as well.

Apart from normal open-heart surgery complications such as bleeding, blood clot or infection, heart transplant surgery has other major risks which include: 

 

  • Rejection of donor’s heart: 

After a heart transplant, it’s quite frequent that the patient’s immune system rejects the donor’s heart, and it will eventually damage the heart.

To reduce this rejection of the donor’s heart, medications which are immunosuppressants are prescribed to the patient for some time. The doctor analyzes the condition of the donor’s heart through frequent biopsies.   

 

  • Graft failure:  

Graft failure is one of the main reasons for death after a few months of heart transplant surgery. It is because the heart cannot function properly.  

 

  • Blood vessels complication:  

After a heart transplant surgery, the arteries of the heart thicken and get blocked resulting in cardiac allograft vasculopathy.

This eventually leads to other heart complications such as heart attack, heart failure and cardiac death.  

 

  • Drug side effects:  

The drugs used to cause further complications. Normally used immunosuppressants can interfere with the working of other organs. This leads to damage to the kidney and other organs.  

 

  • Cancer or infection:   

The use of an immunosuppressant can decrease the ability of the patient’s immune system to destroy foreign organisms or substances.

It decreases the ability to fight infectious organisms such as bacteria or viruses. These types of drugs can increase the risk of skin cancer or other blood cancers.  

The Process of Heart Transplant Surgery 

The heart transplant surgery takes several hours as it is a complex surgery. Before beginning the procedure, the patient is given general anesthesia and a heart and lung bypass machine. The heart-lung bypass machine helps to circulate oxygenated blood to the body. 

The surgeon will be making an incision in your chest and the chest bone is removed which can let the surgeon operate on the heart directly. The surgeons will detach the diseased heart from the blood vessels and remove it. 

 After the removal of the diseased heart, a healthy donor heart will be embedded into the cardiac cavity.

The blood vessels will be joined back to the new heart. This will lead to blood travelling to the new heart and its working takes place. In some cases, an electric shock can be provided to the heart so that it can begin beating. 

After the operation, a pain reliever and certain medications will be provided to the patient.

The patient will be admitted to the ICU after the surgery to ensure that other organs are working properly.

After successful transplantation of the heart, the patient will be discharged in a few weeks. Regular check-ups will be required so that the doctor can assure that the patient is doing file. 

 

Before and After the Heart Transplant Surgery   

There are some things that a patient needs to manage before and after going under a heart transplant surgery.  

 

  • Before Heart Transplant Surgery 

Before the heart transplant surgery should be considered, the doctor will decide if the patient is eligible for the transplant or not.

After that, the doctor will run some tests to check the overall health of the patient or the current condition of the heart of the patient.  

After the patient has been considered eligible, then the patient will be placed on the waiting list for a heart transplant.

Until a matched donor is found, the patient can either get assistance from VAD or an artificial heart. Both of these devices help the weakened heart of the heart failure patient to work efficiently.  

 

  • After Heart Transplant Surgery 

After a donor heart has been found and transplanted into the patient, the patient will be kept under observation in the ICU.

The medical professionals will take care of the patient and look for any risks or complications after the procedure.  

The patient will be given some medications and immunosuppressants to reduce the risk of organ rejection.

There will be many lifestyle changes that the patient needs to make in their day-to-day life.

The doctor will ask the patient to take cardiac rehabilitation which can help them regain their strength and ability to do daily chores. 

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