More than two months after he was brought to India in a critical state, Mohammad Zubair Ashmi, 40, is ready to go back to his country Pakistan, with a new heart.
The heart transplant was performed on April 23 by Dr KR Balakrishnan, director, cardiac sciences, Dr Suresh Rao, head, cardiac anesthesia and critical care and their team at Fortis Malar Hospital, Chennai, Tamil Nadu.
A teacher at the local mosque in district Gujarat, Ashmi was diagnosed with dilated cardiomyopathy, a condition in which the heart becomes so weak and enlarged that it begins to affect the supply of blood to lungs, liver and other vital organs, in 2012.
To make his condition worse, Ashmi also suffered from hepatitis C, had failing kidneys with a serum creatinine level of nearly 4 as opposed to the normal 1, and urine output as low as 200ml in a day. He lost nearly 15 kgs post surgery which was all water that had accumulated in the abdomen and legs.
“When he came to us his condition was so bad that it didn’t look like he would even survive more than a couple of days. We put him on advanced heart-failure medicines and listed him on our organ recipient list,” said Dr Balakrishnan.
Ashmi was fortunate to have received the organ within two months of having been put on the wait-list, after a 37-year-old road traffic victim was declared brain dead in a local hospital and his family agreed to donate his organs.
“We prepared for a transplant at 3 in the morning and fortunately for him the heart started beating within minutes of having been fit into the chest cavity,” said Dr Rao.
One of the major challenges before the medical team was to ensure his kidneys di not pack up as immunosuppressants commonly given to transplant patients are kidney toxic. The blood group of the donor was also different from him.
“We had to give him the modified form of drug and go in for gross matching and put him on medication to bring down the virus load,” said Dr Balakrishnan.
He could barely whisper before the surgery but one month after the transplant he now engages in long conversations. “I am feeling much better now. I want to go back now and teach. My wife and three kids are waiting for me and I also cannot wait to see them,” said Ashmi.
He will stay in the hospital for roughly 10 more days till the risk of infections runs out completely. “We are coordinating with cardiologists in Lahore so that he doesn’t have to make frequent trips to India for follow ups,” said Dr Balakrishnan.
The cost of treatment that came about Rs. 30 lakh because of his extremely sick condition and required him to be in the intensive care unit for more than 2 months, was borne substantially by the government of Pakistan.
On an average 250 hearts are donated in Tamil Nadu every year but not all get transplanted.
“Heart patients are usually very sick and unlike kidney patients who can carry on for years with dialysis, they cannot survive for more than two months. By the time a patient gets an organ, he has either already passed away or is too sick to bear the surgery,” said Dr Balakrishnan.