For the past one year, Dr A Bahl, cardiologist, the Post Graduate Institute of Medical Education and Research (PGIMER), has been closely following up the case of Rohit (name changed) — the first successful heart transplant recipient at the hospital. In an interaction with Hindustan Times correspondent Tanbir Dhaliwal, Dr A Bahl shares some more details about the lesser known heart transplant.
How different or difficult is life after a heart transplant?
The first year after the heart transplant is very difficult, especially the first six months, as a patient is on high doses of immunosuppressant, which have its side effects. Patients are also prone to infections during this period. However, the life returns to normal after one year.
Why transplant was needed in Rohit’s case?
I am following up the case since April 2015. He had dilated cardiomyopathy (weakness of heart muscles) and his condition was not improving despite drug therapy. There was a risk of progressive heart failure or sudden death.
Does all those suffering from dilated cardiomyopathy need transplant?
Some patients respond to drug therapy, but those who do not respond need to undergo heart transplant.
What’s the cost of a heart transplant?
The effective cost of a heart transplant surgery is around Rs 80,000 to Rs 1 lakh. But the cost of immunosuppressant is quite high; it comes around Rs 5-6 lakh during the first year. The expenditure after the first year comes down to around Rs 60,000 in the second year. If major complications occur, than additional cost of around Rs 1 lakh could be added.
What’s the survival rate of such patients?
The data pertaining to Indian patients is not available. However, as per the western data, chances of five-year survival are 80% and around 50% for around 10-11 years. In some cases, people also live for over 30 years.
What are the main challenges in planning a heart transplant?
A major challenge is availability of a donor and the second chance is maintenance of the donor. Unless a donor is well maintained, the quality of heart goes down. And it reflects in the recipient. And the heart needs to be transplanted in just four hours.
How many heart transplants have been performed at the PGIMER?
Only two heart transplants have been performed at the hospital as of now. The first patient was improving but he died after five-and-a-half month.
How long is the waiting list?
Right now there’s only one application that has been accepted, while two more are admitted at the hospital, who also want to undergo transplant but we are analysing their cases. We have had a waiting list of heart transplant patients. Many of them, who could not get heart transplant, died on drug therapy. Some died in the want of the organ, while others making up their mind whether they should undergo transplant or not.
How many cases of dilated cardiomyopathy are seen at the PGIMER?
I don’t have the exact number, but I have personally examined around 450 cases in the past 10 years. One third recovered with drug therapy, which ideally goes for a lifetime. In rest of the cases, in which patients’ condition becomes critical, heart transplant is considered.
Do younger patients respond better to heart transplants?
The evidence suggests the rejection rate is slightly more among youngsters than older ones, though there’s a marginal difference.