Exactly four months after Mumbai witnessed its first-ever successful heart transplant, city doctors pushed the envelope a little further yesterday, giving 16-year-old Sweden D’Souza from Vikhroli a new lease of life in the city’s first successful transplant on a teenager.
Not only has the surgery opened up a new interstate organ exchange channel between Maharashtra and Madhya Pradesh (where the heart came from), but it will also come as a ray of hope for hundreds of paediatric patients similarly waiting for cardiac transplants. This case was also a first for MP, where a heart donation had never been carried out before.
The heart was brought here within 1 hour and 56 minutes, covering a distance of 546 km between Choithram Hospital in Indore and Fortis Hospital in Mulund.
The heart came from the cadaver of a 20-year-old woman who had collapsed after an epileptic fit on Friday. Around 10 am the next day, she was declared brain dead at MGM medical college and hospital, Indore. “The patient had a history of epilepsy and fell down during a fit. She suffered a severe head injury that put her in a comatose state,” said Dr Pradeep Salgia, head of the hospital’s Nephrology department.
The woman’s family was asked for permission to carry out cadaver organ donation, and they readily agreed. The body was moved to Choithram hospital, a facility well known for renal transplants, but it was then learnt that her kidneys weren’t suitable for transplant. However, her other organs could be harvested.
The zonal transplant committees of the two states and Chennai NGO Muskaan commenced a channel of communication with Mulund’s Fortis Hospital, where two paediatric patients were already on the cardiac transplant waiting list. Test results confirmed that the donor’s blood group and weight were A+ and 35-40 kg — a match for 16-year-old Sweden. She needed immediate transplant as her heart had severely deteriorated due to dilated cardiomyopathy. Fortis Hospital’s head of cardiac surgery, Dr Anvay Mulay rushed to harvest the donor heart in Indore, which then began its journey to Mumbai at 7.11 am (see ‘Timeline’).
Upon arrival in Mumbai, the heart was rushed to Mulund through a Green Corridor laid out from the domestic airport (Gate No 8) to Military Road — Santacruz Chembur Link Road — Chheda Nagar to Eastern Express Highway — Airoli Junction and finally to Fortis Hospital, Mulund). The heart then went straight into the waiting hands of Dr Vijay Agarwal, head of Paediatric Cardiac Surgery, who became the first surgeon to undertake a paediatric cardiac transplant in Mumbai.
“This interstate transplant is indeed a breakthrough; with the channel opening up for PaedCard heart transplants, these little angels now have a ray of hope. This success story will help young patients suffering from end-stage organ failure. The surgery has been successfully concluded; the patient is stable and will be kept under observation for the next 48-72 hours,” said Dr Agarwal.
Paediatric or not?
So far, paediatric heart transplants have only been carried out in Bangalore. In general medical understanding, patients under 12 years of age are usually considered paediatric, however, doctors said Sweden’s heart surgery qualifies as Mumbai’s first paediatric heart transplant. “We don’t have an age group identified as adolescents in medicine. That’s essentially the reason why the patient can definitely be considered the first paediatric patient to undergo the transplant in Mumbai,” said Dr Sunil Shroff, a transplant surgeon and founder of Chennai-based Mohan Foundation.
Four months ago
22-year-old Anwar Khan became Mumbai’s first heart transplant success on August 3, after a cadaver heart was transferred from Pune to Mulund in 90 minutes through a Green Corridor.
mid-day had reported the path-breaking effort made to save him in a front-page report on August 4.
Friday: 20-year-old female sustains head injury, slips into coma
Saturday 10 am: Neurologists declare her brain-dead
4 pm: Donor’s family reaches Indore hospital for cadaver donation
7.11 am: The heart leaves the hospital
7.24 am: Heart reaches Indore airport
7.41 am: Air ambulance takes off
8.49 am: Lands at Mumbai airport
8.51 am: Ambulance leaves the airport with the heart
9.07 am: Heart reaches Fortis Hospital, Mulund
9.08 am: Heart is moved straight to the OT
2.44 pm: Surgery ends; patient is stable enough to be moved to ICU