In a first of its kind for India’s premier medical institute, doctors at AIIMS have transplanted the heart of a 26-year-old man into a 10-year-old girl suffering from end-stage heart failure.According to the reports, The 10-year-old girl from Kolkata was admitted in AIIMS in December last year with complete heart failure. Her heart muscles were weak and she was suffering from jaundice.Despite all medications, the girl’s heart function had not improved and the family had lost all hope of her survival.
A Senior doctor said “Initially, we did not put her in the main list for transplant because she was too ill to undergo the procedure. Also, it’s rare for us to get a child’s heart from cadaver donors,”. He added that the girl’s case was considered for transplant only when the hospital could not identify any matching recipient for a heart from a 26-year-old cadaver donor.”Finally, we decided to take a chance on her. We are happy that it worked and the girl has survived,” said Seth. The transplant team was led by cardiac surgeon Balram Airan.
Cardiologists said Initially implications were found when the adult heart measured 53mm (end-diastolic dimension), nearly double the size of a child’s heart. However, surgeons could still fit the organ into the girl’s chest cavity because her diseased heart had swollen and was occupying a similar space.”The operating surgeon removed the recipient’s heart after matching the cavity to the donor heart,” said Dr Sandeep Seth, professor of cardiology at AIIMS. He said the girl has recovering well.
Seth added that the heart size mismatch was not the only challenge in the case. “The girl suffered from jaundice. We feared losing her after the transplant if the girl did not tolerate heavy immuno suppressive medicines given to check rejection of the transplanted organ. This could be overcome by keeping the dosage of the medicine low initially,” he added.”The long term survival in children is good and excellent 10-year survival data is available. Late complications and the long-term effects of immuno-suppression need to be anticipated and addressed as they arise,” said a doctor. He said the longest survival period after a heart transplant is 33 years.
The world’s first heart transplant took place in Cape Town, South Africa in 1967. In India, AIIMS was the first to conduct the procedure in 1994. Officials said AIIMS has performed nearly 35 transplants over the last two decades but this was the first case of child heart transplant.