Thiruvananthapuram: Once the consent is received from the donor's kin, the functioning of the heart is monitored closely. If the ECG, echocardiography and clinical functioning are normal and cross-matching of the blood of donor and recipient are perfect, then preparations are made to extract the organ.
The actual surgical procedure to extract the heart takes just about 15 to 20 minutes. The heart is then arrested.
After it is taken out, protection is given to improve the outcome of heart transplantation and reduce morbidity and mortality. Histidine-tryptophan-ketoglutarate (HTK) solution (it is a high flow, low potassium preservation solution is used for organ transplantations) for preserving it during transportation.
The donated heart is kept in a sterile plastic cover inside a picnic box filled with ice. This system can only preserve the heart for a maximum of four hours (two hours for optimal transplant results).
Though the recipient is kept ready for the transplant at the other end, his damaged heart is taken out only after the arrival of the donor organ. The patient is then put on cardio pulmonary bypass machine (a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body).
Once placed after surgical procedures, blood will be allowed to go into the heart and it will start pumping. When the blood reaches coronary vessels the heart muscles receive blood and energy and it starts functioning.
After transplantation surgery, the patient is put on ventilator and there are 60 per cent chances of him being taken off ventilator next morning. In the event of any problem, the patient may continue for one more day.
Once out of hospital, the patient has to be on lifelong immunosuppressants and come for regular check-ups besides biopsies to ensure there is no rejection.
( Dr Varghese Panicker, cardiac surgeon, Sree Chitra Institute of Medical Science and Technology)
