Resuscitation technology offers new possibilities in heart transplants

Extra-corporeal membrane oxygenation helps in revival after cardiac arrests

Updated - March 21, 2018 06:31 pm IST

Published - March 21, 2018 06:56 am IST - CHENNAI

 Two recipients of hearts, along with their parents and doctors, at Fortis Malar Hospital.

Two recipients of hearts, along with their parents and doctors, at Fortis Malar Hospital.

When 12-year-old Sri Supriya suffered a cardiac arrest while waiting for a heart transplant recently, doctors massaged her heart for around an hour. Then, they put her on ECMO — extra-corporeal membrane oxygenation — a process in which the blood is oxygenated in a device and pumped back into the body. This form of Extra Corporeal Pulmonary Resuscitation (ECPR), said K.G. Suresh Rao, head of cardiac anaesthesia at Fortis Malar Hospital, saved her life. After two weeks on ECMO, when a donor heart became available, it was transplanted on to her, and now she is doing very well,” he said.

Dr. Rao was speaking at a press meet conducted by the hospital on Tuesday. In the 19 cases that the hospital has performed ECPR where the patients have had cardiac arrests and then transplanted a heart, 13 have survived, he said. In many cases, the heart has stopped for an hour and more before reviving, the doctors said.

In another case at the hospital, an 8-year-old Russian boy, Roman, who too was waiting for a transplant, had three cardiac arrests — one before his transplant, and two after. Traditionally, said K.R. Balakrishnan, director, cardiac sciences, at the hospital, if the brain remains without blood flow for three minutes, it is irreparably damaged. There is a little more time if the patient is in an ICU, he said, but not more than 10 minutes or so.

Traditional CPR or massaging the heart had a less than 10% survival rate in cases of cardiac arrest, but the hospital found that with ECPR, it was around 70%, said Dr. Rao.

The hospital also used adult donor hearts that were considered sub-optimal — rejected by several other hospitals as their function was not very good.

However, Dr. Balakrishnan said they often became completely normal after being preserved and transplanted.

Parents of the children thanked the team and the Aishwarya Trust, which helped fund the surgeries. Russian Consul General in Chennai Sergey L. Kotov participated.

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