Heart transplants to be performed soon in Pune's Ruby Hall Clinic, 27 years after its first kidney transplant. The hospital is waiting for its license from the state government.
It will be a crucial medical service given, once in place, that not a single hospital in Pune has the license to perform heart transplants. Every year 150 to 200 patients with end-stage cardiac diseases in Pune require transplants, say doctors.
In Maharashtra, only 4 hospitals (all from Mumbai) have the license to perform the procedure. Cardiac surgeon Chandrashekhar Kulkarni said, "Some of the end stage cardiac disease patients are at the prime of their lives. And they have no other option but to head to Hyderabad, Bangalore, Chennai and Mumbai for heart transplant. The city needs a functional heart transplant center."
Bomi Bhote, chief executive officer (CEO) of Ruby Hall Clinic said, "We applied for starting a heart transplant center four months ago. We are likely to get the approval from the Directorate of State Health Services in a couple of months. We have the requisite infrastructure and skilled manpower to carry out heart transplants."
Two patients are registered with Zonal Transplant Coordination Centre (ZTCC) in Mumbai which undertook its first heart transplant in 47 years. But in Pune, not a single patient is registered with ZTCC simply because there is no facility available.
Since 1997, more than 1,700-1,800 kidney transplant procedures have been taken up in city hospitals and doctors say the city is equipped for heart transplants as well. "If started, this will not only help needy patients get the needed treatment here but it will also attract patients from other countries as well. The city has already become one of the most sought after medical hubs in the country. Starting a heart transplant will further enhance this image," said cardiac surgeon Avinash Inamdar.
Also Pune has an extensive pool of medical experts, best operation theaters and many hospitals with with the national accreditation board - National Accreditation Board for Hospitals and Healthcare Providers (NABH) tag, said Inamdar. "Besides, the state government has now simplified the processes and defined rules for declaring brain dead persons, hence medico-legal issues are no more a hurdle," he said.
"The city has evolved considerably in organ transplant over the period. Starting heart transplant will take this image a notch higher. It will not only make the transplant available within Pune but also bring down the cost comparatively," said nephrologist Abhay Huparikar, secretary of the Zonal Transplant Coordination Centre, Pune. Huparikar along with a medical team did the first live and cadaver kidney transplant in Pune.
During November 2013 Pune's liver transplant program was initiated at Ruby Hall Clinic. Sixteen liver transplants have been carried out since then. Ruby Hall Clinic, KEM hospital and Deenanath Mangeshkar hospital have the requisite permission to carry out liver transplants in Pune.
The constraints in carrying out heart transplant as compared to kidney and liver transplant, was pointed out by Huparikar. "The deceased donor needs to be relatively young, free of heart diseases, hypertension, severe diabetes, liver, lungs diseases and infections. Even in Chennai, where the heart transplant program has fully streamlined, hospitals get very few cadaver donors. Besides, a retrieved heart needs to be transplanted within four hours as against liver and kidney which can be transplanted in 10 hours to 16 hours respectively," said Huparikar.
For a successful heart transplant program, a massive team too needs to be in place. Bhote said the hospital needs to have a team of medical professionals consisting of heart transplant surgeon, cardiologists, anesthesiologists, critical care specialists, physicians, physiotherapists, paramedical staff and social workers. "Besides, having a state of the art operation theater, the hospital also needs to have intensive care unit with isolation facility and requisite medical equipments and devices. The staff should be trained on the clinical care protocols and also be trained on the key aspects of transplant surgery, immediate post operative period, infection control aspects and nutritional aspects," said Bhote.