Child undergoes ABO-incompatible heart transplant post multiple cardiac arrests

CHENNAI: A 18 month old child, who was suffering from terminal heart failure due to dilated cardiomyopathy was airlifted from Bulgaria to Chennai for possible further treatment.

The child suffered cardiac arrest in the airspace and was successfully resuscitated after 40 minutes of CPR.

Despite multiple cardiac arrests, the child underwent a successful ABO-incompatible heart transplant and has recovered well.

He was brought to a private hospital in the city, where he again suffered another cardiac arrest and was resuscitated after 45 minutes of CPR with chest compressions.

The child was rushed to the operating room, and put on a veno-arterial ECMO to support the heart, and shifted to the ICU with the chest open.

The baby woke up after 48 hours and was recovering from multiple cardiac arrests.

Meanwhile, a donor heart from a two-year-old brain-dead donor of a different blood group became available and was allotted to this baby by National Organ and Tissue Transplant Organization as there was no suitable Indian recipient for the organ.

The organ was accepted despite being of a different, incompatible blood group and having significant dysfunction in view of the critical condition of this baby.

The child was transplanted with the new heart while he was on ECMO support for several days after surgery for the heart to completely recover.

Dr K R Balakrishnan, Director, Institute of Heart and Lung Transplant and Mechanical Circulatory Support at MGM Healthcare said, "ABO-incompatible heart transplants can only be performed on babies and small children since the immune system is immature and there is very little chance of organ rejection response, which can allow for an ABO-mismatch heart to be used. This increases the donor pool and decreases wait-list mortality."

The transplant on the child was successful, and he has recovered well.