Green Corridor from Bangalore to Chennai facilitated the surgery
M Neelam Kachhap – Bengaluru
Critically ill Russian toddler Gleb Kudriavtsev was given a new lease of life when a brain dead child’s heart was transplanted on to him at Chennai. At two years, nine months Gleb became India’s youngest paediatric heart transplant recipient. The eight-hour long complex surgery was performed by Dr KR Balakrishnan, Director-Cardiac Sciences and Dr Suresh Rao KG, HOD Critical Care & Cardiac Anaesthesia at Fortis Malar, Chennai.
Baby Gleb, was diagnosed with restrictive cardiomyopathy in Russia when he was just one year old. He suffered heart failure. Nelli Kudriavtceva, child’s mother took the child to Munich, Germany for treatment as Russian doctors could not treat the child. Gleb was recommended a heart-transplant but the waiting period and cost were not conducive for the patient. Finally, the child was refereed to Fortis Malar, Chennai.
On arrival, Gleb’s condition was quite critical, with an extremely low heart function and high levels of creatinine, due to poor kidney function. He was immediately listed on the transplant list at both the state level and the regional level so that he could get a suitable heart at the earliest. During the wait for a heart his condition started to deteriorate and he suffered a stroke, though he soon recovered. After one and half months, on December 18, 2014 evening, the team at Fortis Malar hospital received an alert about a donor at Manipal Hospital, Bengaluru. Kind parents of a two-year old boy who was declared brain dead agreed to donate his organs. A team comprising a cardio thoracic surgeon, paediatric interventional cardiologist, cardiac anaesthetist, perfusionist and intensivist went to Bengaluru to evaluate the heart. Subsequently, the heart was harvested, airlifted using a charter flight and brought to Fortis Malar Hospital at Chennai. The heart was transported using an inter-state green Corridor that took 47 minutes, in all to travel, from Bengaluru to Chennai. The surgery was carried out successfully on 19 December, 2014. In view of high lung pressure, the new heart took about 10 days to adjust after which he recovered rapidly. At present the baby is doing well and is discharged from the hospital.
The surgery was technically difficult and challenging as the recipient was low weight (seven kg) and very young. Starting from giving anaesthesia to fixing the heart in the chamber was a risky one because the boy was too sick to withstand anaesthesia The other major challenge, was that Baby Gleb had severe pulmonary artery hypertension, which would in turn lead to Right Ventricular dysfunction after transplant. As expected, Gleb developed right ventricular dysfunction post transplant, however we could efficiently manage it with nitric oxide and other medications. Today, his right ventricle has recovered completely; he is already weighing 10.5 kg and recovering rapidly, said Dr Rao.
Advances in medicine have made heart transplants safer and a real option in managing cases of end stage heart failure. Our goal is to provide the highest quality of patient-centered care to many more patients, right here in India, utilising our interdisciplinary approach, enormous talent and the multi-skilled resources within our team, said Dr Balakrishnan.
The cardiac transplant team at Fortis Malar has so far performed 45-ECMO, 37 heart-transplants, 10-VAD’s and is credited with India’s first successful implantation of heartmate II LVAD and HVAD, a mechanical artificial heart pump and Inter-state heart transplant.
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