MGM Healthcare Performs an ABO-Incompatible Pediatric Heart Transplant on a 1 ½ year-old Child

CHENNAI:
MGM Healthcare is proud to announce the successful completion of an ABO-incompatible Paediatric Heart Transplant, crossing the blood group barrier. The one-& half year-old baby had multiple episodes of cardiac arrests before the transplant surgery. Dr. K.R. Balakrishnan, Dr. Suresh Rao KG and their team, handled the child cautiously and resuscitated the patient every time she had a cardiac arrest and successfully performed a ABO incompatible Paediatric Heart Transplant.

A one and a half-year-old child who was suffering from terminal heart failure due to dilated cardiomyopathy (DCM) was airlifted from Bulgaria to Chennai for possible further treatment. On the way, over Karachi airspace, the baby suffered a cardiac arrest, was successfully resuscitated after 40 minutes of CPR, and finally landed in Chennai. On arrival at MGM Healthcare, the baby suffered another cardiac arrest and was resuscitated after 45 minutes of CPR with chest compressions.

The child was rushed to the operating room, connected to venoarterial (VA)-ECMO to support the heart, and shifted to the ICU with the chest open. The baby miraculously woke up after 48 hours and was recovering from the insult of multiple cardiac arrests. The doctors were debating the further course of action of implanting an artificial heart pump. In the meantime, a donor heart from a 2- year-old brain-dead donor of a different blood group became available at Wadia Children’s Hospital in Mumbai. The organ was allotted to this baby by NOTTO 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 and needed ECMO and support for several days after surgery for the heart to completely recover. Meanwhile, immunosuppression was tailored to manage the ABO-incompatible organ. The baby has made a complete recovery and is thriving very well.

Dr. K R Balakrishnan, Director, Institute of Heart and Lung Transplant and Mechanical Circulatory Support, MGM Healthcare, shared his perspective, stating, “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. As an adult, if they received a heart that wasn’t their blood type, they would reject it immediately. This case exemplifies the true potential of medical science when coupled with determination and a collaborative spirit. Witnessing this young child’s recovery reaffirms our commitment to pushing the boundaries of medical excellence and offering a second chance at life. There are several highlights in this case. The use of ECMO to resuscitate from cardiac arrest even in a small baby, the continued use of this technology to allow a poorly contracting donor heart to recover, and the possibility of transplanting organs across blood group barriers in the current era, especially for small children.”

Dr. Suresh Rao KG, Co-Director of the Institute of Heart and Lung Transplant and Mechanical Circulatory Support, MGM Healthcare, emphasized, “This successful outcome underscores the synergy between global medical expertise and innovative infrastructure. We are proud to have played a pivotal role in giving this child a new life. The child’s remarkable journey of recovery saw a transition from intensive care to the general ward, a testament to the remarkable progress in medical technology.”

Harish Manian, Group CEO, MGM Healthcare, said, “The successful outcome of this paediatric cardiac transplant highlights the synergy between medical expertise, advanced infrastructure, and the spirit of global cooperation. It also highlights the importance of excellent cooperation by government agencies like TRANSTAN and NOTTO for saving precious lives by promoting organ donation across the length and breadth of the country. It was an inspirational and incredible journey, and it is a testament to how far our Heart and Lung transplant program has come. It reinforces how incredible our team is when it comes to pulling together to deliver true state-of-the- art care and always doing more better. MGM Healthcare continues to lead the way in delivering exceptional patient care, rewriting the boundaries of medical possibility, and offering hope to those in need.”

MGM Healthcare is a leader in the field of organ transplantation in the country, with an expert team that has successfully performed more than 600 heart and lung transplants and giving new life to numerous patients. Our commitment to providing exceptional care is reflected in the high standard of patient outcomes we consistently achieve.