Heart transplant in India: Lessons learned

• Main Authors: Balram Airan, Sarvesh Pal Singh, Sandeep Seth, Milind Padmakar Hote, Manoj Kumar Sahu, Palleti Rajashekar, Velayoudham Devagourou, Sambhunath Das, Neeraj Parakh, Ruma Ray, Sudheer Arava
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Journal of the Practice of Cardiovascular Sciences
• Subjects: Heart; India; transplant; AIIMS
• Online Access: http://www.j-pcs.org/article.asp?issn=2395-5414;year=2017;volume=3;issue=2;spage=94;epage=99;aulast=Airan

Introduction: Heart Transplant in India started in 1994. We were initially doing 1-2 per year but the numbers have picked up since 2014 and we have done 25 in the past 3 years. We describe our experience of the last 4 years in this paper. Results: Initially, we experienced a relatively higher rate of rejections, fungal infections and graft failure. As we changed protocols, stopped using induction therapy except in high risk, maintained higher levels of immune suppression and tapered steroids faster in the first year, the complications reduced. All patients who had rejections and all the later transplants were maintained on a regime of tacrolimus, mycophenolate mofetil and steroids along with six months of valgancyclovir, voriconazole and co-trimoxazole. Steroids were tapered by six months to 0.1 mg/kg per day in all patients. Conclusions: In our recent patients, infection was the most common adverse event followed by rejection and PGD. In the latter half of our experience, we found that the complications reduced, suggesting that experience leads to less complications.