Advancement of the medical science enabled doctors to transplant organs from one person to another in order to save their lives. Since 50 years back medical specialists have been transplanting eyes, kidneys, lungs, livers, pancreas as well as hearts.
Among organs transplant, the heart transplant is the most complex and complicated surgery. The heart operation demands the help of a large number specialists and auxiliary staff. Nevertheless, after 50 years of beginning heart transplants in the world, a team of specialist doctors in Sri Lanka performed a heart transplant for the first time in the Kandy hospital. The heart of a brain dead 22-year-old youth, who met with a road accident, was transplanted to a female heart patient of 37 years old.
On the initiatives of heart specialist Dr. Anil Abeywickrema, a heart and lung transplant association was formed in 2015 with the guidance of the Director of International Heart Transplant Institute in New Castle, Professor Steve C. Clarke who provided guidance and advice to this institution.
Drawing specialists from the Kandy, Anuradhapura, Welisara, Lady Ridgeway hospitals and special Children’s Unit of the Kandy Bandranaike hospital, a team of experts was formed on the guidance of the Director of the Hospital, Dr. Saman Ratnayake to perform heart transplants in Sri Lanka.
Heart specialists Dr. K. Gnanakanthan, Dr. Anil Abeywickrama and Dr. Mutditha Lansakara in the Heart and Chest Unit of the Kandy General Hospital identified that18 heart patients attending the heart clinic needed heart surgeries. Screening them only three were identified as fit for a heart surgery and others were at the terminal stage of the illness due to complications of the disease.
All three patients selected for the surgery were females and were in critical condition. They were kept on the waiting list and prepared for the surgery according to the internationally accepted procedures.
The next challenge was the finding of a donor. Though several donors were found, they could not be selected due to medical incompatibility with the recipients. A potential donor was found in the Kandy general hospital that was brain dead in an accident and lying in the intensive care unit.
Neuro-surgeon Dr. Leslie Siriwardene and Neuro-anesthetist Dr. Ravi Weerakone confirmed the accident victim was brain dead. Such brain dead persons’ organs were previously transplanted in the hospital to others with the consent their guardians.
On the consent of the parents of brain dead patient, Pradeep Sampath was chosen as the donor to 37-year-old heart patient Pushpa Kumari, a mother of one child sent from the Anuradhapura hospital whose blood group was compatible with the donor.
The recipient when admitted to the Kandy hospital, her heart functioned 45 percent and declined to 10 percent after one year in the hospital and was in a critical condition.
Recipient Pushpa Kumari and donor Pradeep Sampath’s heart were subjected to myriad of tests to determine whether the recipient would not reject the organ. The recipient was administered drugs to minimize immunity to prevent the rejection of the transplanted organ.
The two patients were prepared for the operation in two operating theatres A and B, at 7 p.m. on July 7 after chanting Seth Pirith by Ven. Saranankara and two other monks of the Asgiriya Chapter.
The operation commenced at theatre A at 7 p.m. A team of kidney specialists led by Dr. Hariscchandra removed the donor’s kidneys before the heart was harvested by a team of heart specialists led by Dr. Anil Abywickrema as the kidneys should be removed before the heart was harvested, otherwise other organs would be starved of blood.
In theatre B, the recipient was prepared for the transplant. The team of specialists involved in the operation was Drs. K. Gnanakanthan. Mutditha Lansakara, Lasantha Shirmini with anesthetic Drs. Jagathi Perera, Aruni Jayasekera, Priyantha Dissanayake.
It took 45 minutes to anesthetize her. Subsequently, her chest was opened and a respiratory machine was attached to her prior to the operation. In 75 minutes, the recipient’s heart was removed. Eight minutes afterwards the donor’s heart was brought to the recipient’s theatre in an ice bucket. The transplant surgery commenced within 15 minutes, leaving the recipient without a heart for 15 minutes. The recipient’s blood supply was started after one hour and fifty five minutes and the recipient’s new heart started beating in ten minutes. But at the start the heart beat was weak and blood supply was assisted by an artificial heart.
Meanwhile, the anesthetists kept on monitoring the patient’s blood pressure and heart specialists took echo tests of the new heart. By about 2.30 a.m. the chest was closed up as the heart condition was steady while taking necessary precautions to prevent internal bleeding.
The operation took eight and half hours. Then the patient was transferred to the intensive care unit (ICU). Then onwards the patient’s immunity power was checked regularly by a doctor and two nurses.
The team of doctors involved in this operation meets daily to observe the progress of the patient and to adjust treatments necessary.
After two days the patient was fed with liquid diets through tubes and was orally fed liquid diets in five days. Now, she shows some signs of response and is given low doses of heart drugs. Presently, the respiratory machine is removed from her. She is due to transfer to the normal ward in next four or five days,
This is the first heart transplant in Sri Lanka. It was successful due to the dedication of a team of expert doctors, said specialist doctor Muditha Lansakara.
Dr. Thilak Sirisena, Dr. Gamini Weerakoon, Dr. Sunethra B. Athauda, Dr. A. Vithanage, Dr. Rohitha Muthugala, Dr. Mahen Kotelawala, Dr. Udaya Karunaratne and Dr. M. Subramaniam,DR. Duminda Rathnasena, Dr. K. H. K. Shirantha,Dr. Sunethra Irugalbandara,Dr. Roshan Paranamana, Dr. Ashani and Dr. Chathurika Herath were also among the specialist doctors who conducted this critical heart transplant operation.
(Translated by Ananda Elkaduwa)
Pradeep Sampath Kumara is the first heart donor in Sri Lanka whose heart was transplanted to Pushpa Kumari in the Kandy hospital.
He was the only son of three children. His father, I.G. Nandasena, is a helper in construction work. His mother, Indra Kalyani is a tea plucker. He has a married elder sister and a younger sister. He was not a bright student and left school after sitting O/L.
He was doing odd jobs and had a lot of friends. His mother had bought him a three-wheeler through a loan of Rs.50,000 from a bank. However, tt was seized by the bank for defaulting.
Then he bought a trail bike for Rs. 50,000 the money for which was borrowed from his mother and sister. He joined his brother-in-law’s motor garage as an apprentice hardly a week before his untimely death.
On that fateful day, he was returning from work on his motorcycle, which was being ridden by his brother-in-law. The bike collided with a van belonging to the Health Department and he was thrown out to a canal by the road and was admitted to the Bambaradeniya hospital.
Due to profuse bleeding he was transferred to the Kandy General Hospital.
After 11 days in the hospital the doctor who treated him told his parents that he was brain dead and could survive no longer. The doctor said that if they wished, his organs could be donated.
His parents agreed to it wishing his son be born in the next birth without meeting similar tragedy and refused to accept any money for it.
His organs including the eyes, kidneys and heart were donated to deserving patients. Though he is dead by now his heart is giving life to a 37-year-old mother. Pradeep’s mother Kalyani finding solace in that her only son could give life in his death to another person.
Pradeep’s mother said that she saw on TV that her son’s heart was being harvested. The Director of the Kandy hospital called the parents at the hospital and told them that the President had promised to gift them a house.
According to the belief of Buddhists, Pradeep’s meritorious act of donating organs will earn him enough merits to lead a happy life in his next births.