Nepali doc in ‘dead heart’ transplant

  • Hearts retrieved from bodies 20 min after death were kept beating through resuscitation and preservation
- Chahana Sigdel, Kathmandu
Nepali doc in ‘dead heart’ transplant

Oct 26, 2014-

A Nepali doctor in Australia has successfully transplanted a ‘dead’ heart that was resuscitated and kept beating. Cardiothoracic and transplant surgeon Dr Kumud Dhital carried out the “groundbreaking” procedure along with a team of doctors that resuscitated a heart using a revolutionary preservation solution.

So far three patients have received the organs retrieved within 20 minutes of death and treated for their revival. “We knew that the heart, like other organs, could be revived. We have been able to achieve it. A heart that stopped beating somewhere can now be resuscitated by a team, put in a box and successfully transplanted,” Dhital told the Post on the phone.

The operation has been dubbed “heart in a box” and was hailed as the biggest heart transplant breakthrough in a decade.

While similar transplantation procedure has been trialled with kidneys and lungs before, this “donation after circulatory death” had never been attempted.

In the technique developed by Sydney’s St Vincent Hospital and the Victor Chang Cardiac Research Institute, a heart is brought back to life and put in a machine, before it is injected with a nutrient solution. The heart should have been preserved in the nutrient fluid after which it is put in the machine.

Until now, surgeons have relied on still-beating hearts and doctors said it could save the lives of 30 percent more patients and also increase the pool of donors.

Several international news media and applauded the

historic achievement while congratulatory messages appeared aplenty on Twitter and Facebook. Sydney Morning Herald called the success “huge breakthrough” while the Australian said the transplant offers “new hope”.

Local politicians also praised Dhital’s triumph as Finance Minister Ram Sharan Mahat tweeted: “Congratulations to Dr Kumud Dhital on his success of heart transplant from the dead. We Nepalis are proud of you.”

Dr Bhagawan Koirala, who pioneered open heart surgery in Nepal, said the transplant was a significant development. While it was technically not very complicated, he said, financial constraints and logistical hassles had prevented heart transplants in Nepal.

It feels great to have made an achievement

Dr Kumud Dhital is a specialist cardiothoracic and transplant surgeon at St Vincent’s Hospital. He is an associate professor at the University of New South Wales. Before moving to Australia, Dhital served as the director of the Cardiopulmonary Transplant Union in Palermo, Italy, and director of Lung Transplantation in Cambridge. Dhital, originally from Kharibot in Gorkha, has been living in Australia for the past five years.

How does it feel to have revived a heart that stopped beating?

It was scary in the beginning but we managed it and it feels great. The foremost credit goes to the donors without whom this would not have been possible. This is a great achievement and opens the door for many opportunities in organ transplant.

Is organ transplant feasible in Nepal?

Organ transplant is not a simple procedure and is very costly too. One transplant costs up to 100 thousand dollars. In Nepal, it might be opened up in the private sector but this could be chaotic. The public service sector needs to be just as proactive. Universities need to carry out extensive researches and the government also has to take initiatives--otherwise it will just end up being dysfunctional. Realistically speaking, transplants in Nepal still have a long way to go because there are many things associated with the whole process--but this doesn’t mean that we wait until then.

So how do we start?

Nepal needs a local champion. We have a lot of capable doctors working in their respective fields--we need more doctors like them. Basically we need someone willing to make a sacrifice and work in the field to pick up the pieces.

The best piece of advice you have received?

My father used to say even if you live or work abroad try and live like locals or even better. You don’t have to think you’re lower or different, just work hard and you will excel.

There are a lot of Nepalis living abroad and you have become a role model. What is your message to them?

It is very humbling to see so much excitement in Nepal about this transplant success. It is great to know that a lot of people are picking up on the news. What I’d like to tell them is that find your inner strength and follow it:

don’t be afraid to aim high but also remember that dreaming big is not enough. Have a goal and work towards achieving it every day.

Published: 27-10-2014 09:00

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