Over the years, Heart transplant in India has become a well-recognized and opted treatment for people with Heart Failure.
Heart transplant offers you a second Life. Though you need to take care of your new heart and follow the instruction and medications given by the doctor. In recent times, Heart Transplant in India has gained pace, since hospitals are getting licenses to perform Heart Transplant.
In the past one decade, India has become a hub for medical treatments which has boosted the Medical Tourism sector. Though Heart Transplant in India is one such critical area where it had ironically lagged behind. But lately the hospitals in India are getting the license to perform Heart Transplant, which has given a new hope for the family members of the patients with heart failure. Some of the Best Heart hospitals in India now offer a professional support service to overseas patients. With special facilities such as airport pick-ups, accommodations and a personal assistant staff required languages to interact with foreign patients. India is becoming a global destination for patients seeking transplants. The market size of the medical tourism industry in India is expected to reach $3 million by 2020. Patients mainly visiting for heart surgeries, transplants, cancer treatments etc. India draws around 2 to 3 lakh patients per annum mainly due to high quality treatment, high quality facilities at hospitals & latest cutting-edge technology at comparatively lower costs compared to developed nations like USA, Canada, UK etc.
The major reasons and factors that have made Heart transplant surgery in India a success are:
Heart Transplant is not considered to be a cure for heart disease, but a life-saving treatment intended to improve the quality of life for recipients.
Also, heart transplant cost in India plays a very crucial role as this surgery is relatively much reasonable in India than other countries.
A common worry that the family members of the Heart Transplant patient have is the cost of Heart Transplant in India. The heart transplant cost in India is generally around Rs. 1000000.00 – Rs.1500000.00 if there is no major complication. The cost can go as high as Rs. 1800000.00- Rs. 2500000.00 if there are any complications. Cities like Bangalore, Chennai and Mumbai are the best places to visit for Heart Transplant in India, since the hospitals here have retained the heart transplant program and have the best facilities for it.
The cost of heart transplant in India includes cost of anti-rejection drugs which are expensive, cost of biopsies, which are to be done periodically and other transplant costs.
There are many expenses as well after the heart transplant surgery, mainly for the medicines which are expensive. The cost is generally estimated to be Rs. 300000.00 per year. This added expenses increases your overall cost of heart transplant in India.
With recent developments, India has significantly started providing the best facilities for the heart transplant patients. There are many hospitals that have started the Heart Transplant surgeries in India and have set up a programme for the same.
Chennai, Delhi and Bangalore are the most recommended cities for heart transplant in India.
Let's find out the list of the Hospitals for Heart Transplant in India, where there are heart transplant surgeries performed.
Fortis Escorts Heart Institute & Research Center (FEHI) is a pioneer in cardiac care and is considered as one of the best heart hospital in Delhi and has earned a name for itself around the world.
The hospital is renowned for its clinical expertise and state of art medical technology for its services in the field of Cardiac Bypass Surgery, Paediatric Cardiology, Minimally Invasive Surgery, Paediatric Cardiac Surgery, Non-invasive Cardiology, Interventional Cardiology, Electrophysiology and Preventive Cardiology. FEHI has a team of a highly experienced cardiologist in Delhi, dedicated support staff and hi-tech world-class laboratories which together handle over 14500 admission and 7200 emergency cases every year. Dr. Ashok Seth, the chairman of cardiac sciences at Fortis Escorts is considered the no.1 cardiologist in India.
Prominent features :
Okhla Road, Opp Holy Family Hospital, New Delhi, Delhi 110025, India.
Apollo hospitals are one of the largest integrated healthcare groups in India having hospitals all over the sub-continent. Indraprastha Apollo Hospital, the flagship hospital of this group is JCI accredited that is famous for its heart institutes due to which it is considered
as the best cardiac hospital in India. It has some of the best cardiologist in India with dedicated team of heart transplant surgeons. Apollo Hospitals has successfully performed over 32 Heart transplant in India. Apollo Hospitals performed India's first Heart Lung and Kidney transplant (2nd in world).
Prominent features :
Sarita Vihar, Mathura Road, New Delhi, Delhi, 110076, India
Max Super Speciality Hospital, Saket has received prestigious JCI Accreditation which is world's gold standard for healthcare quality. It is a leading hospital offering excellent healthcare at fraction of international price having reputation of having done a number
of heart transplant in India. Max Institute of Heart and Vascular Sciences attract people from far and wide as it is considered the best heart hospital in Delhi by many. It is a one stop destination for all kinds of heart ailments such as pulmonary heart failure, congenital heart disease, heart defects and coronary artery diseases.Max has a team of the best cardiac surgeon in India who are expert in providing treatments such as heart transplant, ECMO, LVAD to end-stage heart-failure patients. You can find some of the top 10 cardiologist in Delhi at Max.
Prominent features :
Press Enclave Road, Saket, New Delhi, Delhi 110017, India.
The Wockhardt Hospital at Mumbai Central, Mumbai is a JCI accredited hospital that is centrally located and easily accessible by patients from in and around Mumbai. Since its inception in 1990,
it has successfully treated thousands of heart patients and is considered the most preferred destination for national and international patients. The hospital has a team of best cardiologist in Mumbai who with their skill, precision and proficiency provide excellent cardiac care making it the best heart hospital in Mumbai.
Prominent features :
Dr. Anand Rao Nair Road, Ne Dr. Anand Rao Nair Road, Near Agripada Police Station, Mumbai Central East, Mumbai 400011, India
Manipal Hospital on HAL Airport Road is a top quaternary care multi super specialty centre with 56 specialties. Manipal Hospitals are a group of 15 hospitals across the country which deliver quality healthcare at affordable cost.
Manipal Heart Institute is a comprehensive cardiac center having the best cardiologist in India representing all the sub-specialty related to heart and vascular medicine. It is one of the largest heart institutes in Asia catering to domestic and international clientele. The success rate is on par with the leading hospitals in the world thus making it the best heart hospital in India.
Prominent features :
HAL Airport Road, Kodihalli, Bangalore, Karnataka 560017, India.
Aditya Birla Memorial Hospital (ABMH) is a multi-specialty hospital with JCI accreditation and the first hospital in India to be HACCP and ISO: 22000:2005 certified. This 500 bed hospital offers excellent cost-effective
cardiac treatment and is known as the best heart hospital in India having 152 ICU beds, flat panel Cath lab, sophisticated medical technology and the best cardiologist in India practicing here.
Prominent features :
Aditya Birla Marg, Chinchwad, Pune 411033, India.
It is the is a finest example of medical excellence for heart transplant in India. Experts at Kokilaben Hospital have said to performed more than 1700+ Coronary Angioplasties and 6200+ Cardiac Surgeries.
The heart transplant programm at Kokilaben Hospital is headed by Dr Nandkishore Kapadia with experience of over 200 heart and lung transplants in France, USA and in India. The heart transplantation programme at Kokilaben hospital now ranks among top 10 of the transplant programmes in India.
Prominent features :
Rao Saheb Achutrao, Patwardhan Marg, Four Bunglows, Mumbai - 400053, India.
Heart failure occurs when the heart is unable to pump enough blood to meet the needs of the body. The common cause for damage to the heart muscle that results in heart failure is the coronary artery disease.
A Heart Transplant is generally done when the other treatments for heart failure haven’t worked leading to heart failure.
With high end facilities and experienced doctors available for Heart Transplant in India, hospitals are now focusing to act quickly in case of heart transplant.
In adults, heart failure can occur due to several conditions and reasons, including:
A weakening of the heart muscle called cardiomyopathy. Coronary artery disease Heart valve disease Hypertensions Alcohol and illicit Drug use Inherited If you are born with a heart problem (congenital heart defect) Dangerous abnormal heart rhythms (ventricular arrhythmias) Amyloidosis Failure of a previous heart transplant, in case you have undergone it In children, heart failure is most often caused by either a congenital heart defect or a cardiomyopathy.
The typical symptoms of heart failure are:
If your heart failure symptoms and heart function cannot be improved by medications or surgery, you may be advised for a heart transplant surgery. It should be pointed out; however, that heart transplantation is a treatment and not a cure. The 1-year survival rate is over 80%, with an average length of survival of 9 year. Nearly 70% survive for 5 year and 60% for 10 year.
If you need a heart transplant, your cardiologist will refer you to a transplant physician for further evaluation.
A heart transplant surgery is a relatively simple operation for a cardiac surgeon. In fact, the procedure actually consists of three operations.
As in a kidney transplant, in a heart transplant too, two teams of doctors are involved; one harvesting the organ, and the other transplanting it.
Members of the Transplant Team
Cardiologist Cardiovascular surgeon Transplant coordinator Social worker Dietician Psychiatrist
The first operation is harvesting the heart from the donor. The donor is usually a person who has suffered a serious brain injury that is irreversible, leading to "brain death".
The second operation is removing the recipient’s damaged heart. Removing the damaged heart may be very easy or very difficult, depending on whether the recipient has had previous heart surgery. If there has been previous surgery, cutting through the scar tissue may prolong and complicate removal of the heart.
The third operation is probably the easiest; the implantation of the donor heart. Today, this operation basically involves the creation of only five lines of stitches, or "anastomoses". These lines connect the large blood vessels entering and leaving the heart.
A heart has to be used within 4-6 hours after it is taken out. The success of the transplant is higher, if the surgery is performed immediately after the heart is harvested. Once a donor and recipient are matched, the surgery takes two to three hours. This surgery is highly risky as the doctors need to act faster and since the patients have no other options left.
A transplant team is responsible for assessing whether you are a suitable heart transplant candidate.
For heart transplant surgery in India, several tests are conducted to check whether one needs a Heart Transplant or not and if one is fit for the heart transplant surgery.
These tests may include:
Once it is confirmed that you need a heart transplant and are a suitable candidate, you will be listed on a waiting list. The waiting time can vary from days to several months depending on the availability of the organ, your blood group, and how serious you are. Some patients may have serious medical events (such as stroke, severe infections, kidney failure, etc.) while waiting for a heart transplant surgery. If these are temporary, the patient may be temporarily removed from the active list of patients awaiting a transplant.
Once on the waiting list, you will be contacted when a heart becomes available. It is important to go to the hospital as soon as possible.
Unfortunately, there are not enough hearts for every patient in need, and some people may die while waiting for a transplant. Public campaigns urging people to sign an organ donor card and let loved ones know their wishes are very important in improving the shortage of organ donors. Donor hearts come from individuals who have been declared brain dead, usually from severe head injuries resulting from car accidents, gunshot wounds, or bleeding in the brain. The donor must be similar in weight and height as you. The ethnic background and sex of the donor do not matter. Donor organs are given according to the severity of illness or status level of the patient, size and blood group compatibility, and the length of time spent on the waiting list. When a heart that is a match for you becomes available, you will be contacted by phone or mobile. If you are leaving town, notify your transplant program, and leave a telephone number where you can be reached.
When a donor is available
When the hospital authorities notify you that a heart is available, you are expected to reach the hospital within 2 hours of receiving the call. When you arrive, a team of doctors and nurses will prepare you for surgery. This includes a number of tests and procedures, such as measurement of your pulmonary artery pressures. Occasionally, there may be a false alarm, which occurs when the donor heart does not function well enough after examination by the surgeon. This may be very stressful, and the transplant team is available to counsel you. Remember that you want a healthy new heart, not just any heart.
Preparation for Surgery
Blood test ECG Chest x-ray Urine sample Intravenous line for measuring pressures in lung arteries
Once the heart has been deemed suitable, you will be taken to the operating room, where surgery will take about 4 hours. During the operation, a bypass machine will be used to give the blood oxygen for use in the rest of your body while the surgeon works on your heart. Most of the old heart is removed and the new one is attached to the incoming and outgoing blood vessels.
After the Surgery
After the surgery, you will be in the cardiovascular intensive care unit. Initially, a ventilator will help you breath, and you will have tubes in your chest to drain fluid around your lungs and heart. There will be continuous monitoring after the surgery. During this critical time, the cardiac surgeon, cardiologist and other members of the hospital staff will watch closely for any signs of heart rejection or infection.
You will have several heart biopsies after the transplant to monitor for rejection. Heart biopsies involve inserting a tube holder into the vein in the neck or groin. Through this tube, a bioptome (biopsy device) is inserted into the heart and small samples are taken. A pathologist reviews these to see if rejection is present. The frequency of biopsies depends on the time elapsed from transplant, your rejection history, and the protocols followed at each transplant centre.
While in hospital after your heart transplant surgery in India, you will receive counselling from a dietician, a physiotherapist, and a pharmacist to prepare you for your return home. One can spend as many as 10 days to 2 weeks in the hospital.
Patients are generally not very active in the next couple of days after the surgery, but should be able to walk around in just three or four days. The new heart will beat significantly faster than the original heart and will not respond as promptly to increased physical stress (e.g., when exercising). This is because the new heart lacks the nerve connections that help a normal heart respond to changes in activity. You will be moved to a regular room once your condition becomes stable and normal.
Post Heart Transplant Surgery in India
After leaving the hospital, one has to slowly increase the activities over the following 6 to 8 weeks. Cardiac rehabilitation is an excellent way to get your full strength back, and your cardiologist may recommend a program for you. You should watch for possible signs of infection, including fever, sore throat, shortness of breath, cough, change in sputum, cold sores, flu-like symptoms, or redness, swelling, or drainage from your incision. If any of these develop, you should contact your transplant centre as soon as possible. The only way to diagnose rejection is by heart biopsy. One should contact the transplant centre if these symptoms develop along with regular cardiology follow-up with your physician.
As with any surgery, complications may occur with Heart Transplant surgery as well. Potential risks of a heart transplant may include:
Infection Bleeding during or after the surgery Blood clots that can cause heart attack, stroke, or lung problems Breathing problems Kidney failure Coronary allograft vasculopathy (CAV). This is a problem with the blood vessels that carry blood to the heart muscle itself. They become thick and hard. This can cause serious heart muscle damage. Failure of the donor heart Death.
Your body's immune system may reject the new heart. Rejection is your body's normal reaction to a foreign object or tissue. When you get a new heart, your immune system reacts as it sees it as a foreign threat and attacks the new organ. To allow the transplanted organ to survive in a new body, you will need to take medicines. The medicines will trick the immune system into accepting the transplant and keep it from attacking it.
You will need to take the medicines to prevent or treat rejection for the rest of your life. These drugs have side effects too. The side effects may depend on the medicines you take.
Current or repeated infection that does not get better with treatment Poor blood circulation throughout the body, including the brain Severe health problems that would make you unable to tolerate the surgery Serious health problems other than heart disease that would not get better after transplant Noncompliance with treatment regimen. For instance, not following your healthcare provider's directions, not taking medicines as prescribed or missing appointments. Drug or alcohol abuse.
There may be other risks depending on your specific health condition. It is advisable to discuss the above with the doctor before the heart transplant surgery in India.
How does a heart transplant patient know if he or she is rejecting the donor organ or developing an infection?
This is not an easy question since the answer may be difficult because many of the symptoms and signs of rejection and infection are the same. These include:
weakness fatigue feeling lousy fever, and Flu symptoms such as chills, headaches, dizziness, diarrhoea, nausea and/or vomiting. The more specific symptoms and signs of infection will vary greatly depending upon the site of infection within the body. Transplant patients who experience any of these findings need to seek medical attention immediately. The transplant physician will then do tests to determine whether the transplanted heart is functioning normally or not. If there is no evidence of rejection, a thorough search for infection will be performed so that the patient can be treated appropriately.
Currently, the rejection is monitored with the end myocardial biopsy. This is a simple operation for the experienced cardiologist and can be done as an outpatient procedure. First, a catheter is put into the jugular vein in the neck. From where, the catheter is pushed into the right side of the heart (right ventricle) using an x-ray method called fluoroscopy for guidance. The catheter has a biotope at its end, a set of two small cups which can be closed to pinch off and remove small samples of heart muscle. The tissue is processed and placed on glass slides to be reviewed under the microscope by a pathologist. Based on the findings, the pathologist can determine whether or not there is rejection.
What are the results of a heart transplant in India?
When all potential problems are considered, the results of transplantation are remarkably good. Keep in mind that heart failure is a very serious and life-threatening disease. In patients with severe forms of heart failure that require transplantation, the one year mortality rate (that is the percent of patients who die in within one year) is 80%. Overall, five year survival in patients with any form of heart failure is less than 50%. Compare these outcomes with cardiac transplant. After heart transplant, five year survival averages about 50%-60%. One year survival averages about 85%-90%.
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