Heart transplants picking up in India, 10-fold increase

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Improved coordination between donation, retrieval and transplantation has led to a 10-fold increase in heart transplantations in India since 2016.
There have been nearly 300 heart transplantations across India in two years, according to data provided by the National Organ and Tissue Transplantation Organisation (NOTTO), the national coordinating agency for cadaveric organ donation, compared to about 350 between 2015 and 1994, when the first heart transplantation was done in India.“This means there has been a tenfold increase in the number of heart transplants in the country in the last two years. Although we have seen a huge spike in the number of heart transplants, transplant and retrieval of other organs like liver and kidneys has also gone up,” said Dr Vimal Bhandari, director of NOTTO.
“However, if we look at the need, this is just a drop. Every centre in India that does heart transplant has a waiting list of 10 or 20 at any given time. An estimated 50,000 hearts are needed for transplants,” said Dr Naresh Trehan, chairman and managing director Medanta – The Medicity.
Since NOTTO was established in 2014, the organisation has worked towards creating awareness about organ donation and training medical staff in performing retrieval and transplant.
“We have conducted around four rounds of retrieval training for doctors in parts of India where organ retrieval is not happening. Our aim is to make all district hospitals retrieval centres even if not transplant centres,” said Dr Bhandari.
Till date, the organisation has also trained 1,300 counsellors across India who can guide families of brain dead patients for organ donation.
The number of centres has also gone up. “Today, there are 78 centres in India that do heart transplants. Of these, 44 came up in the last three years. You can clearly see why the numbers have gone up,” said Dr Aarti Vij, head, Organ Retrieval and Banking Organisation (ORBO), AIIMS.Without the transplant centres, the hearts would go to waste.
And not just hearts, retrieval and transplant of all organs have also picked up. According to data from NOTTO, a total of 1,149 organs had been retrieved in 2014, 1,698 in 2015, 2,347 in 2016 and nearly 3,000 in 2017.The heart pumps blood with a rhythm determined by a group of pacemaking cells in the sinoatrial node. These generate a current that causes contraction of the heart, traveling through the atrioventricular node and along the conduction system of the heart. The heart receives blood low in oxygen from the systemic circulation, which enters the right atrium from the superior and inferior venae cavae and passes to the right ventricle. From here it is pumped into the pulmonary circulation, through the lungs where it receives oxygen and gives off carbon dioxide. Oxygenated blood then returns to the left atrium, passes through the left ventricle and is pumped out through the aorta to the systemic circulation-where the oxygen is used and metabolized to carbon dioxide
“Earlier, transplants were only happening in metro cities like Chennai, Mumbai and Delhi. But now, even tier two cities like Indore, Jaipur, Aurangabad have emerged as transplantation hubs,” said Dr Bhandari.
In fact, in the last two years, allocation of more than 200 organs happened at the national level.
“This means that a match could not be found at the state or regional level. Earlier, these organs would have been wasted because there was no national network,” he said.
“Apart from the coordination by NOTTO, increasing awareness is also a reason for the increase,” noted Dr TrehanExercise is any bodily activity that enhances or maintains physical fitness and overall health and wellness. and also for enjoyment. Many individuals choose to exercise publicly outdoors where they can congregate in groups, socialize, and enhance well-being.
“People in North India refuse donations many a times because of the religious belief. If you look at the data, most of the transplants happen in south India. However, now people are becoming aware that a brain dead patient can save the life of several sick people,” he said.

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