KOLKATA: For more than an estimated 10000 cardiac patients in Bengal, it’s time for a change of heart. But less than 1% is aware of it and none of those who are enlisted for a heart transplant across three city private hospitals are likely to receive the organ in the next one year. Experts pointed out that awareness about the conditions that make a transplant necessary is abysmally low. A large section of doctors still don’t consider heart transplant as an option even for patients who won’t survive without a new heart, they said.Loss of pumping ability, like the one from which Dilchand Singh – Kolkata’s first heart recipient – had been suffering from is one of the conditions that necessitates a transplant. It is termed ‘dilated cardiomyopathy’ which is precipitated by conditions which are still not clear, according to KR Balakrishnan, director of cardiac sciences at Fortis Hospital in Chennai who led the surgical team for the landmark transplant on Monday. “This comes within the ambit of end-stage heart failure which is also triggered by successive heart attacks or cardiac infection. Both render the cardiac muscles weak leaving them unable to pump enough blood. This condition can’t be treated with medicines or surgery. A transplant is the only cure,” said Balakrishnan.But lack of adequate donors has made doctors wary of recommending transplants, according to Tapas Ray Choudhury , director of cardio-thoracic and vascular surgery at Fortis Hospital in Kolkata. “Unless we can get more donors, people will continue to die of end-stage heart failure almost at the same rate as cancer. This is unfortunate since unlike cancer, this condition is curable with transplants. But awareness about the need to donate is abysmally low in eastern India. While Fortis Hospital in Chennai alone gets two hearts everyday, Kolkata hospitals haven’t had a single one in the last several years. It can’t be that our hospitals don’t have brain-dead patients,” said Ray Choudhury.Not even half of those suffering from end-stage heart failure live for six months, said cardiac surgeon Kunal Sarkar. “End stage heart failure is difficult to contain with medical management. You need to augment the pumping function of the heart which can’t be achieved with medicines. It leaves the patient unable to accomplish even the minimum physical excursion without feeling short of breath. Generally, this is taken to be the dead-end for these patients and their prognosis is worse than cancer patients,” said Sarkar. The transplant option is the only ray of hope for end-stage heart failure patients. Around 80% survive for 2-3 years and 60 per cent for 7-10 years,” said Sarkar.The success rate was higher now, according to Balakrishnan. “Around 85% now survive for five years and 70% live for at least seven years. Remember, most of these patients wouldn’t survive even a year without a new heart,” he added.Transplants not only help an end-stage heart failure patients survive, but also improves quality of life, according to a cardiac surgeon. But in the absence of donors, the option is often not spelt out to patients, he said. “Even though it is expensive to get a transplant done and the waiting time could be long, a vast majority of patients is not told about it. As a result, awareness is low and it has become difficult to secure the organ,” he said.

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