Heart transplant in India for international patients: the facts

What is a heart transplant?

NHS Blood and Transplant explains that most people referred have long-standing heart disease that has worsened despite medicines and devices. Heart failure can also come on suddenly, for example after a heart attack that permanently damages the main pumping chamber. Transplant is considered when other treatments can no longer help.

A heart can only come from a deceased donor. NOTTO, India’s national organ transplant body, notes that a heart must be transplanted within a few hours of donation. That is why patients must be close to the transplant centre and ready when an offer comes.

Who may be assessed for a heart transplant?

NHS Blood and Transplant says transplant is not suitable for all patients with chronic heart disease. A series of tests decides whether someone can have one. Suitability depends on the heart condition, the health of other organs, other illnesses and the ability to follow lifelong treatment. Only a transplant team can make that judgement.

How does organ allocation work for foreign nationals in India?

NOTTO explains that deceased-donor organs are distributed within the state first, then regionally and then nationally. Its FAQ lists the order as State list, Regional list, National list, Person of Indian Origin and then Foreigner. In practice this means a foreign national is offered a heart only when no suitable recipient higher in that order is found. No one can promise when or whether a heart will become available.

Which reports does a transplant team usually ask for?

A first review usually needs the reports that show how advanced the heart failure is. Ask the team whether it needs:

• recent echocardiograms
• coronary angiogram and right heart catheter reports, if done
• cardiac MRI or CT, if done
• kidney and liver function tests
• blood group
• details of any devices, such as an ICD or pump
• a full history of admissions and medicines

How do I plan for a heart transplant in India?

Because an organ cannot be scheduled, planning is different from other surgery. You would need to stay near the centre, possibly for a long and uncertain time, with an attendant. Ask the hospital in writing how foreign patients are registered and what happens while waiting. After a transplant, NHS Blood and Transplant describes lifelong medicines to prevent rejection and regular follow-up. You will need a transplant team at home that agrees to share your care.

What should I ask the transplant centre?

• How are foreign nationals registered for deceased-donor hearts under current NOTTO rules?
• Have you reviewed my reports and do you think I can be assessed?
• Where would I stay while waiting and how quickly must I reach the hospital?
• Which anti-rejection medicines would I take and are they available in my country?
• Who at home will share follow-up with your team?