No abstract

No abstract

Cardiac transplantation is still underperformed in India. There is a glaring disproportion between the patients who suffer from heart transplant and those who get it done. The post-transplant rehabilitation also is dependent on the socioeconomic status of patients. The healthcare system in India is not yet fully dependent on the government and most transplants happen in private hospitals with minimal support from the state. This study investigates these socioeconomic aspects of transplant from a Centre that performs the largest number of transplants in the state of Kerala which ranks highest in healthcare in India. Methods: All heart transplants that happened since 2013 at our centre were investigated by looking into records and follow up charts. Special emphasis was given to the social and economic aspects pre-and post-transplant. The preoperative workup, immunosuppression and surgical procedures were identical for all patients. Results: 25 transplants were performed in this period. There were 3 perioperative deaths due to primary graft dysfunction. There was one sudden cardiac death six months from transplant. There were 2 suicides of which one was directly related to the financial crisis following losing job after transplant. There were 3 deaths related to graft rejection. Two recipients who worked in corporate offices could continue their job. Two patients were supported by local Church and friends and obtained a job with decent living. Majority of patients were supported by friends, relatives and local government bodies by raising funds which saw them through the expenses of transplant and initial rehabilitation. Conclusion:The logistics involved in cardiac transplantation are more than other organs and there is an emotional component to it. Developing countries find it difficult to sustain a viable transplant program under the government sector. Private hospitals fill in this void but the economic implications are not well taken care of. Government needs to invest more in this and make it affordable to the socially and economically deprived who often are more susceptible to end stage heart failure.