In death, an Indian accident victim gifts life to a Pakistani school teacher past across the border
Dr. K. R. Balakrishan (right) Director Cardiac Sciences at Fortis Malar hospital with Zubair Ashmi from Pakistan in Chenni recently. Photo: K.V.Srinivasan/The Hindu
A forty year old madrassa teacher from Pakistan who recently received a heart transplant in Chennai, India has a new lease of life thanks to doctors and a 36-year-old accident victim from Chennai whose heart now beats in his chest.
Maulana Mohammed Zubair Ashmi, a resident of a small town in Tehsil Kharian, District Gujarat, Pakistan, was suffering from a condition called dilated cardiomyopathy which had led to him being repeatedly admitted in several hospitals with breathing difficulty, poor urine output and body swelling.
Dilated cardiomyopathy can occur in people of all ages, including infants and children, but mostly between the age group of 20 to 60. The heart becomes weak and enlarged and cannot pump blood efficiently, and the decreased heart function can affect the lungs, liver, and other organs.
Zubair Ashmi had been on medication in Pakistan for over a year. His heart was pumping blood with only 10 per cent efficiency – well below the required average of 60 per cent. In layman’s terms, he had heart failure. Doctors advised his family that his only chance of survival was a heart transplant.
“There is no facility for a (heart) transplant back home,” he told journalists from the hospital, speaking over video as he was still being kept secluded from the general public during his recovery.
Doctors in Lahore made the long-distance call to Dr K. R. Balakrishnan, Director Cardiac Sciences at Fortis Malar hospital in Chennai, one of the few hospitals in India that offers the specialised treatment required.
Then began the lengthy process to get the patient to Chennai. Ashmi was given a medical visa, but his wife could not accompany him as she could not obtain a visa. By the time the patient airlifted from Lahore to Chennai via Dubai, he was critically ill, with renal failure, fluid in his lungs and abdomen, in addition to being Hepatitis C positive.
“All this just made his condition extremely difficult to treat,” says Dr. K. R. Balakrishnan who led the team of cardiac experts that performed the lifesaving complex heart transplant surgery on Zubair Ashmi last week.
Ashmi’s condition had continued to deteriorate the ICU. His kidney was nearing ‘shut down’ with a serum creatinine of about 3.8mg% (normal is less than 1mg %) and scanty urine output. Artificial long-term artificial heart pump support was ruled out since his right ventricle was severely dysfunctional. Two months later, his condition was extremely precarious when a donor became available in March – in the nick of time.
“If the transplant had been delayed by even two days, it would have cost him his life,” says Dr. Suresh Rao, Chief of Cardiac Anesthesia and Critical Care at the hospital.
Fortunately for Zubair, the family of a 37-year-old man who had been declared brain dead after a road accident came forward to donate his organs. In death, the Indian man ended up gifting life to a Pakistani. The procedure was complicated by the fact that the donor and recipient had different blood groups – the donor’s blood group was O+ve and Zubair’s was AB +ve. says Dr. Rao. However, “the tissue mapping in this case was good and viable”.
Doctors treated Zubair’s Hepatitis C with Interferon to reduce the viral load, explains Dr Rao. “Renal disease was managed with Inotropes to increase the renal blood flow and Immuno suppressants was modified to limit damage to the kidneys.”
“It is good government policy in Tamil Nadu that has facilitated a man from Pakistan to get a heart from Chennai. Goes to show that good policies have a major impact on promoting good health, not only locally, but globally too,” adds Dr. Rao.
“There are close to 1.5 million patients diagnosed every year with new onset heart failure in India,” said Dr. K. R. Balakrishan. “At least a third of them will need advanced therapy to survive.”
Zubair Ashmi is still weak, but recuperating well. He is able to walk and eat on his own and his kidney function has completely recovered. Doctors expect him to be discharged in about a month. He would like to go home, to his family and his wife and resume teaching in his mosque although he says he feels just as much at home in Chennai.
“There is no difference between India and Pakistan,” the thin, bearded religious teacher told reporters. “They love me a lot more here, since I am Pakistani. I am ready to live life all over again and it is all due to the kindness of my saviour’s heart. I don’t think I would have made it, really”.
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