Heart Transplant in West Bengal: Insights from a Collective Experience of Multiple Centers in an Indian State

Background: India’s thoracic organ transplant program has undergone significant development, positioning the country as a leading player in the South Asian region. Despite development of infrastructural support and surgical skillsets, the transplant numbers are limited compared to the total population due to low donation and geographical challenges for organ transport. West Bengal, a state in Eastern India, initiated its heart transplant program relatively late in 2018, but has since witnessed notable growth. Methods: Data were collected from seven participating centers in West Bengal in an anonymized manner, including hospital records, outpatient follow-up data, and readmissions. Results: The study included 38 heart transplants conducted in West Bengal from May 2018 to October 2023. Most patients were male (73.6%), with idiopathic dilated cardiomyopathy being the most common pathology (52.6%). The inhospital mortality rate was 13.1%, primarily due to low cardiac output syndrome likely due to primary graft dysfunction (PGD). Follow-up data revealed infections to be a major contributor in mortality and morbidity rates. The average number of transplants per year varied, with 2019 seeing the highest number (nine cases). Conclusion: Despite its delayed initiation, West Bengal’s heart transplant program has experienced significant growth, with seven accredited centers now offering services. This development marks a milestone in the region’s health care, providing hope to patients with end-stage heart failure. Challenges such as postoperative PGD and infections persist but are expected to be addressed with continued efforts, gaining of further experience and infrastructure development.