Cardiovascular Report - A Most Difficult Transplant, a Most Determined Patient
A Most Difficult Transplant, a Most Determined Patient
Date: April 23, 2012
While every heart/lung transplant comes with a multitude of challenges, there is one patient in particular that cardiothoracic surgeon Ashish Shah will never forget. He recalls the day in February 2008 when a petite young woman named Antara Desai was rolled into the operating room.
Finding the right organs is always a challenge, but in this case, it had been further complicated by Desai’s tiny frame: At 5 feet tall and weighing less than 100 pounds by the time of her surgery, Desai proved an extraordinarily difficult patient to fit with a heart and lungs. Yet, as she lay on the operating room table, something happened that made finding new organs seem comparatively straightforward.
As the surgical team began the complicated process of removing her old heart and lungs, she began to swell, and the new heart and lungs didn’t fit. Hoping that the swelling would diminish in a few days, Shah had no choice but to leave Desai’s chest cavity open, the new organs covered by biological dressings, and wait. “You could see her lungs inflating and her heart pumping through the dressings,” Shah says.
Fortunately, over the next three days, the swelling subsided enough for Shah to close Desai’s chest. But the hard work wasn’t over—particularly not for Desai, now 31.
The chain of events leading Desai to Johns Hopkins was a long and complicated one. As a teenager, she was diagnosed with cancer and underwent radiation. Although the treatments defeated the cancer, they also caused irreparable damage to her lungs. In 2006, Desai began having shortness of breath that continued to get worse. She was diagnosed with fibrosis in her lungs, and by 2007 she could barely walk on a flat surface without losing her breath and taking a rest. Her husband had to carry her up the stairs, and she grew dependent on an oxygen tank. Meanwhile, the stress on her lungs increased the pressure on her heart, which also developed fibrosis.
Because she was so sick, whether to approve Desai for a transplant at all was a difficult decision. At one point, she was removed from the transplant list. However, Shah remained an advocate. “I believed that because of her young age and her strong family support,” he says, “there was reason to hope for the best.”
Desai’s recovery from the transplant was long and arduous. After months of relying on a ventilator, she had to learn to breathe unassisted and work to regain her strength. She needed to stay at Hopkins for six months while she was weaned off the ventilator and pushed herself in physical therapy.
“While this transplant could not have been successful without the expertise, hard work and cooperation of our multidisciplinary staff, no one played a greater role in Antara Desai’s recovery than Antara herself,” says Shah. “Throughout her time with us—both before and after the transplant—Antara demonstrated a level of strength and perseverance that was second to none. Those traits—coupled with her optimism and positivity—proved vital to her recovery.”
Fast-forward to the present day, and you would not know what Antara Desai had gone through. She has made a full recovery and is back at work as a physical therapist. And, while she knows that her transplanted organs might not last forever, she chooses to remain positive and appreciative. “I was just so sick before,” she says. “I never would have imagined my life like this. I’m so grateful.”