A new heart begins to beat

Kumudini Hettiarachchi writes on the human saga behind a trailblazing medical feat in Sri Lanka

Overjoyed is H.A. Wijaya Kumarasiri from a village in Anuradhapura. His Sudu, with her new heart beating strongly within, had opened her eyes and given him a smile that morning, as he murmured endearments to her. We meet him the same day, Wednesday, at noon as he lingers outside the Kandy Teaching Hospital’s Cardiothoracic Intensive Care Unit (CTICU), awaiting another glimpse of his wife.

By Thursday, not only was Pushpa Kumari opening her eyes, responding when asked to move her hands and feet and also speaking, she had also been taken off the ventilator.

For Kumarasiri, a mason, Sudu and their 13-yearold daughter, Dinithi Imalsha, a humble family from Dolahela in Anuradhapura it is ‘one small step’ in the recovery of their beloved wife and mother. For the country, it is ‘one giant leap’, rocketing Sri Lanka to a place among the few centres-of-excellence performing heart transplants in the world to international standards.

Thirty-seven-year-old Kumari or Sudu is the trailblazer in the first heart transplant on the night of July 7, under Sri Lanka’s Heart and Lung Transplantation Programme performed at the Kandy Hospital, under the guidance of Director Dr. Saman Rathnayake.

In an amazing coordination effort across the country, six hospitals had come together for this pioneering effort. They are the Kandy Hospital, the Welisara Chest Hospital, the Lady Ridgeway Hospital for Children, Colombo, the Sirimavo Bandaranaike Specialized Children’s Hospital, Peradeniya and the Kurunegala and Anuradhapura Teaching Hospitals.

Kumarasiri tells us how his Sudu’s body started swelling up about a year ago but what they did not know at that time was that her heart was failing. Taken to the Anuradhapura Hospital, the state hospital system has proven to have worked perfectly, for the clinic had referred her to the Cardiology Unit there and she was diagnosed with end-stage heart failure by Consultant Cardiologists Dr. Wasantha Kapuwatte and Dr. Roshan Paranamana and sent to the Kandy Hospital.

Here too the system is working without a flaw, from the time of admission till discharge which is pending. Kumari was sent to the pre-operations ward, then onto the Operating Theatre, from where she was transferred to the CTICU and soon will be sent to the High Dependency Unit and then to the post-op ward from where she will go back home.

Up to July 12, she has been in the Kandy Hospital for two months and seven days, says Kumarasiri. “Harima bayen hitiye,” he says and how relieved he is now, “ada thama hithata sahanayak ave”, while the grandmother is looking after their daughter who is awaiting her Amma’s return.

As we chat to Kumarasiri, who showers blessings on the family who rose above their sorrow to give the heart of their only son to save Sudu’s life, seated in Director Dr. Rathnayake’s office are I.G. Nandasena, D.P.G. Indra Kalyani and M.H. Janu from Mavikumbura North off Pilimatalawa.

Nandasena and Kalyani are the father and the mother and Janu is the aunt of 21-year-old Pradeep Kumara. They will go down in Sri Lanka’s history as having done a wonderful deed, one of the greatest ‘alms’ that can be given – the donation of the heart, along with other organs, of their brain-dead Sampath, as they fondly called him.

The tragedy of his accident-death comes from his teary-eyed parents – Sampath, the middle-son between two daughters, was working in a garage with his brother-in-law. It was June 24, an overcast rainy day and the two brothers-in-law decided to close the garage and head for home early. At the turn-off on a bend to their village from the main road, their motorcycle, with Sampath on the pillion collided with a van and toppled, throwing Sampath onto a rock. He hit his head and was unconscious when rushed to the Kandy Hospital.

With absolutely no signs of Sampath regaining consciousness, the parents had been counselled and approached for organ donation, which they had readily agreed to.

“Sampath merunata, den innawa wage,” sighs Kalyani, adding that though her son is dead, it is as if he is living, for he has given life to one person through his heart, his kidneys to two more and others will see through his eyes.

Even in death, ratata harima ‘sampathak’ vuna, is the poignant feeling among his relatives, now that he has become the first heart donor.

The scene, meanwhile, of the first heart transplant is the 4th Floor of the Kandy Hospital’s Cardiology Building, with the organ retrieval and transplant teams along with the vital anaesthetic team in Operating Theatres (OTs) A and B. All other relevant units had been fully supportive and the staff, from Consultants to junior doctors, senior to junior nurses, laboratory technicians to minor staff, had put their private lives on hold to go beyond the call of duty.