For the first time ever in Hong Kong, a second heart transplant operation has been carried out on the same patient.
Au said on Wednesday the patient was still in a “critical” condition and that the next 48 hours would be important to his recovery.
The man had surgery in 2000 to replace his mitral valve – connecting the left atrium and left ventricle – but his health continued to deteriorate, resulting in the first transplant in 2005.
While the new heart worked well for some time, it gradually weakened. Au said the patient was deemed two years ago to be suffering from end-stage heart failure, and was listed again for a heart transplant at the start of this year.
On Wednesday, he received his second heart transplant. Surgery started at about 10.30am at Queen Mary and took about seven hours.
Au explained there were two main problems in performing a heart transplant for the second time on the same person. The first was the formation of adhesions, or scar tissue, from previous surgery, as these join two usually separated surfaces.
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This meant there was a higher chance during surgery of damaging “surrounding structures such as the airway, vessels and nerves” as well as difficulty removing the previous heart.
Au added that the second problem was a higher risk of infection, as the patient had already been taking anti-rejection drugs for a long time and his immune system was weak.
But the patient’s relative youth and eagerness to have the second transplant boded well, the surgeon said, noting: “He has a very positive attitude.” Hospital staff would need to carefully monitor the new heart for rejection in a longer period of intensive care, he said.
Au said the organ donor was a man in his 50s, who was certified brain-dead on Tuesday night after suffering a severe head injury and brain haemorrhage. The man’s liver and kidneys were also donated.
Expressing gratitude to the heart donor and his family, Au urged the public to be more aware of organ donation.
In Hong Kong, heart transplants are fewer compared to those for liver and kidney. Hospital Authority data showed that as of June 30 this year, 49 patients were waiting for a new heart. Six heart transplants were performed in the first six months of this year.