The patient, who has now recovered to lead a normal life after the operation on May 3 at the Madras Medical Mission Hospital, could survive because of the cooperation and understanding in organ sharing between the city's hospitals specialising in different branches of medical sciences, doctors associated with the project said.

"Though there is no formal organ sharing network as such to distribute the organs, the Dr M G R Medical University in Chennai has a central registry network," said K M Cherian, director of the Institute of Cardiovascular Diseases of the Mission Hospital.

The woman was about to be discharged from the Mission Hospital following primary pulmonary hypertension or hypertension in the lungs, and secondary heart failure when the hospital received information from the city's Apollo Hospital about a 40-year-oldman, who had died following a brain haemorrhage.

The man's relatives, including his 70-year-old mother and his wife, agreed to donate his organs. The heart and lungs were harvested at the Apollo Hospital. The liver, kidneys and skin were used for patients of that hospital and the eyes were used in Shankar Nethralaya, a premier eye hospital in the city. Cherian was assisted in the operation by S Rajan, Shirish Pargaonkar, Kalyan Singh and Benjamin Ninan. "This is the first heart-lung transplant performed in India," said Cherian. "There are not many centres that have got the facilities to do heart transplant and combined heart and lung transplant," he explained.

The All India Institute of Medical Sciences, Delhi, has done around six heart transplants, but it has not done any lung transplant, he said. "Our's is the only centre that is doing heart transplants, both in adults and paediatrics, as well as heart and lung transplants," Cherian said. He said the initiative was taken by the MGR Medical University inorganising the organ-sharing network and lauded the donor family whose decision helped eight patients.

Madhu Sankar, the heart and lung transplant coordinator of the Mission Hospital, suggested that other hospitals in the country set up similar units which will benefit a lot of patients and avoid wastage of invaluable organs. "The procedure costs for the heart-lung transplant are similar to open-heart surgical procedures and also donor surgical procedures. The costs also include post operative follow-up and drug therapy, including immunosuppressive therapy. The country can certainly afford such expenses," he said.

Sankar said the Mission Hospital's transplant unit undertakes selection and evaluation of patients in need of heart and lung transplant and maintains a registry. It coordinates with other hospitals on brain death certification and supervision of multi-organ harvest procedures.

He urged non-resident Indian (NRI) doctors to donate immunosuppressive drugs that are at present expensive in thecountry. "NRI doctors can also help in arranging continuing medical education programmes for Indian doctors involved in such programmes in hospitals abroad," Sankar added. "The pharmaceutical companies that are making these drugs should subsidise them for the poor patients," Sankar felt.

Although organ transplants are possible following enactment of legislation, public awareness is minimal, the medical specialists said. "It is very difficult to get donors," lamented Cherian.