In the days before his 68th birthday, Prem Sagar was fighting hard to stay alive as his body continued to shut down. His kidneys had stopped working, a side effect of nearly a decade living with cardiomyopathy, a disease of the heart muscle. His heart was also failing. Prem’s medical team at St. Paul’s Hospital was planning to put him on a mechanical heart pump – a left ventricular assist device – which had a long list of potential complications, before starting dialysis. He remembers how difficult it was to hear the news, “I was so down at the time. I told my cardiologist ‘Well, whatever it is, you know best.’”
But the next day, the miracle Prem had been waiting for – a donor heart had become available for him. The transplant was risky, according to cardiovascular surgeon Dr. Anson Cheung, given the stress such an invasive surgery would put on Prem’s kidneys. But the father and grandfather knew he had to take the chance.
“Before they took me into the operating room, Dr. Cheung came and checked on me,” recalls the Surrey man. “I showed him my hospital wristband with my date of birth, which was that day. I received my transplant on my 68th birthday. I was just born again.”
The start of a marathon
As he walked into the surgery late that August night, Dr. Cheung had no idea he was about to make provincial history. While he already knew there was likely going to be a second heart transplant following Prem’s surgery, it didn’t stop there. “During the second transplant, I knew there would be a third, and then a fourth.”
The heart transplant marathon ended 60 hours later. All four heart transplants were performed by Dr. Cheung, “It’s magic every single time. All four of them went very well and very smoothly.”
That was the first time there have been four heart transplants in a row at St. Paul’s. (In June 2016, Dr. Cheung performed three heart transplants in 24 hours.)
New heart transplant record set in 2019
But that was not the only incredible milestone from 2019. Last year there was a new record – a total of 30 heart transplants at St. Paul’s Hospital, the adult provincial heart transplant centre. (There was one pediatric heart transplant in 2019 at BC Children’s Hospital.)
Dr. Mustafa Toma, medical director of the heart transplant program, says this success is only possible with incredible teamwork, “It takes the hard work of many people across the province to make one transplant occur successfully. There is no way that we could continue to increase our volume of transplantation, while improving outcomes, without the dedication of members of the transplant teams in BC.”
“When I first started, we were doing about a dozen heart transplants per year,” remembers Dr. Cheung. “I thought we could do better than that, and I always thought we could get to this point.”
Both transplant specialists say a huge factor in the increase has been the efforts of BC Transplant to increase organ donation in hospitals across BC, along with heightened public awareness that has led to growing numbers of registered organ donors.
New heart, new life
Five months later, Prem is recovering well. His near-failing kidneys have recovered completely. He is now able to play with his four year old granddaughter, even lifting her up and carrying her around – something that was virtually impossible before his transplant. “When I compare to last year, I am back to 80 or 90 per cent. Last month, I even shovelled a bit of snow!”
When Prem and other recipients come back for check-ups post transplant, it’s so rewarding for Dr. Toma and the team. “It’s one of the highlights of my job. When they tell me they have not felt this well in many years, it brings joy to my life. It’s also a reminder of the sacrifices that organ donors and their families make to give the gift of life.”
Prem has already exchanged letters with the family of his donor, who remains anonymous at this point. Prem says his donor was ultimately able to save six lives.
One of Prem’s three daughters had registered as an organ donor years ago, long before she knew her dad would need a life-saving transplant. But now, his other two daughters and wife are also registered. They say it’s the very least they can do to honour the precious gift they have been given.
Here is an excerpt from Prem’s letter to his donor family:
“Words cannot begin to express my gratitude for the gift your loved one has given me, given my family. They always say it takes just one person to make a difference. I have never understood that as much as I do today, your loved one has given me a gift that has changed everything. It has given me a second chance at life.”– Prem Sagar, grateful heart recipient
The other three recipients from the heart transplant marathon are also recovering well.
To register as an organ donor, or to check if you are already registered, please visit the BC Transplant website.