UAE: Heart transplant saves 28-year-old Emirati with multi-organ failure

Muhammad Al Ketbi, a 28-year-old Emirati heart disease patient with multi-organ failure, received a successful heart transplant from Cleveland Clinic Abu Dhabi after four months of waiting.

Al Ketbi who had been suffering from familial cardiomyopathy, a heart disease he's been enduring for more than a decade, was first transferred to the hospital in a state of cardiogenic shock, a life threatening condition.

He was initially put on an extracorporeal membrane oxygenation (ECMO) support - an external pump for the heart. He was later placed on a biventricular assist device (BiVAD), which consists of two separate pumps positioned on the left and right side of his heart.

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Multi-disciplinary approach

Explaining the complexity of the case, Dr. Nadya Almatrooshi, Staff Physician for cardiology in advanced heart failure and transplant within the Heart, Vascular & Thoracic Institute at Cleveland Clinic Abu Dhabi said, “When Muhammad came to us, his condition was very severe. He could not even lie down comfortably and was having severe difficulty breathing. We learnt from his previous care team that Muhammad had stopped responding to medication. He was therefore admitted to the Intensive Care Unit (ICU) at Cleveland Clinic Abu Dhabi for close monitoring. However, his condition continued to deteriorate, affecting his liver and kidneys.”

It was clear that a heart transplant was imminent, but with multi-organ failure, Al Ketbi's condition was unstable. He was placed on ECMO support, which provided cardiac and respiratory assistance.

“In order to prepare Muhammad for the transplant, we had to improve his strength and overall condition. Our multidisciplinary team of physicians determined that installing a BiVAD, two implantable pumps that ensure blood circulation, would help reverse his kidney and liver failure, and present the best chance to help Muhammad as he awaited a suitable donor heart,” explained Dr. Mitesh Badiwala, Staff Physician for cardiothoracic surgery in the Heart, Vascular & Thoracic Institute of Cleveland Clinic Abu Dhabi.

The 28-year-old patient remained in the ICU on BiVAD for four months, where his condition improved with nutrition and physical therapy, in time for surgery, when a heart compatible with his age and weight was found.

Dr. Feras Bader the Section Head for Heart Failure and Transplantation in the Heart, Vascular & Thoracic Institute of Cleveland Clinic Abu Dhabi said, “During this challenging procedure, the BiVAD was removed, and the donor heart was transplanted. The entire process took approximately six hours and was carried out smoothly with the support of our experts from various subspecialties, including cardiothoracic surgery, anesthesia, cardiac intensive care, nursing, pharmacy, and other areas to provide world-class care.”

“Muhammad's case exemplifies how Cleveland Clinic Abu Dhabi can tackle the most complex cardiac cases through a coordinated effort across specialties. The successful heart transplant and ultimately Muhammad’s return to full health is a testament to the knowledge and dedication of our multidisciplinary team at the Heart, Vascular & Thoracic Institute," added Dr. Bader.

Improved condition

Five days after the procedure, Muhammad Al Ketbi's condition improved and was moved out of the ICU to a cardiology ward. His care team advised him to adhere to a regimen of immunosuppressants , ensuring hat his body did not reject the transplanted heart.

A week later, he was finally discharged with advice to follow up regularly with the hospital's transplant center.

After enduring the disease for more than a decade, he is now living a normal life.

“My family and I are extremely grateful for the high standards of care I received at Cleveland Clinic Abu Dhabi, which has been made possible through the vision of our wise leadership. It was a tremendous blessing to be able to undergo a heart transplant so close to home, surrounded by my family and friends. I am also thankful to my medical team, who monitored my health and well-being closely during a four-month stay at the ICU, and then gave me a new lease on life with a heart transplant," he said, expressing gratitude to his caregivers.

Al Ketbi's procedure marks a milestone, since it's the first in the UAE where a patient has successfully undergone three consecutive stages of treatment.

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