Thankful from the bottom of donor's heart
He pays it forward by donating heart valves from his old heart
REPORT:  HEDY KHOO

WHILE many others are giving and receiving presents this time of year, Mr Rahman Abdullah may have recently received the most important gift of all - the chance to live.

And it came from a complete stranger - a heart donor a foreigner, who suffered brain death.

He said: "I feel very grateful to the donor and the donor's family.

"I feel a lot of sympathy for their loss, but I am very thankful that their generosity has allowed me to have a new lease of life."

Mr Rahman, 40, a delivery man had suffered a massive hearl attack earlier this year, on 27 Feb.

Since then he has been kept alive by an implanted mechanical heart system laiown as a paracorporeal ventricular assist device (PVAD).

He is the 10th patient in Singapore to have the PVAD mechanical heart system implanted.

Now he is he fourth PVAD patient to have had a successful heart transplant, which took place on 8 Oct.

And he, in turn, has passed on the goodwill by donating two heart valves from his old heart.

For reconstruction
Those valves can be used to reconstruct the heart of children born with heart defects or adults with damaged heart valves.

Mr Rahman's life has changed dramatically since the transplant. "It has given me freedom," he said.

Simple things like strumming a guitar, which he enjoys, were impossible before, when he was connected to the heart device.

Four tubes ran out of his stomach, connecting his own heart to me mechanical device and driver powered by a rechargeable battery.

He had to take the 9kg portable driver wherever he went. As a result, he was confined to his hospital ward for the past eight months.

"It is wonderful not to have tubes coming out of my body and having so many cables around me all the time," he said.

Mr Rahman recalled the morning he was told to prepare himself for a possible heart transplant.

"Two months earlier, I had also been told the same thing but it later turned out that the donor heart was not suitable. This time I decided I did not want to give myself any false hopes," he said.

"So I didn't think much of it and occupied myself by surfing the Internet."

But that same day at 6.20pm, when he was told the transplant was conlirmed, he was overwhelmed with emotion.

He said: " I was trembling and my hands were shaking so much I had difficulty dialling my sister's number on the phone to tell her the good news. I was so happy but at the bame time very nervous and frightened.

"I didn't know what the outcome would be."

And just moments before the operation, he remembered the transplant coordinator squeezing his hand to encourage him.

He said: "Before I was sedated, I remembered feeling a lot of pain from needles being poked into my neck. It was so bad that I was tearing.

"Then the transplant coordinator said to me, 'You have already endured so much, just hang in there a
little more.' "

Mr Rahman's operation lasted about six hours.

Dr Sivathasan, the mechanical heart device programme director and co-director of the heart and lung transplant programme at the National Heart Centre Singapore said the donor heart had to be checked for suitability.

The blood type of both the donor and recipient must match. It is also imperative that the difference in the body weight of Lhe donor and recipient not differ by more than 10 per cent, he said.

Once the heart is found to be suitable, it is harvested. The donor heart must then be transplanted within four hours before it begins to deteriorate.

When Mr Rahman regained consciousness, his first thought was, "I am still alive."

The silence around him also felt "strange", he said.

"I had grown so used to listening to the loud ticking of the mechanical heart, it felt odd not to hear it," he recalled.

He was transferred to the general ward after three days in intensive care.

"I took a stethoscope and listened to my new heart beat. I spoke to my heart and prayed for an hour," he said, chuckling.

"I tole my new heart, 'Since you are a part of me now, please function properly and co-operate with the rest of my organs. We have to work as a team.' "

But Mr Rahman said he knows that he is living on borrowed time.

Heart transplant patients have a 60 per cent chance to live over 10 years if no complications develop, said Dr Sivathasan.

Mr Rahman has to be on anti-rejection treatment for life. He now has to take 12 different drugs every day. He also goes for regular check-ups at the hospital.

"I don't dare to make plans. I just five one day at a time," he said.

But Dr Sivathasan said patients who have been on the mechanical heart system tend to recover faster than those who were not.

This is because the mechanical heart system helps with blood circulation, and this in turn helps keep the other organs in good condition while the patient is waiting for a transplant.

Said Dr Sivathasan: "It also helps when the patient himself is motivated in the recovery process."
 
Mr Rahman said what kept liirn going during the long wait for a heart transplant was the belief that there was a reason for his surviving the heart attack.

"I was saved on time. Now that I have a chance for a new life, I hope to be able to give something back to society," he said.

"I hope that my story can motivate people to be organ donors. One donor can save the lives of many people."

Mr Rahman hopes to be able to return to work as a driver in six months, after he has fully recovered.

He said: "I cannot carry heavy things, but I would like to find a job as a school bus driver."