Cleveland Clinic Abu Dhabi's multidisciplinary team successfully performs heart transplant on 28-year-old Emirati patient with multi-organ failure

• Emirati patient required support through extracorporeal membrane oxygenation (ECMO) and biventricular assistance device (BiVAD) to reverse multi-organ failure before heart transplant • Series of challenging interventions is a testament to Cleveland Clinic Abu Dhabi’s world-class complex care, and the success of its multidisciplinary approach • The hospital has multi-organ transplant center, and is a Centre of Excellence for adult cardiac surgery

Cleveland Clinic Abu Dhabi, part of the M42 group, has successfully completed a complex heart transplant for Muhammad Al Ketbi suffering from familial cardiomyopathy. The 28-year-old Emirati patient, who had been suffering with heart disease for more than a decade, developed multi-organ failure, and was initially placed on an Extracorporeal membrane oxygenation (an external pump for their heart).

Muhammad later needed to be placed on two separate pumps, one for the right and one for the left side of the heart, known as a biventricular assist device (BiVAD). For four months, he was on a BiVAD to stabilize his condition while awaiting a suitable donor for a heart transplant. This landmark case is the first in the UAE where the patient has successfully undergone these three sequential stages of treatment.

Muhammad was first transferred to Cleveland Clinic Abu Dhabi in a state of cardiogenic shock. Following a thorough assessment, the medical team found debilitating fluid accumulation in his lungs and abdomen. The multidisciplinary team of physicians intervened immediately to drain the fluid in his abdomen, which resulted in an improvement in his breathing.

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, Muhammad’s condition was unstable He was placed on extracorporeal membrane oxygenation (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.

Muhammad remained in the ICU on BiVAD, 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.

Five days after the procedure, Muhammad’s condition improved and was moved out of the ICU to a cardiology ward. It was there that his care team explained the need to adhere to a regimen of immunosuppressants to ensure that his body did not reject the transplanted heart. A week later, Muhammad was finally discharged with advice to follow up regularly with Cleveland Clinic Abu Dhabi’s Transplant Center.

Muhammad, who is now living a normal life, expressed immense gratitude to his caregivers, “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.”

Muhammad’s story of a return to health is a reaffirmation of Cleveland Clinic Abu Dhabi’s personalized approach to care, which is enhanced with the use of cutting-edge technologies. The hospital houses the only multi-organ transplant center in the UAE and has also been designated by the Department of Health – Abu Dhabi as a Centre of Excellence (COE) for adult cardiac surgery.

To learn more about Cleveland Clinic Abu Dhabi’s Heart, Vascular & Thoracic Institute visit, https://www.clevelandclinicabudhabi.ae/en/institutes-and-specialties/heart-vascular-and-thoracic-institute

For more information on Cleveland Clinic Abu Dhabi’s Transplant Center visit, https://www.clevelandclinicabudhabi.ae/en/institutes-and-specialties/transplant-center

To book an appointment at Cleveland Clinic Abu Dhabi, call 800 8 CCAD (2223) visit www.clevelandclinicabudhabi.ae or download the Cleveland Clinic Abu Dhabi Patient Portal App.