THE euphoria among cardiologists at the Delhi-based All India Institute of Medical Sciences (aiims) over the country's first heart transplant operation has proved to be shortlived. Plans to perform another such operation in October received a setback when the prospective recipient, 38 year-old Ram Kali, suddenly refused to accept a donated heart. "Mujhe operation ke naam se bhi khatra lagta hain (I am scared by the very mention of the word 'operation')," said Ram Kali. As a result, the donor heart, which had been brought in from Gangaram Hospital, was wasted.

Senior cardiac surgeons of aiims have called for a binding agreement, signed by the heart acceptor, with a built in clause for punitive action, in case of refusal. As one surgeon at aiims says, "We cannot waste hearts just because people are afraid of operation theatres." Other measures now being taken at aiims include maintaining an updated register of those requiring transplants. This will help ascertain compatibility when a donor heart is available.

And although Ram Kali's husband is confident and says that such a problem will not recur, doctors at aiims are debating whether such a chance should be taken again.