Despite the introduction of mechanical circulatory assist systems in India two decades ago, there has not been their wide usage due to two main reasons: (1) economic-financial unaffordability and (2) lack of social support. There have been a number of significant steps taken by the government and by the media for augmenting awareness for organ donation. A sizeable donor pool in India falls into the category of marginal donors, due to a variety of reasons like geographical distances, lack of rapid transport, suboptimal donor management due to the lack of resources, and trained manpower in hospitals where donor harvest is done.

Consequently, the usage of the heart as a donor organ is less than 20% in India. There is a lack of statistical data regarding the usage of heterotopic heart transplants, due to the absence of a registry, since the procedure is rarely performed, and comparative…