Onam 2025 brought a very “from-the-heart” release to theatres: Hridayapoorvam, directed by Sathyan Anthikad and headlined by Mohanlal. Early reactions call it a warm, feel-good family drama—and its core tracks the life of Sandeep, a heart-transplant survivor who unexpectedly connects with his donor’s family.

That premise is more than movie magic. It’s a doorway into one of modern medicine’s most life-affirming stories: heart transplantation—when it’s offered, how it works, what life looks like after, and how all of us can help more patients get a second chance.

Heart transplant, in one breath

A heart transplant is offered to people with advanced heart failure when medications and devices can no longer keep the heart doing its job. Done at specialized centres with strict evaluation, it’s one of medicine’s most effective therapies for the right patient: about 90% of recipients are alive at one year, and the typical (median) survival after transplant is ~12–13 years, with many living much longer.[1]

The decision and the wait

• Who is considered? People with severe heart failure despite optimal care (often on inotropes, sometimes after ventricular-assist devices), and who are fit enough to undergo major surgery and lifelong follow-up. [2]
• Matching a heart: Teams consider blood group, size, urgency, and a safety crossmatch before transplant. Donor hearts come overwhelmingly from deceased donors after brain death. (A growing minority are from circulatory-death donors in some countries.)[3]

The surgery (and the first 90 days)

Most modern operations are orthotopic transplants—the diseased heart is removed and the donor heart is sewn into place. After surgery, patients spend days in ICU, then weeks in step-down care. The medical team tunes:

• Immunosuppression: Usually a three-drug maintenance plan—calcineurin inhibitor (e.g., tacrolimus), antimetabolite (e.g., mycophenolate), plus steroids—sometimes with induction therapy, with adjustments to protect kidneys or reduce side-effects.
• Rejection monitoring: Traditionally through endomyocardial biopsies, with some centres adding less-invasive blood tests and imaging to reduce biopsy frequency when risk is low.[4]
• Infection prevention & rehab: Antimicrobials as needed, vaccines when due, and carefully graded cardiac rehabilitation.

“What can I expect after a transplant?”

• Energy & daily life: Many recipients go from struggling with breathlessness to returning to work, travel, and family life within months, alongside routine follow-ups. Large registries confirm strong survival and quality-of-life gains for most patients.[5]
• Long-term watch-outs: Teams screen for high blood pressure, diabetes, kidney strain from medicines, and chronic graft vasculopathy (a slow-change in the heart’s blood vessels), adjusting therapy to keep the graft healthy.

In short: a transplant isn’t a “cure” for all heart disease, but it’s a powerful reset—adding years of life and living when nothing else can.

India’s picture: hope, progress—and a gap we can close

India has made real strides in organ transplantation, posting record overall transplant counts in 2024, yet the need far outweighs supply, especially for deceased-donor hearts (no living donors possible for heart). Official registries and reports show continuing growth in Indian heart-transplant numbers, but they remain modest compared with need.[6]

What helps most?
Families who accept brain-death diagnosis and consent to donate can save multiple lives. The government’s NOTTO platform supports pledging, allocation, and awareness drives across states. [7]

Reel vs real: what Hridayapoorvam gets us talking about

The film’s choice to centre a heart-transplant survivor invites conversations we often postpone:

• Identity & gratitude: Recipients sometimes feel a powerful bond with their unknown donors; that is human psychology, not “memory transfer” from donor tissue (there’s no evidence for that). Meeting donor families, when handled ethically and mutually desired, can be deeply healing—just as the film explores. [8]
• Stigma & myths: Transplant recipients are encouraged to live fully; they’re not “fragile forever.” With sensible precautions and medical follow-up, school, work, travel, and even sports can return.

If you or a loved one is being evaluated for transplant

1. Ask about centre experience & outcomes. Know survival rates, infection prevention protocols, and follow-up schedules. (Centres track these via ISHLT/SRTR standards.) [9]
2. Understand the medicines. Learn your immunosuppressants, food/drug interactions, labs, and what to do if you miss a dose. [10]
3. Plan for life after. Cardiac rehab, vaccines, dental care, mental-health support, and sun protection (skin-cancer risk rises on some meds). [11]
4. Build your support circle. Family and friends help with appointments, meal hygiene, and the “new normal”—which gets easier, faster than most expect.

How you can change the ending

• Pledge your organs (and tell your family). The consent conversation must be clear at home; it’s what lets your pledge become action.
• Share accurate info. Realistic survival, the need for deceased-donor hearts, and the dignity of brain-death donation help neighbours say yes when it counts.[12]

A final, heartfelt note

Hridayapoorvam is fiction, but the second chances it depicts are very real. Somewhere, tonight, an ambulance is creating a green corridor for a donor heart; a surgical team is preparing; a family is choosing generosity in their hardest hour. If you loved the film’s warmth, consider leaving someone, someday, the gift of a beat.

Ganam pole—let the heart sing again.