A heart transplant is the surgical replacement of a patients’ diseased heart with a donor’s healthy heart. A donor is a person who has died and pre-registered as a heart donor, or his family has agreed to donate his organs.
Since the positive outcome of the first human heart transplant in 1967, the heart transplant procedure has changed to an established treatment for advanced heart disease.
A heart transplant is usually reserved for people who have tried medications or other surgeries, but their conditions haven’t sufficiently improved.
Some conditions may eventually require a heart transplant:
Congestive Heart Failure: In this condition, the heart muscle gets weaker, and it fails to pump blood efficiently.
Coronary heart disease: It is a build-up of fatty substances in the arteries supplying blood to the heart, which block or interrupt blood flow to the heart.
Cardiomyopathy: During this, the walls of the heart have become stretched, thickened or stiff.
Congenital heart disease: These are the birth defects that affect the normal workings of the heart.
Heart transplantation is performed when other treatments for heart problems haven’t worked. If not treated, it may lead to heart failure. In adults, heart failure can be caused by several conditions:
Coronary artery disease
A weakening of the heart muscle (cardiomyopathy)
Congenital heart defect (heart problem with birth)
Failure of a previous heart transplant
Heart valve disease
Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) that are not controlled by other treatments
Another organ transplant (liver, lung or kidney) may be performed at the same time as a heart transplant in people with certain conditions at select medical centers. It is known as multi organ transplants.
Heart-liver transplant: This procedure is an option for people with particular heart and liver conditions.
Heart-kidney transplant: This procedure can be an option for people with heart failure in addition to kidney failure.
Heart-lung transplant: In rare circumstances, doctors may suggest this procedure for people with severe heart and lung diseases if the conditions aren’t able to be treated by only a lung transplant or heart transplant.
Factors that may affect the eligibility for a heart transplant
A heart transplant can’t be considered as the right treatment for everyone. There may be certain factors that indicate whether you’re not the right candidate for a heart transplant. However, each case is considered individually by the transplant center, but a heart transplant may not be regarded as appropriate if a patient:
Is of advanced age as it may interfere with the ability to recover after the surgery.
Has another medical condition that could shorten your life, even after receiving a donor heart, such as a serious liver, kidney or lung disease.
Has an active infection
Has a recent medical history of cancer
Are not willing to make lifestyle changes necessary to keep your donor heart-healthy, such as not drinking alcohol or not smoking
Cardiologist determines whether you are eligible for a heart transplant or not. Your Psychological and social evaluation is also considered.
Based on your assessment, if you are considered suitable for a heart transplant, then you will be registered onto the transplant waiting list.
Diagnostic test- These tests will help to access the overall health of the recipient.
Blood test: Your blood tests are done to determine a good donor match.
Test such as ultrasound, x-ray, CT scan, pulmonary function test and dental examination are done.
Others- several immunizations are given to prevent infections.
Heart transplantation usually takes between 4-6 hours.
Once a donor’s heart becomes available, a surgeon removes the heart from the donor’s body, and it is stored in a special solution. The transplant surgery needs to be performed at the earliest after the donor’s heart removed from his body.
The procedure is performed under general anaesthesia.
The patient is placed on a heart-lung machine for the surgery.
The surgeon makes an incision in the sternum to get access to the heart.
The diseased heart is removed.
The donor’s healthy heart is placed in the patient’s body, and blood vessels are connected.
After the completion of the procedure, the heart will get restarted.
When the heart begins to pump the blood, and the condition is stable, the heart-lung machine will be turned off.
The tube is attached to drain fluid from the heart.
The sternum will be joined and sutured together with wires.
After the operation, the patient is moved to the intensive care unit.
A ventilator is attached so that breathing will be assisted.
To check the functioning of the new heart, the blood samples will be taken frequently.
Immunosuppressant medicine will be given.
You will have a wound along the sternum
It is important to keep the surgical area clean and dry. The patient is advised to avoid strenuous activities until the sternum is fully healed, which can take up to three or four months.
There will follow- up after the surgery, which may include a blood test, X-Ray or other tests.
You are advised to attend all your appointments; this allows the doctor to monitor your health and alter medications if needed.
You should take the prescribed medication on time.
After a heart transplant, the patient should make the necessary lifestyle changes such as Don’t smoke (help to keep your heart healthy), eat a healthy, balanced diet, control cholesterol and blood pressure, maintain a healthy weight by doing regular physical activity
Maintain personal and food hygiene to avoid infection.