Heart Transplant

An operation, when a damaged or diseased heart is replaced with a healthier, donor heart, is called heart transplant.

If a person’s condition did not improve by the use of medications or other surgeries, a heart transplant may be an option.

Your chance of survival is good even if it is a major operation. Discuss first with your doctor the risks and benefits of a heart transplant.

The main reason a heart transplant is used if other treatments for your heart did not work, which can lead to heart failure.

Heart failure can be caused by:

• cardiomyopathy or the weakening of the heart muscle
• coronary artery disease
• failure of a recent heart transplant
• congenital heart defect or a heart problem you are born with
• valvular heart disease

This procedure is not for everyone. There will be certain factors that need to be considered.

Heart transplant is not for you if:

• you have another medical condition that can shorten your life even if you have a heart transplant
• you are 65 years old or older
• you cannot make lifestyle changes such as smoking and drink alcohol
• you have a personal medical history of cancer
• you have a peripheral artery disease or have a serious blockage in the arteries

Another option for people who cannot have a heart transplant is called ventricular assist device or VAD.

A miniature pump implanted in your chest that helps pump blood through your body is the use of VAD.

Sometimes this may be used as a temporary treatment or some used this as a permanent treatment.

The most common risk for a heart transplant is rejection. Since your immune system will not recognize the new heart, it will try to attack the donor's heart.

Almost 25 percent of heart transplant recipients still show signs of rejection even if they are given immunosuppressants.

You should not miss a dose of medication because it can result in the severe rejection of the donor's heart.

A few months after the transplant, you will undergo frequent biopsies to make sure that your body is not rejecting the new heart.

The possible signs and symptoms of rejection include:

• fever;
• shortness of breath;
• fatigue;
• not urinating as much as usual;
• weight gain due to fluid retention.

After the transplant, other risks include:

• side effects from the medications – that may lead to kidney damage or other problems
• artery problems – that can lead to cardiac allograft vasculopathy that can make blood circulation through your heart difficult and can cause a heart attack, heart arrhythmias, heart failure or even cardiac arrest
• infection – because immunosuppressants decrease your ability to fight off infection
• cancer - because immunosuppressants can increase your risk of cancer

In order to prepare for the procedure, your doctor will refer you to a heart transplant center for an evaluation first. Check with your insurance company is heart transplant is covered.

You can check the center how many had a successful heart transplant in that center. You can also check the additional services the center is offering.

When you are done checking with the center, they will evaluate you if you are a candidate for a transplant.

They will check if you:

• will benefit from other less aggressive treatment options
• have a heart condition that would benefit from transplantation
• will agree to quit smoking
• are healthy enough to undergo surgery and post-transplant treatments
• can emotionally handle the wait for a donor's heart
• have a support group or if your family and friends will help you cope
• are willing to follow the medical program outlined by the transplant team

The center will put you on the waiting list if they determine that you are a right candidate. There are not enough hearts in the world for every person in need.

Some patients even die without receiving a heart transplant. Your team will monitor your heart and other organs.

If you develop a significant medical condition such as infection, they will remove your name from the list temporarily.

Your doctor may suggest that you have ventricular assist devices or VADs - a device implanted to support your heart while you wait for a donor organ – if medical therapy fails to support your vital organs.

The factors that will determine if there is a match is the donor-recipient match which includes:

• blood type (A, B, AB or O)
• the medical urgency of potential recipients
• time spent on the waiting list
• the size of the donor organ
• antibodies the recipients might have developed

To remain usable, a heart transplant usually needs to occur within four hours of organ removal for the donor organ.

Some of the transplant centers will provide you a cell phone so they can contact you if there is a donor organ. You have to make a decision fast because the time is limited.

Some heart transplant centers provide private air transportation so plan ahead of your transplant.

Read on to learn more about what to expect before, during, and after your heart transplant procedure.

Heart transplant surgery can take up to four hours. To keep oxygen-rich blood flowing throughout your body, your surgeon will open your chest and connect you to a heart-lung machine.

The damaged heart will be removed then the donor heart will then be sewed. When blood flow is restored, the new heart often starts beating.

In some cases, an electric shock is needed to make the donor heart beat properly. Your doctor will give you medications because you will be in pain after the surgery.

He will also provide you with tubes to drain the fluids in your heart and lungs and ventilator so you can breathe properly. You will stay at the hospital for up to two weeks.

Your team will monitor you even after you leave the hospital for up to four months. You will undergo exams such as echocardiograms, blood work, heart biopsies, electrocardiograms, and lung function tests.

The long-term adjustments that you need to take include:

Drinking immunosuppressants – so that your new heart will not be attacked by your immune system. There will be side effects for some of the medications that you are going to take.

Your face may become round and full, develop acne or facial hair, experience stomach problems or may gain weight if you are taking corticosteroids.

You will also be given antiviral, antifungal and antibacterial medications because immunosuppressants make your body more vulnerable to infection.

The doses and number of anti-rejection drugs can be reduced over time as the risk of rejection is reduced.

Managing medications and therapies – you should keep a list of all the medications that you are going to take so you will not forget them.

Cardiac rehabilitation – this will help you adjust to changes such as exercise and diet.

Emotional support – some of the patients will experience stress because of the transplant so look for a support group near your area to help you cope with your situation.

Understanding the results of your heart transplant will be made possible by your doctor.

You can go back to your normal activities three to six months after the transplant but will have some restrictions. Recipient survival rates vary based on a number of factors.

Because of the development of valvular heart disease or coronary artery disease or because of organ rejection, your new heart might fail.

Discuss this with your doctor. He may suggest adjusting your medicines or it will be possible to have another heart transplant.