A heart transplant is a medical procedure that removes a person’s sick heart and is replaced by a healthy heart. The new heart comes from an organ donor.
Before going through a heart transplant, a healthcare provider should be able to tell you if this is the best treatment choice for your heart failure. They will also need to make sure you are otherwise healthy enough to go through the transplant process.
Why Do You Need a Heart Transplant?
A heart transplant may be needed if the heart fails and other treatments are ineffective. Heart failure is a disease in which the heart muscle struggles severely to pump blood throughout the body, causing serious damage.
When heart failure reaches end-stage, this means that other treatments have stopped working. Despite its name, the diagnosis of heart failure does not mean that the heart stops beating. It simply means that the heart muscle does not pump blood because it is damaged, very weak, or both.
Some causes of heart failure are:
- Heart attack (myocardial infarction or MI)
- Viral infection of the heart muscle
- High blood pressure
- Heart valve disease
- Heart defects present at birth (congenital)
- Irregular heartbeats (arrhythmias)
- High blood pressure in the lungs (pulmonary hypertension)
- Alcoholism or drug abuse
- Chronic lung diseases
- Heart muscle is enlarged, thick, and stiff (cardiomyopathy)
- Low red blood cell count (anemia)
Your doctor may recommend a heart transplant for other reasons not listed above.
How is a Heart Transplant Done?
You undergo general anesthesia and will not be awake during surgery. Medicine is given to you through the intravenous (IV) line of your arm. A breathing tube connected to the ventilator helps with breathing. The surgeon opens your chest, connects your arteries with a heart-lung machine, and removes your heart. The body’s veins and veins are removed from the bypass device and reconnected to the heart of a healthy donor. A heart transplant is completed after the surgeon closes the chest.
After surgery, you will recover in the hospital’s intensive care unit (ICU) and stay in the hospital for up to 3 weeks.
During recovery, you can start a cardiac rehabilitation program. Your healthcare provider will monitor your overall health before you leave the hospital. You will learn how to look at your weight, blood pressure, pulse, and temperature. You will also know the signs of heart transplant rejection or infection.
For the first three months after discharge, you will need to return regularly to detect infections or rejection of the new heart. Your medical team will also assess your heart function, and ensure normal recovery.
How Does Transplant Affect the Heart?
The donor’s heart should already be compatible with the recipient, depending on blood type and body size. However, there is still a chance that your body may reject it. That is why you will also need to take immunosuppressive drugs to prevent your immune system from rejecting the new heart.
The medical team makes sure that the amount of immunosuppressive drugs that you need is enough to prevent rejection. These medications also help prevent the risk of side effects such as infection and cancer.
Risk of Heart Transplant
Heart transplantation is a complicated and dangerous procedure. Below are the possible complications you may experience when going through a transplant:
- The immune system recognizes the transplanted heart as a foreign body and attacks it (rejection)
- The donated heart does not function properly (graft failure)
- Stenosis of the arteries that supply the heart (cardiac allograft angiopathy)
- Side effects of immunosuppressive agents such as increased vulnerability to infection, weight gain, kidney problems, etc.
Many of these problems are treatable, but may require another heart transplant if possible. What do you need in the future? After a heart transplant, the medical team will monitor for any heart rejection that can occur in the cells of the heart muscle and the arteries. They are also on the lookout for the side effects of immunosuppressive drugs such as diabetes, infections, kidney disease, cancer and high blood pressure.
If any of these problems occur, your doctor will change the type or dose of the drug. You and your doctor may also decide to change your immunosuppressive drug when new drugs become available.
Ventricular Assist Devices
Ventricular assist devices (VADs) may be another option for some people who cannot receive a heart transplant. A ventricular assist device is an implanted mechanical pump. It helps the heart pump blood to the rest of the body.
VAD is a temporary treatment for people waiting for a heart transplant. People with heart failure who are not eligible for a heart transplant make use of these devices as a long-term treatment. If VAD does not help the heart, doctors may consider a complete artificial heart, a device that replaces the ventricles of the heart, as a short-term alternative treatment while waiting for a heart transplant.
Learn more about Heart Failure here.
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