Heart transplantation is the procedure of removing a healthy heart from a recently deceased person and transplanting it into the body of someone who has a severe heart condition that is no longer treatable with medications or other types of surgery.
People who have one of the following illnesses, which cannot be adequately treated with medications or other forms of surgery, are candidates for heart transplantation:
- Severe heart failure
- Coronary artery disease
- Irregular heart rhythms (arrhythmias)
- Other severe heart disorders
If persons have severe pulmonary hypertension (high blood pressure in the arteries of the lungs) that has not responded to medication treatment, heart transplantation is not an option. These folks would almost certainly benefit from a combination heart-lung transplant.
Heart machines can keep individuals alive for weeks or months in some medical centers until a matching heart can be identified. In addition, recently created implantable artificial hearts (called ventricular assist devices or VADs) that pump blood to the rest of the body are being utilized to help people wait for a heart or in people who aren’t candidates for a heart transplant. These devices are increasingly being used as a long-term replacement since they have substantially improved. As a result, the need for heart transplants has dropped slightly.
About 95% of people who have had a heart transplant can exercise and perform daily duties far better than they could before the surgery. Over 70% of persons return to full-time employment. Heart transplant recipients live for an average of 85 to 90 percent of the time.
Donors
All of the donated hearts are from people who have recently passed away. Donors must be under the age of 70 and free of coronary artery disease or other heart problems. The donor and recipient’s blood types and heart sizes must also be compatible.
Hearts that have been donated must be implanted within 4 to 6 hours.
Procedure for Heart Transplantation
Most of the diseased heart is removed through a chest incision, although the back wall of one of the upper heart chambers (atria) is left. The donor’s heart is subsequently connected to the recipient’s remaining heart.
It takes 3 to 5 hours to perform a heart transplant. The hospital stay following this procedure is typically 7 to 14 days.
Immunosuppressants, such as corticosteroids, are administered on the day of transplantation to suppress the immune system. These medications can help lower the chances of the transplanted heart being rejected by the recipient.
Complications of Heart Transplantation
Transplantation can result in a number of problems.
The majority of deaths following heart transplantation are caused by early rejection or infections.
Rejection
To avoid rejection of a transplanted heart, immunosuppressants must be used.
If you are rejected, you may have weakness and an irregular heartbeat. When a transplanted heart is rejected, it may not function properly, resulting in low blood pressure and the accumulation of fluid in the legs and sometimes the abdomen, producing swelling—a condition known as edema. Fluid can also build up in the lungs, making breathing harder. Rejection, on the other hand, is frequently mild. There may be no symptoms, but electrocardiography (ECG) can identify alterations in the electrical activity of the heart.
A biopsy is routinely performed if doctors suspect rejection. A catheter is placed into a vein in the neck and threaded to the heart through an incision in the neck. A little bit of cardiac tissue is removed using a device at the catheter’s end and viewed under a microscope. Because the consequences of rejection might be severe, clinicians do a biopsy once a year to check for rejection that has not yet manifested itself.
Transplant-related to atherosclerosis
Atherosclerosis in the coronary arteries affects about one-fourth of persons who receive a heart transplant.
Drugs that lower lipid (fat) levels in the blood, as well as diltiazem, are used to treat the condition (a drug that can help prevent blood vessels from narrowing).
