Heart Transplant

The heart is a muscular organ found behind the breastbone. It is the size of a fist and is situated slightly to the left side. It pumps blood that is used by the body cells for its survival through:

• Aiding in transporting nutrients around the body
• Protects the body from infection through the immune system
• Helps in regulating body temperature
• Helps to maintain the fluid balance in the body. 

 

What is a heart transplant operation?

Heart transplantation is a surgical procedure in which a diseased non-functioning heart is replaced with a healthier donor heart. It is a treatment that’s usually reserved for people whose condition hasn’t improved enough with medications or other procedures [1]. Heart Transplantation can be done with other organ transplants simultaneously. They include: Heart-kidney transplant It is recommended for people having several kidney and heart conditions. The transplantation is carried out together. Heart-liver transplant This procedure involves transplanting the heart together with the liver in the recipients with heart and liver diseases. Heart-lung transplant This very delicate procedure is only recommended when the lung and heart conditions cannot be treated conservatively or for other surgical procedures. Why would a patient need a heart transplant? Reasons for Heart Transplantation is: Heart Transplantation is mostly recommended when the diseased heart is not responding to other medications and other management processes, leading to heart failure.

What are the eligibility criteria for heart transplantation?

Criteria for a Heart Transplantation Before having a heart transplant, certain factors have to be considered. They include:

• The age of the recipient, to a large extent, determines the recovery rate of the recipient. The recipient must be under 65 years old. 
• Medical history of cancer, multiple organ failure, infections, and serious medical conditions are not eligible for the transplant.
• Examination for kidney disease, liver disease, or lung disease to certain the type of procedure to be used
• Have to be an end-stage heart disease whose ejection fraction is less than 20%.
• Children with congenital heart disease for which no conventional therapy works or failed.
• Must have avoided alcohol and smoking for at least 3 months before surgery
• Patients who are estimated to have a life expectancy of less than 1 year without the transplant are not being helped by any other conventional treatment [2].

Preparations and procedures for Heart Transplant?

After picking a good surgeon and hospital, Anavara can help you do that with our team of experienced doctors; the next step is to undergo a series of tests to ascertain the patient’s state of health. After that, the patient will be placed on a waiting list to get a matching donor. That is why the patient’s life expectancy should at least be a year. The waiting period is dependent on

• Getting a good match for the recipient’s heart
• How severe is the patient’s condition 
• Blood group and genotype
• The size of patient’s heart

The patient will also have to undergo some psychological and financial counseling. Prior to the surgery:

• After receiving a call to visit the hospital, the patient must be there within 4 hours.
•  The patient should not eat or drink anything within the hours of going to the hospital.
• The patient has to carry their medications, including their ventricular assist device- they aim to support the heart and extend their life expectancy while waiting for the new heart. 
• Once the patient arrives at the hospital, the surgeon and the transplant team will do a final evaluation to check if the donor’s heart is suitable for the recipient or not.

In the surgery: Picture Courtesy: Templehealth

• You will be given a general anesthesia 
• Then a heart-lungs bypass machine to keep the inflow of oxygen is made.
• After that, an incision is made on the chest
• The rib cage is opened, the diseased heart is removed, and the healthy heart is placed.
• Then major blood vessels are attached to the new heart for blood flow into the new heart.
• Usually, the new heart will start functioning ( heart beating) when the blood flow is restored.
• At times the surgeon might give an electrical shock to help the new heartbeat properly.

After surgery:

• The patient will be given some pain killer medications to help relieve the pain.
• Fluids and medications will be given intravenously.
• Initially, the patient will be placed in the intensive care unit for a few days before being moved to a regular room.
• The number of days varies from person to person, depending on the type of surgical procedure.  
• The patient will be monitored intensely for the first few months for signs and symptoms of rejection.
• The patient will also undergo heart biopsies, where a tube is inserted into a vein in the neck and directed into the new heart. A sample is taken to the lab for signs of rejection.
• The patient will be placed on anti-rejection( immunosuppressants) drugs.
• The patient will be placed on cardiac rehabilitation programs to help the patient adjust to the new lifestyle.

How many hours does a Heart Transplant take? A heart transplant may take up to 4-6 hours to perform, depending on how complicated the surgery may turn out to be.

Possible Complications of Heart Transplantation

Complications encountered with heart transplantation may include:

• Blood clotting
• Excess blood loss
• The body may reject the donated heart.
• Primary graft failure may occur-failure of the donated heart to function.
• Cardiac allograft vasculopathy-thickening of the arteries
• Kidney damage due to side of immunosuppressants
• Reduced ability of the body to fight infections and disease because of the immunosuppressive.
• Atherosclerosis (blockage) of the heart’s arteries or coronary artery disease develops in almost half of the patients who receive a transplant.
• High blood pressure
• Breathing problems [4].

Recovery and Success Rates Worldwide the survival rate is more than 85 per cent after one year and 69 per cent after 5 years in the recipient of heart. Of course, survival depends on certain factors, but with the advance in medical technologies, the mortality rate has reduced compared to when it started. Source: www.mayoclinic.com Can the new heart fail? It could fail for some reasons, such as age, recipient inability to recover, or primary graft failure. Therefore, heart Transplantation is not for everyone and is suggested when other options are not yielding positive results. Cost of Heart Transplant? The coat of Heart Transplantation varies for different transplant centers. Anavara can help you connect with good and reliable surgeons across the globe to perform this procedure at an affordable cost. Contact us at [email protected]. You can also visit our website: www.anavara.com. We will be glad to help. Where to do a Heart Transplant? This is a major fact that is very crucial to the success of the transplant. Anavara helps the patient locate good transplant centers with low mortality records and success rates. Please email us for more inquiries at [email protected]

Causes

What is heart failure?

Heart failure occurs when the heart can no longer carry out its main function of pumping blood for circulation in the body. Heart failure occurs when the artery or arteries of the heart gets narrowed or blocked, as a result, the heart cannot pump sufficient blood needed by the body cells for survival and increases the blood pressure in the body.

What causes heart failure?

Heart failure may the causes of the following factors such as:

• The disease of the artery
• Ventricular arrhythmia; when the heart is producing abnormal rhythm that is not responding to treatment
• Congenital heart defect; when someone is born with it. It is one of the main reasons for heart failures in children
• When the muscles of the heart are become weaken.

FAQ

1. What is the life expectancy of a heart transplant?

According to a report by Mayo clinic, over an estimate of 85 per cent of recipients survive after one year and 69 per cent after 5 years. However, life expectancy is mostly dependent on the recipient’s lifestyle, properly following the necessary medications, and a positive attitude.

2. Can heart failure occur in children?

Heart failure can occur in children, and this can be due to congenital heart defects or cardiomyopathy.

3. What is the cost of heart transplantation?

Heart Transplantation involves a delicate process with much expertise; hence its cost varies according to the transplant center involved, and also proper medical consultation with the surgeon is important. Anavara can help the patient contact reliable surgeons with good experience at an affordable price.

4. What is rejection?

Rejection occurs when the body’s defense system identifies the donated heart as foreign material in the body and attacks it. If left untreated, the body’s immune system would damage the cells of the new heart and destroy it. Hence to avoid rejection, the doctor would prescribe immunosuppressants to the patient after the surgery. 

5. What are the signs of rejection in heart transplants?

Rejection could happen without showing symptoms, so the patient must undergo an endomyocardial biopsy (biopsy of the donated heart). Some symptoms that may show include shortness of breath, fever, malaise, fatigue, urinary difficulty, weight gain, flu-like symptoms etc.

6. Can heart transplant patients live a normal life?

After a heart transplant patient can lead a normal life by following a healthy lifestyle and following the doctor’s medications regularly, and following up with the surgeon regularly [3].

7. Can a heart transplant patient drink alcohol?

No, a heart transplant patient needs to follow a healthy lifestyle and quit drinking alcohol and smoking.

8. Can heart transplant patients get covid vaccination?

The patient can get covid vaccination after the transplant [5].

 

 

References

1. https://www.mayoclinic.org/tests-procedures/heart-transplant/about/pac-20384750
2. https://emedicine.medscape.com/article/429816-overview.
3. https://delhi.apollohospitals.com/blog/leading-a-normal-life-after-a-hearttransplant/#:~:text=The%20transplanted%20heart%20may%20take,regularly%20after%20checking%20with%20them.&text=After%20a%20heart%20transplant%2C%20exercising,to%20leading%20a%20healthy%20life.
4. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/heart-transplant
5. https://www.vcuhealth.org/news/covid-19/covid-19-vaccines-and-transplant-patients-is-safe#:~:text=Transplant%20patients%20can%20receive%20their,(804)%20393%2D0591.