A heart transplant is a medical operation that is performed to address severe cases of heart disease. It is a treatment alternative for persons with heart failure who are at the end-stage. Medical providers also recommend heart transplants if medication, lifestyle modifications, and minimally invasive treatments have failed.
To undergo the procedure, you must meet certain requirements. A healthcare provider must also determine that the transplant is the best treatment option for your heart failure before putting you on the waiting list. Furthermore, they will ensure that you are in good health to undergo the transplant procedure.
Why Heart Transplant is performed?
When your heart is gradually failing while other treatment options aren't working, you may require a heart transplant. End-stage heart failure is a condition whereby the heart muscle's ability to pump blood throughout the body is significantly compromised. It usually means that other therapies are no longer effective. The final stage of heart failure is thus known as end-stage heart failure.
A heart failure diagnosis does not, however, imply that the heart is going to stop beating. Instead, it means the heart muscle's inability to pump blood normally due to injury, weakness, or sometimes both.
Heart failure can occur due to the following causes;
- Viral infection of the cardiac muscle
- Heart attack (myocardial infarction or MI)
- Hypertension (high blood pressure)
- Congenital heart abnormalities
- Heart valve disease
- Arrhythmias (irregular heart rhythm)
- Pulmonary hypertension (elevated blood pressure within the lungs)
- Chronic lung diseases, including chronic obstructive pulmonary disease (COPD) or emphysema
- Alcohol or drug abuse
- Cardiomyopathy (enlarged, stiff, and thick heart muscle)
- Anemia (reduced red blood cell count)
On the other hand, not everyone is a suitable candidate for a heart transplant. If you have any of the following, then you may not be eligible for a heart transplant:
- You are of a certain age that would make it difficult for you to recuperate from transplant surgery.
- You have an underlying health condition that, despite getting a donor's heart, would shorten your general life (examples of these conditions are chronic liver, kidney, or lung disease).
- You have an infection that is still active.
- You have a recent medical history of cancer.
- You are reluctant or unable to make the necessary lifestyle adjustments, including not drinking or smoking, to keep the donor heart in a healthy condition.
How to Prepare for Heart Transplant?
A heart transplant is not suitable for everyone. Therefore, the transplant team will assess the evaluation due to the comprehensive data required to determine if a person is qualified before putting them on the heart transplant list.
The following steps will be included in the heart transplant evaluation process;
Social and psychological assessment: Stress, financial concerns, and support from family or significant others are some of the psychological and social problems that come with heart transplantation. These factors can have a big impact on how well you recover from the transplant.
Blood tests: The doctor may require blood tests to assist you in finding a suitable donor match. This also increases the likelihood that the donor heart won’t get rejected.
Diagnosis tests: You'll undergo several tests to evaluate both your lungs and your general health. X-rays, CT scans, ultrasounds, pulmonary function tests (PFTs), as well as dental checks are some of these tests. A Pap test, mammography, and gynecological assessment are the diagnostic options women may have.
Additional preparations: Various vaccinations may be administered to help reduce your risks of contracting infections that could jeopardize the newly transplanted organ.
In addition, you'll need to do the following prior to the heart transplant procedure;
- The healthcare professional will go over the procedure with you and answer any questions you may have.
- You will be required to sign a form of consent granting permission for the cardiosurgery to take place. If anything is confusing, read the form thoroughly and ask any relevant questions.
- As soon as you get notified that a heart is available, you should avoid eating or drinking anything (quickly).
- You may receive medication to assist you in relaxing and remain comfortable during the procedure (sedative).
- Your healthcare professional may require further preparation (which you will be informed of) depending on your medical condition.
What Happens During Heart Transplant?
A heart transplant is typically an open-heart surgery that takes a few hours to complete. If you have previously had heart surgery, the procedure will be more complex and might even take longer.
Before the heart transplant surgery, you'll be given medication to put you to sleep (general anesthesia). The cardiosurgeon will link you to a heart-lung bypass machine to keep oxygen-rich blood moving in the body. After that, he or she will create an incision or small cut on the chest. In order to operate on the heart, the surgeon will start by separating the chest bone while opening the rib cage.
The next step will involve removing the diseased or damaged heart and sewing the donor heart in place. The surgeon will then connect the donor heart's major blood veins. When blood flow is restored, the replacement heart usually begins to beat. An electric shock may be required to get the donor's heart to beat appropriately.
After the procedure, you'll receive medicine to help you manage the associated pain and discomfort. A ventilator will assist you with breathing, while the tubes in the chest will help drain the fluids from within the lungs as well as the heart. Intravenous (IV) tubes will also be used to administer fluids and drugs following surgery.
Heart Transplant Recovery
You'll be transferred to the intensive care unit (ICU) once your operation is complete. The healthcare team will closely monitor you, administer pain medicine, and place the drainage tubes in your chest cavity to help eliminate extra fluid.
In most cases, you may be transferred from the ICU immediately after one or two days following the heart transplant procedure. You will, nonetheless, remain within the hospital setting as you gradually recover. Your hospital stays might last anywhere from one to three weeks, depending on how quickly you recover.
In addition, the care team will check and monitor you for any infection as your treatment starts. Anti-rejection drugs are necessary to prevent your body from rejecting the new donor heart. To assist you in adjusting to the new life of being a transplant recipient, the surgeon might refer you to a heart rehabilitation program or a facility.
A heart transplant recovery could take a more extended period. On the other hand, complete recovery might take up to six months in most patients.
Heart Transplant Results
The majority of patients who have a heart transplant have a high quality of life. You may continue with most of your day-to-day activities, including returning to work, engaging in your hobbies, sports, and even working out, based on your condition. Consult your medical provider to determine the activities that are more suitable for you.
Other women who have undergone a heart transplant are able to conceive. Nevertheless, if you plan to have children following the transplant, speak with your doctor first. This is because some medicines can lead to pregnancy difficulties. Therefore, you will probably need to modify your meds before getting pregnant.
Generally, the chances of surviving following a heart transplant depend on a variety of factors. Despite a rise in older and increased-risk heart transplant recipients, survival rates keep on improving.
Heart Transplant Follow-Up
The long-term healing and control of a heart transplant necessitate several follow-up appointments. During the first year following the procedure, the healthcare team will regularly conduct blood tests, catheterized cardiac biopsies, and echocardiograms. This is to confirm that your replacement heart is working appropriately.
If necessary, your immunosuppressive drugs may be modified. Moreover, you will be asked whether you have ever had any of the following symptoms of heart transplant rejection;
- Breathing problems
- Fluid retention, causing unexpected weight gain
- Low urine output
Complications of Heart Transplant
Infection, as well as rejection, are the most common reasons for death after a heart transplant. Also, patients using medications to prevent the new heart from being rejected are at risk of various conditions such as;
- Renal damage
- Increased blood pressure
- Osteoporosis (a severe weakening of the bones that can lead to fractures)
- Lymphoma (a form of cancer that affects the body immune system cells)
Atherosclerosis in the arteries of the heart or coronary artery disease affects about half of all heart transplant recipients. Furthermore, most of them experience zero symptoms, like angina or chest pain, as their replacement hearts lack sensations.
A heart transplant is a procedure that involves replacing a damaged or failing heart with a new and healthy donor heart. People who need a heart transplant are mainly those whose condition has been unable to improve even with drugs or other treatments.
The transplant aims at improving the length and life quality of individuals with end-stage heart failure. But even though a heart transplant is a major surgical procedure, you have a high probability of survival with proper follow-up care.