HEART TRANSPLANT

Hearts transplants, or cardiac transplantation, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease. The most common procedure is to take a working heart from a recently deceased organ donor (allograft) and implant it into the patient. The patient’s own heart may either be removed (orthotopic procedure) or, less commonly, left in to support the donor heart (heterotopic procedure); both are controversial solutions to one of the most enduring human ailments. Post-operation survival periods now average 15 years.

Why the Procedure is Performed ?

A heart transplant may be recommended for : –

• Severe angina that can no longer be treated with medications or surgeries to repair the coronary arteries
• Severe heart failure, when medicines, other treatments, and surgery no longer help. Possible causes of severe heart failure are:
  1. Coronary artery disease
  2. Cardiomyopathy (disease of the heart muscle)
  3. Heart valve disease with congestive heart failure
• Severe heart defects that were present at birth and cannot be fixed with surgery
• Life-threatening abnormal heart beats or rhythms that do not respond to other therapy

Heart transplant surgery may NOT be recommended for patients who have : –

• Had cancer
• Infections such as hepatitis, that are considered to be active
• Insulin-dependent diabetes with poor function of other organs
• Kidney, lung, nerve, or liver disease
• Malnutrition
• Other diseases that affect the blood vessels of the neck and leg
• Smoking, alcohol or drug abuse, or other lifestyle habits that may damage the new heart

The doctor may also recommend against a heart transplant if there is concern that the patient will not be able to comply with the many hospital and doctor’s office visits, tests, and medications needed to keep the new heart healthy.

Risks Risks for any anesthesia are : –

• Reactions to medications
• Problems breathing

Risks for any surgery are : –

• Bleeding
• Infection

Risks of transplant include : –

• Blood clots (deep venous thrombosis)
• Damage to the kidneys, liver, or other body organs from anti-rejection (immunosuppression) medications
• Heart attack or stroke
• Heart rhythm problems
• Increased risk for infections due to anti-rejection (immunosuppression) medications
• Wound infections

Expectations after surgery in India Heart transplant prolongs the life of a patient who would otherwise die. About 80% of heart transplants are alive 2 years after the operation. The main problem, as with other transplants, is graft rejection. If rejection can be controlled, the patient’s survival can be increased to over 10 years.

Drugs that prevent transplant rejection must be taken for the rest of the patient’s life. Normal activities can resume as soon as the patient feels well enough and after consulting with the doctor. However, vigorous physical activities should be avoided.

The major problems are the same for all major organ transplants : –

• Finding a donor
• Fighting the rejection effect
• The cost of the surgery
• Avoiding infection
• Avoiding blocked blood vessels in the transplanted organ

Finding a donor can be difficult. In heart transplantation, the healthy heart must come from a person who recently died or is on life-support and is brain dead. This is different than a kidney transplant, because a kidney may be donated by a living person.

Timing is very important because there is no good way to keep a donor heart alive for long periods of time. A person in need of a heart transplant may be kept alive on artificial heart devices for longer and longer periods of time. However, artificial hearts also have major risks. While some of these devices are fully approved, others are still considered experimental.

Fighting rejection is an ongoing process. The body’s immune system considers the transplanted organ an infection and fights it. For this reason, organ transplant patients must take drugs such as cyclosporine and corticosteroids that suppress the body’s immune response. The downside of these drugs is that they weaken the body’s natural defense against infection.