The human heart is one of the most important organs. It is a muscular organ located behind the breastbone or chest. Its main function is to pump blood through the network of arteries and veins called the cardiovascular system.
When the heart muscles don’t pump blood properly, and it does not meet the body’s requirement of blood and oxygen, this leads to a condition called congestive heart failure. There are various stages of heart failure. At the end-stage of heart failure, all the medicines, treatment options fail to treat the patient and they need a heart transplant to survive.
Heart Transplant is a surgical process to replace a damaged or diseased heart with a healthy heart donated by an organ donor. The donor has to be declared brain dead by the healthcare providers. It is major surgery and with proper post-operative care, the survival rate is good.
Who Needs A Heart Transplant?
People with congestive heart failure who cannot be treated by medicines or other treatments for heart diseases, need a heart transplant to survive.
Causes of heart failure:
- Heart muscles weakness
- Congenital heart defects
- The disease of the heart valve
- Recurring Arrhythmias
- Previous unsuccessful heart transplant
- Heart attack
- Alcohol or drugs addiction
- Pulmonary hypertension
- Chronic disease of the lungs
- Heart muscle infections due to virus
How to prepare for a heart transplant
Once the cardiac specialist recommends that you would need a heart transplant to survive you will be thoroughly evaluated at a specialized heart transplant center. The evaluation will be done to check if you are the right candidate to undergo the transplant, that includes:
- Your mental status and readiness to undergo such a complex surgery
- If you are ready to follow all the outlined precautions properly
- Your heart disease is at a stage that would only be treated via a transplant
- You are emotionally ready to handle the wait for a donor
- You have a proper support system at your home to help you overcome the stress and recover fast
Few factors define that you might not be a good candidate for a heart transplant such as:
- Advanced age
- Another chronic illness that can be life-threatening for example diseases of kidney or lungs
- History of cancer
- Recurring infections
- If a person is not willing to make lifestyle changes for example unable to quit smoking or alcohol
The waiting period
If everything goes well and the transplant center declares that you are a good candidate for a heart transplant then you will be put on a waiting list to find a donor. A donor is compatible with you based on your age, blood type, health status, and your body size.
During this waiting time, your heart and other organs will be monitored and be made suitable to undergo transplant surgery. If your heart is not so strong, a device called a ventricular assist device (VAD) will be implanted in your heart. This device will support your heart function will you find a compatible donor.
Before the Heart Transplant surgery
Once, a donor is found, the heart transplant has to occur within 4 hours of the heart is removed from the donor’s body. This is the most crucial time and that is why the transport of the donor’s heart to the recipient should be in time. Nowadays, air transport services are also provided by a few heart transplant centres to avoid traffic.
Once you are admitted, as there is a limited time you and the donor’s heart would be evaluated for the final time to check the compatibility.
During the heart transplant surgery
A heart transplant is an open-heart surgery that may take several hours to complete. You will be put to a heart-lung machine during the procedure.
The cardiac surgeon will make an incision in your chest to access your heart. The diseased heart will be removed and the donor’s healthy heart will be positioned. All the heart vessels will be connected to the new heart. The new heart starts beating once the blood flow is restored. Sometimes, mild electric shocks are given to make the transplanted heart work.
You will be kept in the ICU and given medications for pain management. You will be attached to a ventilator to support breathing.
After the heart transplant surgery
After being monitored for a few weeks in the ICU, you will be shifted to a normal hospital room. Total hospitalization would be around 3 weeks post which you will be discharged. Post the discharge from the hospital, your recovery depends on post-operative precautions and regular follow-up visits for the first three months. The main thing to monitor is to check for any signs of organ rejection such as any kind of infection, fever, fatigue, breathing difficulty, urine output, and sudden weight gain.
To determine whether your body is rejecting the new heart, you’ll have frequent heart biopsies in the first few months after heart transplantation, when rejection is most likely to occur. The frequency of necessary biopsies decreases over time.
Life after the Heart transplant
Mostly, a heart transplant increases the survival rates of the patients. They spend a good quality of life. Depending on your condition, you may be able to resume many of your daily life activities, such as returning to work, participating in hobbies, sports, and exercising.