Heart Transplant Surgery: What is the Outlook?

Health

Heart transplant is the operation to remove and replace a failing, diseased heart with a healthier donor heart. This procedure is reserved for people with heart conditions who have not had much luck with medications or other surgeries.

People who need Heart Transplants

  1. Sudden cardiac death from failure of the electrical conduction system of the heart
  2. End-stage heart disease
  3. Heart failure arising from:

∙                  Myocardial Infarction

∙                  Pulmonary Hypertension

∙                  Heart Valve Disease

∙                  Viral infection of the Myocardium

∙                  Congenital heart defects; the major cause in children

∙                  Ventricular Arrhythmias

∙                  Alcoholism/ Drug Abuse

∙                  Chronic Lung Diseases, such as Emphysema or COPD ( Chronic Obstructive

∙                  Pulmonary Disease)

∙                  Anemia

∙                  Cardiomyopathy (enlargement of Heart Muscle)

∙                  Coronary Artery Disease

Contraindications of Heart transplant

∙                  Advanced Age

∙                  Pre Existing condition, such as kidney failure, a serious liver or lung disease

∙                  Active infection

∙                  Medical history of Cancer

∙                  Unwilling or unable to make lifestyle changes

Heart Transplant Process

 

  1. Psychological & Social Evaluation

Upon recommendation by your doctor, you shall be referred to a heart transplant center and evaluated for eligibility.

The criteria for eligibility are:

  1. Heart conditions that benefit from transplantation
  2. Have run out of other treatment options
  3. Your health can bear surgery and post-transplant treatments
  4. Are ready to cut down on smoking or drinking habits
  5. Are able to wait for a donor heart; emotionally stable
  1. Blood & Diagnostic Tests

To find a donor match and assess health; tests like CT scan, Pulmonary Function Tests,  X-rays.

  1. Waiting for a donor organ

This can be a very long and grueling process. Ventricular assist devices might be implanted in you, meanwhile.

A match is determined by:

∙           The recipient’s medical emergency

∙           Blood type (A, B, O or AB)

∙           Donor organ size

∙           Time spent on the waiting list

  1. Pre Transplant- Heart transplants need to occur within 4 hours of organ removal. You are notified by the center to ask whether you accept the donation. Thereupon, you must rush to the transplant hospital; often, airlifts are provided by centers.
  2. Surgery

Upon arrival, a final evaluation precedes the surgery. It is a 3 step process:

First step – The donor must be declared brain-dead for their heart to be “harvested,” transported on ice to keep it alive and viable, and taken to the nearest transplant center.

Second step – The recipient’s damaged heart is removed.

Third step – The transplantation, with the help of 5 lines of stitches called “anastomoses.” The large blood vessels of the recipient are connected to the donor’s heart.

Complications of Heart Transplant

Every surgery holds some inherent risks, and heart transplants are no different in this regard. Let’s take a look at some of the biggest risks of having a heart transplant surgery:

  1. Bleeding out during or after the surgery
  2. Widespread Infection; some infections may be recurrent and hard to treat or cure. Immunosuppressants are known to decrease your body’s ability to fight infection. It is very common to have to get hospitalized within the first year of the transplant owing to infection.
  3. Blood clots which cause future heart attacks or strokes or lung problems
  4. Breathing problems
  5. Kidney Failure
  6. Failure of the donor’s heart

Primary graft failure is the most dreaded complication. It is possible for your body to reject the new donor heart, and the immune system wreaks havoc on it, treating it the way it would any harmful foreign body. Either an active rejection or a chronic rejection will follow, resulting in a scar tissue that blocks the blood vessels.

Specialized drugs known as “Immunosuppressive medications” are needed to help your body to not view the new heart as a threat and to allow it to survive. The medicines trick the body into accepting the transplant and keeps it from attacking it.

  1. Coronary Allograft Vasculopathy (CAV) – The vessels that carry blood to the heart muscles become thick and hard. This, in turn, causes serious heart muscle damage.
  2. Death
  3. Metastatic Cancer

Immunosuppressive medicines might, in turn, may make you susceptible to cancers, like Non-Hodgkin’s Lymphoma, skin and lip tumors, etc. The spread of preexisting cancer to other parts of the body is not uncommon.

Results of Heart Transplants

You can expect to enjoy a good quality of life after your transplant. It depends on your healing and recovery, to determine how much of your daily activities you are able to resume.

Putting major complications aside, the results of heart transplantation are remarkably good.

Survival rate:

The one-year mortality rate in patients with severe forms of heart failure is 80%.

5-year survival rate amongst patients with any type of heart failure is less than 50%.

Yet, after the survival averages about   50 – 60%

And one-year survival averages about 85 – 90%

For adults, the global overall survival rate is more than 85% after one a year and about 69% after five years

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