Heart Transplant


DESCRIPTION

Heart transplantation is a surgical procedure performed on patients who suffer from end-stage heart failure.  It is the process of removing a patient’s dysfunctional heart and replacing it with a healthy heart from a deceased donor. End - stage heart failure is a stage when all other treatments and less drastic surgeries have failed their purpose. It is that condition when the heart has suffered maximum damage and has become too weak to pump blood to meet the body’s needs. Heart transplant is regarded as one of the most sought after surgeries in cardiology. This may be because of the difficulty in finding healthy donors for the transplant. A heart transplant surgery involves careful evaluation and testing procedures while selecting both the donor and recipient. The donor’s heart has to be healthy enough to reside in the recipient’s body and the recipient should be healthy enough to accommodate the donor’s heart. Most of the patients suffering from severe coronary heart disease and end stage heart failure are the ones who have to undergo a heart transplant.



THE PROCESS

Heart transplant process consists of 2 procedures; Orthotopic and heterotropic. Either of these procedures will be followed depending on the condition of the patient and the donor heart.


ORTHOTOPIC PROCEDURE

This procedure begins with the surgeons making a vertical inline incision along a sternum after which the sternum is divided and the surgeons can easily gain access to the heart. The surgeons then dissect the blood vessels and attach the patient to cardiopulmonary bypass. The dysfunctional heart is then removed by transecting the great vessels and a portion of the left atrium keeping the pulmonary veins in place. The donor heart is trimmed suitably and the vessels are sutured back in place. The transplanted heart is then restarted and the patient is then disconnected from the bypass machine. The incision is closed after that.

HETEROTOPIC PROCEDURE

In the heterotopic procedure, the patient’s own heart is not removed before the transplant. The new heart is positioned so that the chambers and blood vessels can be connected to form a sort of double heart. The procedure actually gives the patient’s original heart a chance to recover, and if the donor’s heart happens to fail through rejection, it may be removed, allowing the patient’s original heart to start working again. Heterotopic procedure is used only in cases where the donor heart is not strong enough to function by itself due to different reasons like difference in the body mass or size of the patient and the donor, the donor having an unhealthy heart or the patient suffering from pulmonary hypertension.



DURATION OF THE PROCESS

A heart transplant surgery may usually take up to 4 hours.



HOSPITALIZATION PERIOD
After a heart transplant surgery, the patient is likely to be hospitalized for 1 – 2 weeks.


TIME SPAN FOR RECOVERY

Patients who prefer to have the transplant surgery abroad can leave to their home country within 2 weeks after the surgery.



AFTERCARE GUIDELINES

Since Heart transplant surgery is one of those surgeries which are used as life saving procedures for a patient, utmost care should be taken after the surgery.

  • After the surgery, patient will be taken to intensive care unit of the hospital and will be monitored by the doctors for the fist few days.
  • Monitoring may include frequent blood tests, lung function tests, Electrocardiograms and biopsies of the heart tissue.
  • During or after the hospitalization period, the patient may be advised to start a cardiac rehabilitation program.
  • The patient is strictly advised to follow the medications and exercises prescribed by the cardiologist.
  • The patient should keep a list of all the medicines with him/her at all times.
  • Look out for chest or lung infections, infections near the incision site, infections or allergies from medicines etc.
  • Patient is advised not to engage in strenuous activities or exercises after the surgery and also to bring about changes in his/her lifestyle which may affect the heart function like quitting smoking, alcohol consumption, changes in diet etc.
  • After the surgery, most heart transplant recipients can resume their normal lifestyle within months with the help of proper medication and maintaining a healthy routine.


THE RISKS

The primary risk in heart transplant is whether the recipient heart can accommodate the donor’s heart successfully both in long term and short term.

  • If the patient experiences weakness, fatigue, malaise (feeling lousy), fever and flu like symptoms such as dizziness, headache, diarrhea, nausea etc. then possibilities are that the patient’s body is rejecting the heart which was transplanted.
  • There may be some complications due to the intake of medicines after the surgery. These might include complications like kidney damage.
  • High blood pressure may also be a side effect arising after the surgery.
  • Osteoporosis or weakening of bones may also arise as a complication from the surgery.
  • Infections at the incision site can occur from the hospital.
  • In some of the patients diseases like Cardio Allograft Vasculopathy has been seen as complications from the surgery.


RESULT

After the surgery, most heart transplant recipients (about 90 percent) can come close to resuming their normal lifestyles.



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