Transplant is the replacement of a ruined or damaged organ with a good one. The idea of organ replacements has been documented in antique mythology. Skin grafts were maybe the first real organ transplants conducted in India back in the second century B.C.
Heart transplant is a simple operation by a cardiac surgeon. In 1967, Dr Christian Barnard did the first heart transplant in S.A. Unfortunately, the patient only survived for eighteen days after the transplant. At the Stanford University in United States, this is where most of the findings that led to successful heart transplant took place. Other centers started reporting successful heart transplants as soon as Stanford University started announcing good results.
Initially, heart transplants are offered at many treatment centers across the United States. However, travelling documents maybe required to get to get to one of these centers from current locations. Treatment bills are covered by the insurance but travel expenses are not covered.
If you already know where you will be going for a Heart transplant, or a consult or second opinion, click here to plan your travel. Otherwise, click here to get information about facilities that specialize in Heart transplant.
If you cannot afford travel for medical treatment, please consult our directory of charitable organizations that can help arrange no-cost transportation for you.
For more information: (links to the sections below)
- How Heart transplant is done?
- Where to go for heart transplants?
- Get a potential heart donor
- Risks associated with heart transplant
- Diagnoses of heart transplant rejection
- Who needs heart transplant?
- Hospital Visits Required for the Heart Transplant
Heart patient has to travel just once for the heart transplant. The patient cannot travel at the last minute because hearts are not always available and not all patients qualify for heart transplant. The notice period for heart transplant is several weeks, months or years prior to receiving a donor heart.
How Heart transplant is done?
Heart operation consists of three operations.
- The first stage
This is where the heart is harvested from the donor. Often, the donor is a patient with major trauma of the head or brain injury but other organs are functioning properly.
- The second stage
This is where the recipient’s damaged heart is removed. This may be difficult depending on whether the recipient had any other heart transplant. Scar tissue may prolong and complicate the heart removal if there had been another transplant.
- The third stage
This is where the implantation of donor heart is conducted. This is probably the least difficult stage. This operation basically involves the creation of only five lines of stitches, or “anastomoses”. These suture lines connect the large blood vessels entering and leaving the heart. Remarkably, if there are no complications, most patients who have had a heart transplant can go home about one week after the transplant.
Where to go for heart transplants?
There are many centres around the country that can perform heart transplant. You can travel for heart transplant to reach these centres. In these centres there are professionals that work closely with the patients and their families. They walk together from the start by determining the candidate to the end process, which is mainly patient follow up care.
- Ronald Reagan UCLA Medical Center
After a heart transplant, most people can return to their normal activities.
However, it’s a major operation and some of the complications can be life threatening.
- 80-90 in every 100 people will live at least a year
- 70-75 in every 100 people will live at least five years
- 50 in every 100 people will live at least 10 years
Some people have survived for more than 25 years after a heart transplant.
Get a potential Heart Donor
Hearts are not always available for those who might need them as there are no enough donors. This makes the selection process to be conducted carefully while distributing the donated hearts fairly. Most of these recipients require a heart because theirs is not pumping well enough to supply blood with oxygen and nutrients thoroughly. Not everyone who needs a heart qualifies for a heart transplant.
All other organs must be functioning properly for one to receive a donated heart. Patients with cancer, bad diabetes, patients who smoke and abuse alcohol are also not good candidates. Hence, all potential transplants patients must undergo psychological testing to identify social and behavioral factors that could interfere with recovery, compliance with medications, and lifestyle changes required after transplantation.
The potential donor heart must be compatible with the receiver’s immune system. The United Network for Organ Sharing (UNOS) is in charge of a system that is in place to assure equitable allocation of organs to individuals who will benefit the most from transplantation.
Risks associated with heart transplant
- This is usually a risky procedure with the following possible complications
- Rejection of the heart by the recipient’s immune system
- Graft failure of the donated heart
- Arteries supplying to the heart narrows
- Side effects resulting from the medication for instance prone to infections, weight gain and kidney problems
Many of these problems are treatable, although sometimes another heart transplant may need to be carried out if possible.
Diagnoses of heart transplant rejection
- End myocardial biopsy:
This is a simple operation for the experienced cardiologist and can be done as an outpatient procedure. First, a catheter is put into the jugular vein in the neck. From there, the catheter is advanced into the right side of the heart using an x-ray method called fluoroscopy for guidance.
The catheter has a bio tome at its end, a set of two small cups which can be closed to pinch off and remove small samples of heart muscle. The tissue is processed and placed on glass slides to be reviewed under the microscope by a pathologist. Based on the findings, the pathologist can determine whether or not there is rejection.
- Immunosuppressive treatment:
This is then conducted accordingly. New highly rated analysis is done using promising blood sample and is easier for the person than the above diagnoses. The test is aimed at the assessment of particular genes in blood cells.
In this way, the amount of expression of these genes shows whether rejection is happening or not. Even though this technique has not taken over from myocardial biopsy, it has ensured that less biopsies have been done among patients.
Who needs heart transplant?
- People with Congenital conditions: People suffering from severe heart defect that is present from birth.
- People with Ventricular arrhythmias: The people suffering from abnormal heartbeats that can not be controlled with medications.
- People with Severe angina: It is a type of chest pain caused by coronary artery disease. This disease is very hard to treat and can continue despite of medications or bypass surgeries.
- People with post-operation complications: The persons who are suffering from infection or malfunction of implanted mechanical heart pump can go for heart transplant surgery.
There are several factors that must be taken care of while deciding for heart transplant surgery. Not everyone is appropriate for heart transplant. The patients with cancer, persons who smoke or persons that use alcohol excessively are generally not recommended for the transplant surgery.
Hospital Visits required for Heart Transplant
Patients who are waiting for a donor heart are required to visit the medical facility for pre-heart transplant treatment on routine basis. The doctor may perform tests to check the strength of heart beat and blood pressure. He may recommend cardiac rehab program that helps to recover health of person suffering from heart disease.
Subsequent to heart transplant, the purpose of clinic visits is monitoring for rejection and closely screening of the side effects of various medications given. Since over the first few months the incidence of rejection is the highest, during the first year scheduled are the frequent clinic visits and biopsies after transplant. The only reliable means are Screening biopsies to predict rejection currently.
Mentioned below is a characteristic schedule of follow-up:
- First Month: Weekly biopsy and clinic
- Second Month: Every other week biopsy and clinic
- Months 3-6: Monthly biopsy and clinic
- Months 6-12: Clinic once a month and biopsy every other month
- After 12 months: Heart biopsies
After leaving the hospital, regular follow-up visits will be required for monitoring your progress. After the transplant, for the first two months, every one to two weeks, you will have to see your doctor.
After six months, if everything goes well, the visits will cut back to one- or two-month intervals. After a year, these visits may be cut back to three- to six-month intervals. On a quarterly basis, computer tracks follow-up care; monitoring of both routine and crisis visits is done for all patients.