Heart and The Transplant

We all are emotional by nature irrespective of the facial appearances and are connected to someone in one or other way. The different stages of human life are fetus, infancy, childhood, adolescence, adulthood and old age and the two most important biological support organs to pass through these stages are - Brain and Heart.

So far we have not heard anyone getting a brain as ‘transplant’ in case of a brain dead condition, but Heart Transplant - Definitely YES. Therefore, let’s talk about Heart Transplant.

A heart transplant is surgery to remove the diseased heart from a person and replace it with a healthy one from an organ donor. To remove the heart from the donor, two or more healthcare providers must declare the donor brain-dead.
Before you can be put on a waiting list for a heart transplant, a healthcare provider makes the decision that this is the best treatment choice for your heart failure. A healthcare team also makes sure you are healthy enough to go through the transplant process.

Why might I need a heart transplant?
You may need a heart transplant if your heart is failing and cannot be treated by other means.

End-stage heart failure is a disease in which the heart muscle is failing severely in its attempt to pump blood through the body. It means all other available treatments are no longer helping to improve the heart's function. End-stage heart failure is the final stage of heart failure. Despite its name, a diagnosis of heart failure does not mean the heart is about to stop beating. The term failure means the heart muscle is failing to pump blood normally because it is damaged or very weak, or both.

Some causes of heart failure include:
• Heart attack (myocardial infarction or MI)
• Viral infection of the heart muscle
• High blood pressure
• Heart valve disease
• Heart conditions present at birth (congenital)
• Irregular heartbeats (arrhythmias)
• High blood pressure in the lungs (pulmonary hypertension)
• Alcoholism or drug abuse
• Chronic lung diseases, such as emphysema or chronic obstructive pulmonary disease (COPD)
• Heart muscle is enlarged, thick, and stiff (cardiomyopathy)
• Low red blood cell count (anemia)

How do I get ready for a heart transplant?
Not everyone is a candidate for heart transplant. Because of the wide range of information needed to know if a person is eligible for transplant, the evaluation process is carried out by a transplant team. The team includes a transplant surgeon, a transplant cardiologist (doctor specializing in the treatment of the heart), nurse practitioners or physician assistants, one or more transplant nurses, a psychiatrist or psychologist.



The transplant evaluation process will include:

• Psychological and social evaluation. Some psychological and social issues that are involved in organ transplant include stress, financial issues, and support from family or significant others. These factors can greatly affect how you do after the transplant.
• Blood tests. Blood tests are needed to help find a good donor match and help improve the chances that the donor heart will not be rejected.
• Diagnostic tests. Diagnostic tests may be done to assess your lungs as well as your overall health. These tests may include X-rays, ultrasound procedures, CT scan, pulmonary function tests (PFTs), and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram.
• Other preparations. You will get several vaccines to decrease the chances of developing infections that can affect the transplanted heart.


The transplant team will consider all the information from interviews, health history, the findings from your physical exam, and diagnostic test results when deciding if you are eligible for a heart transplant.

Once you have been accepted as a transplant candidate and a donor organ becomes available, candidates are selected based on the severity of their condition, body size, and blood type. If the heart is to be yours, you will be told and will need to go to the hospital right away so you can get ready for the transplant. (Most hearts must be transplanted within 4 hours after they’ve been removed from the donor.)

These things will need to be done before the transplant:
• Your medical facilitator will explain the procedure and let you ask questions.
• You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if anything is not clear.
• You should not eat or drink anything (fast) as soon as you have been told that a heart has become available.
• You may be given medicine to help you relax (sedative).
• Based on your health condition, your healthcare provider may request other specific preparation.

What happens after a heart transplant?
In the hospital
After the surgery, you may be taken to a recovery room before being taken to the intensive care unit (ICU) to be closely monitored for several days. Or you may be taken directly to the ICU from the operating room. You will be connected to machines that will constantly display your electrocardiogram (ECG) tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. Heart transplant surgery requires an in-hospital stay of 7 to 14 days, or even longer.

At home
Once you are home, it will be important to keep the surgical area clean and dry. You will be given specific bathing instructions. The sutures or surgical staples will be removed during a follow-up office visit, if they were not removed before leaving the hospital.

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*Reference: John Hopkins, USA.