Heart transplant, also known as cardiac transplant is a major surgical procedure where a diseased or damaged heart is removed and replaced with a healthy one provided by a deceased donor. A Heart transplant is performed to help the patient who is at the end stage of heart disease where other treatment methods were ineffective to stop the advancement of the heart failure. This surgical procedure is highly effective when the heart of the patient cannot perform its functionality of circulating the oxygen rich blood to the entire body. The doctor only recommends this method when other treatment options are ineffective in curing the heart disease and there is no hope for the person to survive for next few years without a transplant.
In order to determine whether you are suitable for a heart transplant, the doctor will perform several tests such as blood tests, CT scan, MRI, X-rays, ultrasound, pap test, physical examination, etc. and review the results. Once you are accepted as a suitable candidate, measurements of your body and heart size will be taken and you will be given instructions to follow before coming for the surgery.
Before starting the procedure, you will be given general anesthesia through injection into a vein to put you to sleep during the procedure. A long flexible tube will be placed into your bladder for draining urine and another tube will be inserted through your mouth or nose to the stomach for draining fluid build ups. A breathing tube will be positioned through your mouth to the lungs to help you breathe properly. During the entire process, your vital signs will be monitored carefully.
The surgeon will make an incision in your chest just above the navel and the breastbone will be cut to access the diseased heart. The blood vessels connecting the heart and lungs, which are responsible for the blood flow to the entire body is then disconnected from the heart and attached to the heart-lung machine. The machine then circulates the blood to the body while the doctor removes the damaged heart and replaces it with the donor’s heart. Once the new heart of the same size is placed well into the site, the blood vessels will be attached back to the heart from the bypass machine. The doctor then provides an electric shock to the heart with small paddles to restart its beating.
Once it begins beating, the health care team closely monitors its functions to track any leakage or irregular functionality. Wires may be placed into your heart attached to a pacemaker for a short period of time to increase the pace of the heartbeat from outside. The incision will be closed with stitches and surgical staples and tubes will be put into your chest for draining fluids and blood around the heart. The whole procedure lasts for some 4-6 hours.
As with any other surgical procedure, heart transplant also has come serious complications that must be discussed with the surgeon before the operation. These potential risks are:
- Blood clot formation
- Lung problems
- Heart attack
- Breathing issues
- Kidney failure
- Coronary allograft vasculopathy (narrowing or hardening of blood vessels)
- Weight gain
Post operative care
After the surgery is finished, you will be placed in the recovery room and then to the ICU for close monitoring for a few days. Your breathing rate, pulse rate, blood pressure and oxygen level will be observed. You will have to stay in the hospital for 7-14 days or even longer, depending on how well you recover.
Once you are discharged from the hospital, you will be given anti-rejection medications and antibiotics. Recovery may take a long period of time ranging up to six months or more.
You will have to visit your doctor and health care team for regular appointments to track your recovery and perform some medical tests. During these visits, you can tell them any complications of rejection symptoms you may be experiencing, such as fever, shortness of breath or weight gain.
You will have to lead a healthy life post heart transplant. Eat healthy and nutritious food and quit smoking and alcohol. Exercise on a daily basis for better recovery and increasing your stamina.
Rejection is the main reason of short life span after heart transplant, therefore, you may need to take immunosuppresant drugs for the rest of your life.
Talk to your doctor if you are planning to become pregnant.