Heart transplantation

What is a heart transplant?

A heart transplant is an operation in which a diseased or diseased heart is replaced by a healthy heart from a donor. Normally, it is a treatment that is reserved only for people who have already tried other treatments and surgeries but have not noticed any improvement in their illnesses.

Transplantation is a complicated and important operation, although once it is performed, and if there is adequate medical follow-up, the patient’s chances of survival will improve considerably.

Why is a heart transplant performed?

A heart transplant is performed when various treatments have failed to solve cardiac problems and heart failure occurs. The transplant is performed for the following reasons:

  • Severe damage to the heart occurs after having a heart attack
  • Severe heart failure occurs at the time when medications and surgery do not work
  • The patient has heart abnormalities from birth that cannot be repaired or changed by surgery.
  • The patient has life-threatening palpitations that do not respond to other treatments Heart failure can be caused by a variety of problems:
  • Weaker heart, heart disease
  • Coronary artery disease
  • Congenital heart defect
  • Ventricular arrhythmias
  • Amyloidosis
  • A transplanted heart gives problems and fails

What does a heart transplant consist of?

As such, heart transplant surgery is an open-heart surgery in which a patient’s diseased heart is replaced with a healthy heart from a clinically deceased but life-supporting donor. The donated heart must be in normal condition, not diseased and must be as compatible as possible with the patient’s heart, in order to avoid possible rejection.

The procedure begins by inducing the patient to deep sleep under general anesthesia. Once the patient is sedated, an incision is made through the sternum and the procedure begins. The patient’s blood will pass through an extracorporeal circulation machine in order to maintain high levels of oxygen in the blood.

Once the incision is made, the diseased heart is removed and replaced with the healthy heart, which is then sutured into place. Once sutured, the heart-lung machine is disconnected and the blood is allowed to flow through the heart.

Tubes will be inserted to allow air, fluid and blood to flow out of the chest, so that the lungs can recover their normal size and expand normally.

The procedure may take seven to ten hours.

Preparation for heart transplantation

When the patient is informed that he or she is to undergo a transplant, the patient must undergo a series of tests to ensure that he or she is suitable for the procedure. A team of specialists will perform various tests such as blood tests and x-rays. However, the following tests may also be performed:

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  • Kidney and liver examination.
  • Electroradiography, echocardiography and cardiac catheterization to check the condition of the heart.
  • Tests to look for cancer
  • Use of ultrasound

Once the patient has passed the tests and is considered a good candidate, he or she will be placed on a waiting list to receive a heart.

The patient’s place on the list will be based on a number of factors, such as the type and severity of his or her disease and the degree of illness.

Care after the procedure

The transplanted patient will remain in the hospital for one to three weeks after the operation. In fact, the first 48 hours will most likely be spent in the intensive care unit (ICU), as during the first few days the patient must be carefully treated to avoid infection.

  • The total transplant recovery period is about three months, and blood tests and check-ups must be continuous.
  • The patient must take medication to inhibit the immune system response, which will consider the new organ as a foreign body and try to attack it. Biopsies are often performed during the first year to check the condition of the organ.
  • The patient can return to daily life about three months after the operation.
  • Transplantation prolongs the lives of people who would undoubtedly die if they kept their diseased heart. The main problem is rejection, although if it is controlled, life expectancy is extended by more than ten years.

Alternatives to heart transplantation

Transplantation is considered the ideal treatment for patients for whom other methods have failed. However, the list of donors is smaller than the list of people who need a new heart.

In turn, there are a number of factors that prevent a person from being transplanted: the person is malnourished, over 65 years of age, has had a stroke, has recently had cancer, is infected with HIV, hepatitis, uses drugs or alcohol, has pulmonary hypertension, is diabetic….

Some alternative methods are the following:

  • Cardiac resynchronization: the heart is stimulated to restore normal order.
  • Ventricular assist: an assist is implanted to replace the function of the left ventricle of the heart.
  • Surgical treatment: techniques such as revascularization in ischemic cardiomyopathy, mitral insufficiency surgery or partial left ventriculectomy are included.