What Does a Heart Transplant Consist Of?
A heart transplant is an operation where the healthy heart of a donor serves as a replacement for the diseased heart of a recipient.
This surgery is usually performed when the treatment the patient was receiving didn’t produce the expected results. Their condition gets worse, causing heart failure.
A heart transplant is a complicated operation. However, if the procedure is carried out properly, the survival rate is high.
Generally, doctors must do the transplant within four hours of extraction. This is why transplant centers offer hearts near the donor first.
Reasons why a person may need a heart transplant
As mentioned above, specialists only do a heart transplant if other medications and even surgeries have failed. When it comes to adults, there are various diseases that can cause heart failure. The most important are the following:
- Problems with coronary arteries or heart valves
- Cardiomyopathy, or the weakening of the heart muscle
- Congenital heart problems
- Ventricular arrhythmias
- Problems after a previous heart transplant
When it comes to children, the most common problems are congenital heart defects or cardiomyopathies. In these cases, most of them occur at birth or in early childhood.
This procedure is open-heart surgery, and the heart transplant process takes several hours. Also, if there were previous heart surgeries, the operation will be more complicated and will take longer.
During the procedure, apart from general anesthesia, an extracorporeal circulation machine is essential. This keeps the patient’s blood circulating in the body rich in oxygen.
The professional, through an incision in the chest, will open the rib cage to operate on the heart. After removing the diseased heart and inserting the donor’s heart, the surgeon connects the blood vessels. Then, they restore blood flow.
In certain cases, the doctors sometimes need to perform a multi-organ transplant. In other words, they transplant another organ, like a lung, liver or kidney, at the same time as the heart transplant.
Post-operative heart transplant
After the heart transplant operation, it’s important to constantly review and monitor the patient’s progress. This is very important, especially because the body can actually reject the donated heart.
For example, the main symptoms of rejection are:
- Difficulty breathing
- Fever and fatigue
- Weight gain
- Insufficient urine
To safely determine possible rejection, doctors take biopsies of the heart. Additionally, the number of biopsies will decrease as time passes. This involves inserting a device into a vein toward the heart to remove a tissue sample. Then, they examine it.
Apart from rejection, there are a number of additional risks that can put the patient at risk. These are:
- Problems with the coronary arteries. The heart’s arteries can become thick and harden. In fact, this can cause a vascular disease of the heart allograft.
- Side effects of medications, especially with immunosuppressants.
- Cancer. In addition, immunosuppressants can also increase the risk of cancer.
- Infections. Immunosuppressants increase the risk of infection.
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Ventricular assist devices
It’s also worth mentioning that there are a number of additional options to heart transplantation. These are aimed at people who, for various reasons, can’t have the operation.
For many patients, a very good solution is a ventricular assist device (VAD) as a long-term treatment. This is a mechanical pump that’s implanted in the chest. This helps the heart pump from the ventricles to the rest of the body.
Also, some patients use these devices temporarily while they wait for a heart transplant.
Finally, if a ventricular assist device isn’t sufficient, but the patient is on standby for the operation, professionals might consider using a totally artificial heart. In fact, this device works by replacing the ventricles of the heart, and can be really helpful.