Heart transplant is an operation in which a failing or diseased heart is replaced with healthier donor heart. It is a major operation with good chances of survival. It is done for patients suffering from end stage heart disease which can be caused by conditions as:
- Dilated cardiomyopathy
- Ischaemic cardiomyopathy
- Congenital heart disease, which was not corrected early in age
Preparation of the patient is to be done weeks to months before
The heart condition is evaluated at a heart transplantation center to see if patient would benefit from the transplantation.
The evaluation of all other systems like kidney, liver, lungs etc. is done, and the body is checked for infections (viral, fungal, bacterial etc.)
The patient has a supportive network from family and friends. If everything shows that the patient is a good candidate for heart transplant, the center will register the patient with the “Jeevandan” trust. While you are on a waiting list your condition will be monitored and if condition worsens then you will be put on a life support system like: inotropic support, ventilation, IABP or ECMO. When the donor heart is available, the donor recipient matching is done using the following factors:
- Blood group (A, B, AB, or O)
- Antibodies in recipients (PRA levels)
- Size of donor organ
After harvesting the donor heart, it is preserved at the low temperature (4° C), transferred to the heart transplant center and transplanted to the recipient with in the 4 to 5 hrs time. Heart Transplant surgery usually takes about 4 hrs. The chest will be opened and patient connected to a heart lung machine. The diseased heart is then removed and donor heart is sewn in place. The new heart starts beating when blood flow is restored. Patient will be on ventilator till he recovers from the surgery.
After the procedure patient will remain in the hospital for a week or two, then closely monitored at the OPD transplant center for 3 months. There will be regular blood test, Echocardiogram etc.
Immunosuppressants decrease the activity of your immune system, so that your body accepts the new heart. These medications will have to be taken for the rest of your life. Initially the medication will be of higher dosage and overtime it will be decreased. For some people who can’t have a heart transplant another option may be a ventricular device (VAD). A VAD is a miniature artificial pump which is attached to the heart; it sucks the blood from the heart and pumps in to the main artery of body (aorta). It runs on batteries which will be outside of the body. VAD can be used as a permanent treatment for the heart failure.