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Heart Transplant
A surgical procedure performed to replace a diseased or damaged heart with a healthy donor heart is known as a heart transplant surgery.
A heart transplant surgery is only done in those patients whose condition fails to improve with medications or other types of surgeries.
Finding a donor for a heart transplant is extremely difficult and a patient needing a heart transplant surgery is generally put on a waiting list till an appropriate donor is found.
A heart transplant surgery is performed in cases of heart failure, that is when the heart fails to pump enough blood to the rest of the body. A heart failure may occur under the following conditions:
- Cardiomyopathy (heart muscle weakening)
- Heart valve disease (when one or more heart valves fail to function properly)
- Coronary artery disease (disease or damage in the major blood vessels of the heart)
- Congenital heart defect (heart defect present at birth)
- Recurrent ventricular arrhythmias (abnormal heart rhythms) not controlled by other treatment methods
- Failure of a prior heart transplant surgery
Symptoms:
The following are the symptoms of a heart failure, which may indicate the need for a heart transplant surgery:
- Chest pain
- Sudden gain of weight
- Flatulence
- Abnormal urination
- Fatigue
- Tiredness
- Difficulty in breathing
- Shortness of breath even during rest
- Changes in sleep pattern
- Difficulty in performing daily activities
The following diagnostic tests may be recommended before a heart transplant surgery:
- Physical examination: The patient’s overall medical health status is evaluated. The patient’s symptoms, medical history, and family history are noted.
- Blood tests: They help in finding a matching heart donor.
- Urine test: This test is done to check for the presence of any infections.
- Liver function test: This test is performed to diagnose any liver damage or disorder.
- HIV test: This test is done to rule out an HIV infection.
- Imaging tests: Tests like chest X-ray, CT scan, and MRI scan are performed to view the images of the internal organs of the body.
- Echocardiogram, Electrocardiogram (ECG), Cardiac catheterization: These tests are performed to evaluate the heart condition.
- Ultrasound: High-frequency sound waves are used in this test to create images of the internal organs of the body.
- The procedure is generally done under general anesthesia, that is, the patient is put to sleep during the procedure.
- The patient is placed on a heart-lung bypass machine during the procedure. This is done to keep the blood circulating throughout the body during the procedure.
- The surgeon makes an incision in the chest area.
- The chest bone is now separated by the surgeon and the rib cage is opened to obtain access to the heart.
- The diseased heart is now removed and replaced by a donor’s heart.
- The arteries and veins of the patient are then connected to the donor's heart.
- An electric shock may be given sometimes to make the donor’s heart beat properly.
- This is known as an open-heart procedure.
- The procedure takes up to four hours to complete.
The following risks are associated with a heart transplant surgery:
-
Allergic reaction to the anesthesia used
-
Bleeding
-
Infection
-
Blood clot formation
-
Organ rejection
-
Graft failure
-
Kidney disease
-
Kidney failure
-
Hypertension (high blood pressure)
-
Nerve damage
-
Arrhythmias (irregular heart rhythms)
-
Osteoporosis (a condition in which the bones become brittle and weak)
-
Pain
-
Stroke (damage to the brain due to interrupted blood supply)
-
Heart attack
-
Delirium (a disturbance in the mental abilities of a person)
-
Depression
-
Blood thinning caused by medications
-
High cholesterol caused by medications
-
The patient is given pain-relieving medications post-surgery.
-
The patient is kept on a ventilator to aid in breathing.
-
The doctor inserts tubes in the chest area for draining the fluids from and around the heart and the lung region.
-
The patient can normally go home after a few days of heart transplant surgery.
-
The patient is instructed to avoid driving after the surgery.
-
Immunosuppressant medicines are prescribed to the patient after surgery.
-
The patient's vital parameters are monitored in the follow-up appointments.
-
The patient is instructed to avoid lifting heavy objects and performing strenuous activities after the surgery.
-
The patient is instructed to avoid swimming and bathing in the bathtub to prevent infection.
-
The patient is instructed on how to keep the wound clean and dry after the procedure.
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Heart Transplant
A surgical procedure performed to replace a diseased or damaged heart with a healthy donor heart is known as a heart transplant surgery.
A heart transplant surgery is only done in those patients whose condition fails to improve with medications or other types of surgeries.
Finding a donor for a heart transplant is extremely difficult and a patient needing a heart transplant surgery is generally put on a waiting list till an appropriate donor is found.
Symptoms
A heart transplant surgery is performed in cases of heart failure, that is when the heart fails to pump enough blood to the rest of the body. A heart failure may occur under the following conditions:
- Cardiomyopathy (heart muscle weakening)
- Heart valve disease (when one or more heart valves fail to function properly)
- Coronary artery disease (disease or damage in the major blood vessels of the heart)
- Congenital heart defect (heart defect present at birth)
- Recurrent ventricular arrhythmias (abnormal heart rhythms) not controlled by other treatment methods
- Failure of a prior heart transplant surgery
Symptoms:
The following are the symptoms of a heart failure, which may indicate the need for a heart transplant surgery:
- Chest pain
- Sudden gain of weight
- Flatulence
- Abnormal urination
- Fatigue
- Tiredness
- Difficulty in breathing
- Shortness of breath even during rest
- Changes in sleep pattern
- Difficulty in performing daily activities
Diagnosis
The following diagnostic tests may be recommended before a heart transplant surgery:
- Physical examination: The patient’s overall medical health status is evaluated. The patient’s symptoms, medical history, and family history are noted.
- Blood tests: They help in finding a matching heart donor.
- Urine test: This test is done to check for the presence of any infections.
- Liver function test: This test is performed to diagnose any liver damage or disorder.
- HIV test: This test is done to rule out an HIV infection.
- Imaging tests: Tests like chest X-ray, CT scan, and MRI scan are performed to view the images of the internal organs of the body.
- Echocardiogram, Electrocardiogram (ECG), Cardiac catheterization: These tests are performed to evaluate the heart condition.
- Ultrasound: High-frequency sound waves are used in this test to create images of the internal organs of the body.
Treatment
- The procedure is generally done under general anesthesia, that is, the patient is put to sleep during the procedure.
- The patient is placed on a heart-lung bypass machine during the procedure. This is done to keep the blood circulating throughout the body during the procedure.
- The surgeon makes an incision in the chest area.
- The chest bone is now separated by the surgeon and the rib cage is opened to obtain access to the heart.
- The diseased heart is now removed and replaced by a donor’s heart.
- The arteries and veins of the patient are then connected to the donor's heart.
- An electric shock may be given sometimes to make the donor’s heart beat properly.
- This is known as an open-heart procedure.
- The procedure takes up to four hours to complete.
Risks
The following risks are associated with a heart transplant surgery:
-
Allergic reaction to the anesthesia used
-
Bleeding
-
Infection
-
Blood clot formation
-
Organ rejection
-
Graft failure
-
Kidney disease
-
Kidney failure
-
Hypertension (high blood pressure)
-
Nerve damage
-
Arrhythmias (irregular heart rhythms)
-
Osteoporosis (a condition in which the bones become brittle and weak)
-
Pain
-
Stroke (damage to the brain due to interrupted blood supply)
-
Heart attack
-
Delirium (a disturbance in the mental abilities of a person)
-
Depression
-
Blood thinning caused by medications
-
High cholesterol caused by medications
After Procedure
-
The patient is given pain-relieving medications post-surgery.
-
The patient is kept on a ventilator to aid in breathing.
-
The doctor inserts tubes in the chest area for draining the fluids from and around the heart and the lung region.
-
The patient can normally go home after a few days of heart transplant surgery.
-
The patient is instructed to avoid driving after the surgery.
-
Immunosuppressant medicines are prescribed to the patient after surgery.
-
The patient's vital parameters are monitored in the follow-up appointments.
-
The patient is instructed to avoid lifting heavy objects and performing strenuous activities after the surgery.
-
The patient is instructed to avoid swimming and bathing in the bathtub to prevent infection.
-
The patient is instructed on how to keep the wound clean and dry after the procedure.
FAQ Section
Heart transplant is a surgical organ transplant procedure which is usually performed to replace the affected heart of a patient suffering from end-stage failure or severe coronary artery disease. This treatment is usually the last resort when all the other
methods have failed and proved to be ineffective.
In this surgery, the failing heart is replaced with a healthier, donor heart. The donor for a heart transplant is usually a person who has recently died or become brain dead when the brain shows no signs of life. The permission for a donation of the heart is provided by the donor before death and the family members during death.
A heart transplant is usually performed as a treatment for the following conditions:
- Cardiomyopathy, weakening of the heart muscle.
- Coronary artery disease
- Heart Valve Disease
- Congenital heart defect
- Amyloidosis
- Failure of a previous heart transplant
A heart transplant is an extremely complex procedure and is associated with quite a few complications. Your doctor or cardiologist will brief you about the risks encountered and the best approach to your condition.
Due to the open heart surgery, the complications that arise are:
- Bleeding
- Infection
- Blood clots
- Heart Attack
- Stroke
- Death in severe cases
- Some of the risks that may occur after the surgery are:
- Rejection of the donor heart by the body
- Problems of the coronary artery disease like thickening of the artery walls, leading cardiac allograft vasculopathy etc.
- Side effects due to the medication like blood pressure, cholesterol, sudden cardiac arrest.
- Cancer
Recent studies have proven that the overall survival rate of a heart transplant after one year is 88% and around 75% after five years.
The right time to undergo a Heart Transplant is when all the other methods have proven to be ineffective. Your cardiologist will recommend you the best approach and if a heart transplant will be necessary to treat your condition.
A heart transplant is recommended when all the other methods have proven to be ineffective. If the medical condition is diagnosed at its initial condition, then it can be treated with any alternative methods. However if the disease is at its final stage, then the last solution is considered to be a heart transplant.
Prior to conducting the surgery, your cardiologist will prescribe some of the following tests in order to asses the physical fitness and necessity of a heart transplant to suit your condition:
- Physical examination
- Perfusion tests or echocardiography, to measure the blood flow to the tissue.
- Cardiac catheterization, including coronary angiography and ventriculography, myocardial biopsy and electrophysiologic studies.
- Pulmonary functions tests like spirometry
- Kidney and liver function tests.
- Cancer screening tests and several other tests.
Heart Transplant Surgery is an open heart surgery, thus making it complicated and time consuming. Previous surgeries may impact the complexity and duration of the surgery. A general anaesthesia is administered prior to the surgery. Your surgeon will connect you to a heart-lung bypass machine in order to ensure the continuous flow of oxygenated blood throughout the body.
The surgery is performed by cutting an incision into the chest. The chest bone is separated and the rib cage is opened to increase ease of access. The diseased heart is removed and replaced by the donors heart which is sewn into place. An electric shock may be given in order to restore the normal heart beat rate.
After the procedure, a ventilator will be provided to help breathe easily and tubes are connected
around the heart in order to drain the fluids.
A heart transplant surgery, being an open heart surgery is complicated and may take about four hours to be performed successfully. If the patient has undergone any previous surgeries, then it may take longer as it complicates the procedure.
The components utilised in this procedure are the basic surgical tools required for the procedure. Your surgeon will inform you if any additional components may be required or used. Some additional components that may be involved in the procedure are tubes or intravenous tubes to facilitate the administration of fluids.
A slight amount of pain around the region in your chest may be experienced immediately after the surgery. Your doctor will provide you with the necessary medications in order to suppress the pain. However, any kind of abnormal pain must immediately be reported to the doctors or nurses as it may lead to further complications if neglected.
Recovery from a heart transplant may take a duration of about three to six months in order to recover completely if taken care of properly. Work can be resumed after a period of two months following the operation. Recovery is the fastest when you take appropriate care and measures as recommended by the doctor and maintaining a healthy lifestyle.
Depending upon the severity of your condition, normal activities may be resumed. You can go back to work after a period of two months after the surgery has been performed. Other activities like sport activities can be performed but should not be excessive or strain the body. Smoking must be completely avoided and the intake of alcohol must be minimal.
A heart transplant surgery may cost about twenty lakh rupees, making it difficult to afford by the common public. However, there are several financial aids provided by various health care facilities and insurance companies.
Organ transplantation is still an evolving field in India due to the shortage of organ donors. However, it boasts of cheaper and some of the best cardiologists around the world, luring patients all over the world.
This decision is completely dependent upon the instincts and judgement of the patient by taking into consideration several factors like affordability, extent of condition, physical stability etc.
The replacement of a diseased or damaged heart with a healthy donor heart using a surgical procedure is known as a heart transplant surgery.
A heart transplant surgery is performed in case of heart failure, which is a condition in which the heart fails to pump sufficient blood to the rest of the body. When heart failure cannot be treated using medications or other forms of surgeries, a heart transplant surgery is recommended.
The following conditions could lead to a heart failure:
- Cardiomyopathy (weakening of the heart muscle)
- Heart valve disease (the failure of one or more heart valves to function properly)
- Coronary artery disease (a condition in which the major blood vessels of the heart are diseased or damaged)
- Congenital heart defect (a condition present at birth)
- Recurrent ventricular arrhythmias or abnormal heart rhythms that cannot be controlled by other treatment methods
- Previous heart transplant surgery that has failed
The following symptoms are associated with a heart failure and may indicate the need for a heart transplant surgery:
- Chest pain
- Flatulence
- Sudden weight gain
- Abnormal urination
- Fatigue
- Breathing difficulty
- Shortness of breath even at rest
- Sleep pattern changes
- Difficulty in performing daily tasks
A heart transplant surgery is not recommended in the following cases:
- Above 65 years of age
- Underlying medical diseases
- Active infection
- Non-cooperative patient
The following diagnostic tests are recommended before a heart transplant surgery:
- Physical examination: The patient’s symptoms, medical history, and family history are noted by the doctor.
- Blood tests: These tests help to find a matching heart donor.
- Urine test: This test is done for checking the presence of any underlying infections.
- Imaging tests: Imaging tests like chest X-ray, CT scan, and MRI scan help in obtaining the images of the internal organs of the body.
- Ultrasound: High-frequency sound waves are used for creating images of the internal organs of the body in this test.
- Liver function test: This test helps in checking any liver damage or disorder that may be present.
- HIV test: This test is performed to rule out an HIV infection.
- Echocardiogram, Electrocardiogram (ECG), Cardiac catheterization: These tests help to evaluate the condition of the heart.
The following preparation may be needed before a heart transplant surgery:
- Inform the doctor about any medications, supplements, or herbs that the patient is taking.
- Inform the doctor if the patient has any medical ailments.
- Inform the doctor if the patient is allergic to anything.
- Quit smoking as soon as possible.
- The patient may be instructed to stop taking blood thinners like warfarin and aspirin a few days before the procedure.
- The patient will be instructed to stop eating or drinking anything as soon as a heart donor is available.
The following are the steps performed during a heart transplant surgery:
- The procedure is generally performed under general anesthesia, that is, the patient is made to sleep during the procedure.
- The patient is now placed on a heart-lung bypass machine to keep the blood circulation throughout the body during the procedure.
- The surgeon then makes an incision in the chest region.
- The chest bone is separated by the surgeon and the rib cage is opened to get access to the heart.
- The diseased heart is removed by the surgeon and replaced with a donor’s heart.
- The main blood vessels of the patient are then connected to the donor's heart.
- An electric shock may be given to make the donor’s heart beat properly.
- This procedure is known as an open-heart procedure and takes approximately four hours to complete.
The following are the after-care steps following a heart transplant surgery:
- Pain-relieving medications are given to the patient after the surgery.
- The patient is kept on a ventilator to help with breathing.
- Tubes are inserted by the doctor in the chest region for draining the fluids around the heart and the lung region.
- The patient usually goes home 10 to 14 days after a heart transplant surgery.
- The patient is told to avoid driving after the surgery.
- Immunosuppressant medicines are prescribed by the doctor to the patient after surgery.
- The vital parameters of the patient are monitored in the follow-up appointments.
- The patient is instructed to avoid lifting heavy objects and performing strenuous activities after the surgery.
- Swimming and bathing in the bathtub should be avoided for a few days after the surgery to prevent infection.
- The wound needs to be kept clean and dry after the procedure.
The complications associated with a heart transplant surgery include:
- Allergic reaction to the anesthesia used
- Bleeding
- Infection
- Blood clot formation
- Organ rejection
- Graft failure
- Kidney disease
- Kidney failure
- Hypertension (high blood pressure)
- Nerve damage
- Arrhythmias (irregular heart rhythms)
- Osteoporosis (a condition in which the bones become brittle and weak)
- Pain
- Stroke (damage to the brain due to interrupted blood supply)
- Heart attack
- Delirium (a disturbance in the mental abilities of a person)
- Depression
The survival rate is more than 85 percent after one year and 69 percent after five years for adults.
The cost of a heart transplant surgery varies depending on the condition of the patient and the overall health status of the patient.
The cost varies amongst different doctors in different hospitals. Normally, the cost of a heart transplant surgery in India is between INR 25,00,000 to INR 30,00,000.