Heart Transplant

Overview

Heart transplant is the surgical replacement of the diseased or failing heart with a healthy heart from a donor. It is the best option for patients who have unsuccessfully tried all other treatment modalities including medications, heart surgeries, devices etc. for their heart disorder.

Let’s first understand little bit about heart and its functioning before moving to heart transplant.

What is Heart?

Human heart is a muscular organ that is located a little left in the mid of the chest. It is about a fist in size and is responsible for uninterrupted supply of oxygen and nutrients to various body parts through blood. It is a pumping organ with two halves; right and left and four chambers (2 atria and 2 ventricles). The blood from body is received by right side of the heart and pumped to the lungs while the left side of the heart receives blood from lungs and supplies it to the body.

Why is Heart Transplant required?

The heart is a pumping organ that supplies oxygen and nutrients to various body organs through blood. A transplant is required in patients whose hearts become unable to pump blood efficiently. A transplant may also be required if the “electrical conduction system” of the heart could not work properly. This electrical system is very important as it determines the rhythm, rate, and sequence of contraction of the heart muscle.

What conditions require Heart Transplant?

Most of the people suffering from heart failure are candidates of heart transplant. Heart transplants is indicated when all other treatment for heart problem fail to give relief to the patient. There are a variety of heart disorders that can lead to heart failure and require a heart transplant, like:

- Congenital heart defects (heart problem a baby is born with)
- Cardiomyopathy or weakening of the heart muscle
- CAD or coronary artery disease
- Congestive heart failure
- Heart valve disease
- Valvular diseases like rheumatic fever, or rheumatic heart diseases
- Dangerous recurring abnormal heart rhythms (ventricular arrhythmias)
- Amyloidosis
- Failure of a previous heart transplant

The procedure

Heart transplant is a major procedure that is done by a team of expert surgeons and doctors. The heart donors are very less as compared to other organ donors as only a deceased person who died because of some accident or was brain dead and kept alive on machines, can donate heart. So, the donor heart can come only from a deceased donor who was healthy and disease free before death. This may take several months to wait for the right donor who is compatible with the recipient.

Transplant Evaluation Process

Once the patient decides to undergo heart transplant, various tests are done before transplant to ensure the safety of the operation and find out the eligibility of the patient for the transplant. Some of the major tests done are:

Chest X-ray
Computed tomography (CT scan) of the chest
Spirometry
Pulmonary function tests
Coronary artery catheterization
Electrocardiogram
Cardiac stress test
Echocardiogram
General metabolic laboratory tests
Coagulation studies
Complete blood count
Bone mineral density test
Colonoscopy
Pap smear and mammogram (women) etc.

After these tests confirm the eligibility status of the patient, next step is to evaluate both patient and donor for compatibility. This requires following tests:

Blood Type Testing
Tissue Typing
Crossmatch
Serelogy

These tests are required to match a donor heart to the recipient and transplant is planned only after confirming the match.

Transplant Surgery

The heart transplant is a complicated procedure that is done under general anesthesia and may take 4 to 10 hours. The transplant procedure consists of three operations.

Harvesting the heart from the donor: The first operation is done upon donor to harvest the heart safely. As the donor is usually a brain dead person, his other organs work well and can be transplanted to other persons. Once such a brain dead donor is identified, a transplant team operates upon the donor to remove donated organs. These organs are either transplanted simultaneously or are transported on ice and in some solution so that they can be kept working until transplantation. The time period for donated heart to be kept working is less than 6 hours.
Removal of the damaged heart from recipient: The second surgery involves removal of damaged heart from the body of the recipient. The patient is placed on a heart-lung machine which helps in supplying of the vital oxygen and nutrients from the blood to the body organs. The damaged heart is removed except the back walls of the atria.
Implantation of the donor heart: Once the damaged heart is removed, the backs of the atria on the donor heart are opened and implanted into the recipient. The large blood vessels entering and leaving the heart are connected.

Within no time, the heart warms up and begins beating. Before removing the patient from heart-lung machine, the surgeon checks all the connected blood vessels and heart chambers for leakage or any other abnormality.

Post-transplant care

Patient is kept on breathing machine for at least 6 to 8 hours after transplant
There will be a catheter in the bladder of recipient for few days
Blood transfusion can also be done if required
Patient is given IV feeding for few days
Patient can move around some time after the procedure
If everything goes well, recipient can go home in about one week after the surgery
Patient is required to undergo regular biopsy of heart tissue to evaluate any chances of organ rejection
Physical and occupational therapists work with patient to build up strength and stamina.

Benefits of Heart Transplant

A successful heart transplant is defined by increase in the blood count levels or control of disease/cancer. In most of the cases, transplant can increase the survival of the patient. It can partially or in some cases completely cure the illness of the patient. Within one year after transplant, patient can resume all the major daily activities and feels far better than before.

Complete or partial cure of the illness
Increased chances of survival and adds years to the life of sufferer
After bone marrow transplant, patient can usually go back to normal activities within one year
Improved quality of life of the person

Results of Heart Transplant

For treatment of epilepsy that does not respond to/ineffective to medications, a brain surgery may be done to control seizures. Surgical procedure may be performed to remove the area of the brain that produces seizures, to interrupt the seizure impulses along the nerve pathway or to implant a neuro stimulator device.

Why NICE ?

We are associated with the best hospitals globally having the emergency infrastructure, fully equipped with the latest technologies and techniques to overcome from every emergency condition.
Our team of doctors are highly experienced in ‘Emergency Patient Management’ and work together to save the patient.
Consultation from doctors through e-mail, phone, and video calling.
Rehabilitation programs are organized to assist complex surgery patients.
Complete support and assistance being given before and after treatment.
Cost of treatment is quite less as compared to other service providers.
We are always ready to offer our helping hand and our services are available Free of Cost 24/7.