Living with Heart Failure can be a great burden on patient and family, A Heart transplant can be a treatment option for your heart failure and the Healthcare professional will access with the heart transplant right for you. Taking a healthy heart from a deceased donor and replacing it with a diseased heart of a patient is known as a heart transplant surgery. Patients who have end-stage heart failure usually go through heart transplant surgery. Damaged or weak heart results in heart failure. Heart Transplant is required when the heart is no more able to pump the required blood through the body and all the medication is no more effective. It involves major surgery during which your failing heart is replaced with the healthy human heart. Although transplantation is one of the greatest achievements of modern medicine, it is a treatment, not a cure. It depends on the Generosity of the donors and their families. Well, transplantation is not the only option for everyone.
Is Heart Transplantation an only option for all patients with heart failure?
Transplantation is not an option for everyone. The patient undergoes extensive investigation otherwise known as “the workup” to answer the following key question.
–Is the patient heart is sick enough?
-The Patient is healthy enough to go through surgery and recovery.
-Do the patient have adequate support to help cope up after surgery.
What happens after the workup?
After the workup is complete your team of doctors, nurses, surgeons, and allied health professionals will discuss whether the Heart transplant is the best option for you.
If the Heart Transplant is not the best option for you?
The reason will be shared with you, some patients are eligible for the mechanical heart well, others may be too sick for surgery. In either case, the patient will be provided with support and symptom relief.
If the transplant is the right option for the patient, then their name will be put on the waiting list. And they wait at home with routine checkup or then have to wait in hospitals if they are very sick. Until the suitable heart become available.
Time of the waiting list varies from days, months to years, During the waiting time condition of the patient may change, few patients may improve others may become sicker resulting bad situation. They were in the very delicate phase any uncertainty can be stressful.
The Heart can be identified anytime.
So, the patient must be easily reachable, ensure the contact information is the updated, live within 4hr or less travel time
What will happen during Transplant surgery?
One the Healthy Heart is identified the patient is asked to come to the hospital immediately and admitted to the Coronary Intensive Care Unit (CICU), not allowed to eat or drink anything.
The surgery may be canceled if the heart is not suitable after the donor’s heart is checked by the Surgeon. If surgery is going ahead, it will take 4-6 Hours to complete.
Most Patient will have a catheter inserted to a large vein in the neck to measure the pressure inside your heart, under general anesthesia. And incision from the top center of the breast bone down to the stomach area will be made. The patient will be connected to a Hear lung bypass machine that keeps the body working while the surgeon will perform the transplant once the transplanted heart is in place the bypass machine will be slowly turned down to the new heart to take over. The patient chest will be closed and skin stitched.
Sometimes the new heart cannot support the blood circulation, the patient needs to be temporarily supported with a mechanical pump (ECMO).
What will happen after transplant surgery?
After the surgery, the patient will be brought to the Cardiovascular Intensive Care Unit (CVICU). Most patient will be woken from anesthesia within 24Hr. TH patient will be on a breathing machine until the patient is strong enough to be on your own Tubes and I.V lines will be removed one the patient recovers, with medication and then shifted to the step down unit or general transplant ward where meet the transplant team, The team will help the patient to get stronger, teach about the new medications, facilitate the transition out of hospital.
We encourage the patient to be an active partner of its care and learn about their health.
Averagely 2 weeks the patient must be in the hospital and after the approval of the Healthcare professionals, the patient can go home. Before releasing the patient, it is making sure that the patient and the caregiver have learned about the medication properly and will connect to professionals frequently providing the recovery reports of the patients.
The Heart Transplant is a major life change and there is no. of things the patient must live with.
1. New Medication – There will be 10 or more different medication, like immunosuppression/ Anti-rejection (protect the heart from the immune system), Antibiotics/ Anti-viral,
2. Heart Biopsies -It is the best procedure to diagnose organ rejection. It is scheduled according to the protocol; the patient is awake during the procedure and the skin will be frozen with local anesthesia.
3. Weekly Hospital Visits- The patient must go to the same healthcare professional frequently up to the 1st year. As it includes many surveillance tests.
4. Avoid high-risk foods- Raw eggs, Mayonnaise, meat, etc.
5. Physical Activity- Until the breast bone is completely healed, don’t lift heavy weight till 3-4months and refer to a cardiac rehabilitation program.
6. Sex Life- Once the surgical wounds are healed, the patient can return to normal sex life.
7. Conception- Some of the medication cause birth defect, Women who wish to become pregnant should notify the professionals and properly counseled by high-risk pregnancy priority conceiving.
8. Pets – Keep your pets clean and healthy, wash your hand properly after contact.
9. Other Activities and Travel- Another common activity is also important, consult your doctors before joining office, start driving, etc. Traveling out of the country only after 1year after consulting doctors.
The medication after transplant have significant potential side effects, complications may occur Cancer, infection, Organ rejection, Kidney Failure, coronary vasculopathy, diabetes.
In general, 10 out of 100 Heart Transplant recipients die within the first year or during the operation if there is any complication. If the recipient survives 1st year the life expectancy on an average is 14th years, the longest survivor is of 30 years following surgery.
The heart transplant is a life-saving measure for end-stage heart failure.
Patients go through a selection process to get the heart from donors since the supply is very less. To receive a new heart patient’s heart must be in end-stage and patient should be in a healthy condition to receive it. Over the past decade, the survival rates have increased to 88 percent for the first year after a heart transplant and 75 percent survive for 5 years. It is seen that most of the patients who have gone through Heart Transplant have returned to their normal day to day activities.