A heart transplant is a surgical procedure to resolve the most serious cases of heart disease. It is generally known as a suitable treatment option in the last stages of heart failure, when medications, lifestyle changes and other treatment methods are insufficient. To be considered a procedural candidate, you must meet certain criteria.
Who Can Be a Heart Transplant Candidate?
Your answers to some basic questions are taken into account to determine if a heart transplant is right for you. It is important to answer questions such as whether all other treatments have been tried for the treatment of your heart disease, whether there is a possibility of death if the transplant does not take place, and whether your general health is good or bad. After the transplant, some changes in your lifestyle take place, including complex medication and frequent checkups. Your ability to adhere to these changes also affects the success of the treatment.
Also, if you have other serious diseases, active infections, or are struggling with morbid obesity, you likely will not be considered a candidate for a transplant.
How is a heart transplant done?
To get a heart transplant, you go through an extensive screening process and are placed on the transplant list. The specialist transplant team checks your medical history, the results of diagnostic tests, and your social and psychological state. It also decides whether you are suitable for lifelong self-care.
After receiving approval, your process of waiting for a heart suitable for you from a donor begins. This period can be long and painful for you and your loved ones. However, your healthcare team will support you with your heart failure and closely monitor your condition until a donor heart is found. When a heart suitable for you is found, you will be contacted immediately and the process will begin.
HOW TO FIND ORGAN DONORS?
Donors for heart transplants are usually people who have recently died or are brain dead. In such cases, the donors are brain dead and their bodies are kept alive by machines. Donors are usually people who have died as a result of a car accident, serious head injury, or gunshot wound and volunteered to donate organs before they died. Unfortunately, there are not enough hearts for people awaiting a transplant. A person may wait months for a transplant, and some of those waiting may not live long enough to receive a new heart.
You may have mixed feelings while waiting for an organ transplant. Because you are aware that someone has to die before the transplant can take place. Many donor families feel a sense of peace after the death of a loved one knowing that they are doing a favor to a sick person, and knowing this can make things easier for you, too.
HOW IS A HEART TRANSPLANTATION DONE?
When a suitable heart for transplantation is found, this heart is placed in a special solution and cooled and brought to the recipient. Before the transplant operation begins, a series of necessary checks is made to ensure that this heart is in good condition. When conditions become suitable, surgery is performed as soon as possible. The person who will receive the heart remains connected to the heart-lung machine during the surgery, and thanks to this machine, the body receives the oxygen and nutrients it needs from the blood. The patient’s heart is then removed, except for the posterior walls of the atria, which are the upper chambers of the heart. The backs of the atria of the new heart are opened and the heart is placed in its place.
The blood vessels are then connected together and blood is allowed to flow through the heart and lungs. As the heart warms, it begins to beat. All blood vessels and heart chambers are checked for leaks before the patient is removed from the heart-lung machine. Heart transplant surgery can take from 4 hours to 10 hours. Most patients are up and about a few days after surgery and can return home within a period of approximately 1-4 weeks, unless the body shows any signs of rejecting the organ immediately.
What Are the Risks of Heart Transplantation?
Infection and rejection are the most common causes of death after heart transplantation. Patients taking drugs to prevent rejection of the new heart may experience kidney damage, high blood pressure, osteoporosis (severe thinning and breakage of bones), and lymphoma (a type of cancer that affects immune cells). In addition to these risks, atherosclerosis of the heart arteries, or coronary artery disease, develops in almost half of transplant patients.
WHAT IS ORGAN REJECTION?
Normally, the immune system is responsible for protecting your body from infections. Organ rejection is defined as the body’s immune cells recognizing the transplanted organ as different from the rest of the body and trying to destroy it. Left alone, the immune system damages and eventually destroys the cells of this new heart.
To prevent rejection, patients are given drugs called immunosuppressants. These drugs suppress the immune system and prevent damage to the new heart. To avoid rejection, heart transplant recipients should strictly follow the instructions for immunosuppressant medication. Researchers are constantly working on immunosuppressive drugs that are safer, more effective and well tolerated.
Heart transplant recipients are carefully monitored for signs of rejection. Doctors often take small samples of the transplanted heart to examine under the microscope. In this procedure, called a biopsy, a thin tube called a catheter is advanced through a vein to the heart. The tip of the catheter has a bioptome for cutting a piece of tissue. If the biopsy results show damaged cells, the dose and type of immunosuppressive drug is changed. Biopsies from the heart muscle are usually repeated after surgery as determined by your doctor.
It is vital that you recognize the signs of possible rejection and infection. As soon as you realize it, you can report them to your doctors and be treated immediately.
The signs of rejection of the transplanted organ are listed as follows:
- Fever (above 38°C)
- Chills, headache or dizziness, nausea and vomiting
- shortness of breath
- Chest pain or tenderness
- feeling unwell and tired
- rising blood pressure
- Due to the over suppression of the immune system, the immune system slows down and this patient can easily get serious infections. Therefore, to fight infections, infection medications can also be given.
Signs of infection are as follows:
- Fever (above 38°C)
- Sweating and trembling
- Having skin rashes
- Pain, redness, swelling and tenderness
- Difficulty healing wounds or cuts
- Sore throat and irritation or a painful feeling when swallowing
- Nasal congestion, sinus drainage and headache
- Cough that persists for more than two days
- White patches in the mouth or tongue
- certain digestive problems, such as nausea, vomiting, or diarrhea
- feeling of exhaustion
- Pain or burning during urination and frequent urination
- Foul-smelling, cloudy, or bloody urine
- If you show signs of organ rejection or infection, tell your doctor immediately.
Life after heart transplant
Your life after a heart transplant depends on your age, general health, and response to the transplant. After the transplant, your doctor may recommend doing physical activity regularly for your general physical and mental health. Regular physical activity keeps blood pressure in check, reduces stress, helps maintain ideal weight and strengthens bones. The transplant team creates an exercise program designed specifically for you in line with your individual needs and goals. In the meantime, you can determine the most suitable activities for you with your transplant team and have a successful recovery process. Do not neglect the health of your heart, which plays a central role in your body, and consult your doctor for more detailed information about heart transplantation.