Heart Transplant surgery is done to replace a damaged heart with a healthy, working heart that is taken from an ‘organ donor’ who has recently died. However, in very rare cases, the diseased heart is kept in its place to support the donated heart, instead of being removed.
Heart transplant is used as a last resort when all the other cardiac treatments fail to improve the health of the patient.
When other cardiac treatments fail to improve the health of the patient, heart transplant is recommended.
When it is suspected that without a transplant, the patient might die within a year
When the patient is suffering from CHF (end-stage congestive heart failure) or serious coronary artery disease
When abnormal heart beats/rhythms that cannot be cured by any other treatment
In case of Congenital Heart Disease - The patient is young child who is born with some serious heart defect
The transplant team checks whether the patient is a suitable candidate for transplant. Most importantly, a suitable donor heart is searched for, and the donor’s heart is tested to check how suitable its condition is.
While the patient is waiting for a donor heart, if the medical treatment is not able to stabilize the vital organs of the patient then Ventricular Assist Device will be implanted
Within 4 to 5 hours of organ removal from the donor's body the heart has to be transplanted in the patient.
Following tests are conducted prior the surgery
Liver and kidney test.
Test to decide whether the patient’s body will accept the donated heart.
Cancer detection test
Though the procedures vary depending upon the patient’s condition and the doctor’s practice, the following is the general overview:
The donor heart is to be transplanted within the short period of 4 to 5 hours after removing it from the donor’s body.
The patient is given general anesthesia and put into deep sleep.
Through the breastbone, a cut will be made.
The blood is kept circulating with the help of a heart bypass machine.
The patient’s damaged heart is removed and the donor heart is stitched in the proper place.
The donor heart is then connected to blood vessels.
The new heart starts beating normally.
The breastbone is rejoined and the skin on it is sewn back together.
Tubes are inserted for draining air, blood and fluid from around the heart, and for the full re-expansion of the lungs.
The patient will be kept under constant monitoring in hospital for 1 to 2 weeks after the surgery.
The patient has to regularly visit hospital for rehabilitation and check-ups; is closely monitored for heart rejection.
The patient is taught how to take care after being discharged.
Immunosuppressant medication is given to prevent rejection.
There will be frequent biopsies of heart to check if the heart is accepted by the body
Risk and Complication
Heart transplant is a major surgery and has considerable risks and complications.
The foremost risk is, the patient body rejects donor heart. Immunosuppresants will work to ensure that the patient's immune system does not attack the heart.
Other risks associated with heart transplant are
Thickening of coronary arteries and blood clots that might cause heart attack, lung problems or stroke
Kidney failure due to immunosuppresants
Cancer (in most cases lip and skin) due to immunosuppresants
Cost: On an average, heart transplant costs between 13 to 18 lakhs INR.
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