Heart Transplant

Which conditions require a heart transplant?

Heart transplantation is the most effective treatment option for an individual who is suffering from last-stage heart failure. End-stage heart failure means that the patient's heart is extremely weak and prevents it from pumping blood throughout the body. Some of the conditions that require a heart transplant include:

• Cardiomyopathy: Cardiomyopathy is a condition that arises due to a defect in the heart muscle. It prevents the heart from pumping blood to the entire body. It also leads to disruption in the heart rhythm, which causes arrhythmias (irregular heartbeats).
• Coronary artery disease: This condition is caused due to extreme blockages in the arteries of the heart. These blockages can cause decreased blood flow and heart muscle damage.
• Congenital heart disease: This disease refers to a problem in the heart's structure that a person is born with. Congenital heart disease cannot be treated using other surgical procedures and needs a heart transplant.
• Valvular heart disease: This condition impacts the heart valves. It affects the blood flow within the heart chambers and then the rest of the body.

What tests or diagnostic procedures are conducted before the heart transplant?

Some of the tests that are conducted before the heart transplant include the following:

• Echocardiogram: This diagnostic test is basically a non-invasive test in which ultrasound is used to form images of the structure of the heart. It also helps create clear and detailed images of the heart's function. The healthcare provider can gather information about the shape, and size of heart chambers to know whether the heart pumps blood adequately.
• Electrocardiogram: This test helps the doctor in knowing the electrical activity of the heart. It helps in providing information related to the heart rate and any irregularities.
• Heart catheterization: This is an invasive diagnostic test in which a catheter is used to measure the blood pressure within the heart chambers. In this test, a flexible tube called a catheter is inserted into a blood vessel in the arm or neck region and is threaded to the heart. It helps in assessing the blood flow and the blood pressure within the arteries and chambers of the heart.
• MVO2 (exercise stress test): This test helps in evaluating the heart's potential to deliver oxygen during any physical event. It helps in knowing about the abnormalities in heart function at the time of physical exertion.
• Bilateral Lower Extremity Doppler and Carotid Doppler: This test evaluates how well the blood vessels are performing. It is a non-invasive test in which sound waves are utilized to assess the blood flow in the vessels. This helps the doctor know about any blockages in the blood vessels of the leg or neck.

What happens during a heart transplant?

Before the heart transplant procedure begins, the patient is evaluated thoroughly because it is a complex surgical procedure. Physical evaluation and diagnostic tests are conducted by the healthcare team to assess the heart condition and the compatibility of the surgery.

The patient is also put on a waiting list to receive the donor's heart. When the new heart becomes accessible, the transplant team checks if it is fit according to the recipient's blood type and body size.

After all these steps, the patient is prepared for the surgery. He/she is given general anesthesia, and an incision (cut) is made in the chest to remove the heart. It involves disengaging the blood vessels from the diseased heart.

The new heart from the donor is implanted at its place and is connected with the blood vessels to ensure blood flow in the body. The surgeon then ensures that the heart is performing its functions well and there are no problems with the connections with the major blood vessels. The incision made is closed using staples or sutures.

How to prepare for a heart transplant?

Heart transplantation can be a huge and life-changing procedure for the patient. Therefore, it is crucial to take some steps before the transplant to ensure the patient is physically and mentally prepared for the procedure. Some of the steps to take before the transplant include the following:

• You'll be there on a waiting list for your donor's heart before the procedure. This is because there are numerous people waiting for a healthy heart for their transplantation. Therefore, prepare your mind in advance that you'll need to wait for your donor heart and during that time your transplant team will monitor your condition.
• When you are waiting for a donor heart, ensure you are completely aware of the procedure, such as its risks, advantages, duration, and cost of the procedure.
• It is necessary to be fit before your heart transplantation. Therefore, ensure you stay active by performing gentle exercises before the procedure. Always consult your healthcare provider about the right exercises to perform.
• The time before the heart transplantation can be emotionally disturbing. Stay positive by being around your loved ones and busy with your work.
• Your healthcare provider will conduct certain diagnostic tests like pulmonary function test, chest X-rays, electrocardiograms, etc. Be prepared for the tests and convey your medical history to the doctor.
• Adopt a healthy diet before your transplantation to enhance your overall health.
• Stop smoking and alcohol. Both of these can impact your recovery period and affect the chances of your successful heart transplant.
• Follow all the instructions provided by your transplant team regarding the medications to take and diet to follow for the days leading up to the procedure.

What are the recovery steps to take after the heart transplant?

Some of the recovery steps to take after heart transplantation include the following:

• After your heart transplantation, you'll be monitored in the ICU for some days to ensure the functioning of the new heart and to avoid any potential complications. After monitoring in the ICU, your healthcare team will move you to a regular room for your rehabilitation and recovery. Your transplant team will help you regain strength and begin with slow daily activities. Prepare your mind, to stay in the hospital for some days after the procedure.
• Once you are home after the procedure, it is crucial to keep the incision area clean. It is also important to keep it dry so that there is no scope for infection. The healthcare provider will provide you with certain instructions on bathing and cleaning the area, therefore, ensure you follow the guidelines diligently.
• Avoid driving until your doctor says it's OK for you. Also, avoid strenuous activities such as cycling, running, and weightlifting.
• Be prepared for frequent follow-up visits with your doctor. In these visits, your healthcare team may conduct certain tests like a biopsy and blood tests.
• Convey your doctor instantly if you experience any issues like pain around the surgical site, problems with breathing, low blood pressure and fever, and chills.
• Your doctor will recommend immunosuppressant medications to avoid the rejection of the new heart by the body. Never miss the medications as stopping them can lead to harmful consequences.