Heart Transplant
What is Heart Transplant ?
A heart transplant is a surgery that replaces your heart with a donated heart from another person. To receive a heart transplant, you must be very ill despite medical therapy and need a new heart to survive. Because there’s a limited availability of donor hearts, you also must meet stringent requirements to qualify for this kind of transplant.
Like other organ transplant surgeries, heart transplants are difficult operations that have risks. After receiving a transplant, you’ll need medical care for the rest of your life to prevent rejection and complications.
Why it's done
Heart transplants are performed when other treatments for heart problems haven’t worked, leading to heart failure. In adults, heart failure can be caused by:
- A weakening of the heart muscle (cardiomyopathy)
- Coronary artery disease
- Heart valve disease
- A heart problem you’re born with (congenital heart defect)
- Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
- Failure of a previous heart transplant
In children, heart failure is most often caused by either a congenital heart defect or cardiomyopathy.
Another organ transplant may be performed at the same time as a heart transplant (multiorgan transplant) in people with certain conditions at select medical centers.
A heart transplant is not right for everyone, however. You might not be a good candidate for a heart transplant if you:
- Are at an advanced age that would interfere with the ability to recover from transplant surgery
- Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver, or lung disease
- Have an active infection
- Have a recent personal medical history of cancer
- Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not using recreational drugs, not smoking, and limiting alcohol use
Risk Factors
Besides the risks of having open-heart surgery, which include bleeding, infection, and blood clots, the risks of a heart transplant include rejection of the donor heart. One of the most worrying risks after a heart transplant is your body rejecting the donor heart. Your immune system may see your donor heart as a foreign object and try to reject it, which can damage the heart. Every heart transplant recipient receives medications to prevent rejection (immunosuppressants), and as a result, the rate of organ rejection continues to decrease. Sometimes, a change in medications will halt rejection if it occurs. To help prevent rejection, you must always take your medications as prescribed and keep all your appointments with your doctor. Rejection often occurs without symptoms. To determine whether your body is rejecting the new heart, you’ll have frequent heart biopsies during the first year after your transplant. After that, you won’t need biopsies as often. Primary graft failure. With this condition, the most frequent cause of death in the first few months after transplant, the donor heart doesn’t function. Problems with your arteries. After your transplant, it’s possible that the walls of the arteries in your heart could thicken and harden, leading to cardiac allograft vasculopathy. This can make blood circulation through your heart difficult and can cause a heart attack, heart failure, heart arrhythmias, or sudden cardiac death. Medication side effects. The immunosuppressants you’ll need to take for the rest of your life can cause serious kidney damage and other problems. Cancer. Immunosuppressants can also increase your risk of developing cancer. Taking these medications can put you at a greater risk of skin cancer and non-Hodgkin lymphoma, among others. Infection. Immunosuppressants decrease your ability to fight infection. Many people who have heart transplants have an infection that requires them to be admitted to the hospital in the first year after their transplant.
