Heart Transplantation is an option when the heart no longer works well enough and a person is at riskheart transplantation of dying. A heart transplant may be considered when a person has severe heart disease and is likely to benefit most from a donor heart. A person might be a candidate for a transplant when any of these conditions are true:
Heart transplant surgery involves removing a greater portion of the diseased heart and replacing it with a healthy one. Typically the donor heart will be from a healthy person who has died. The recipient needs to be available at the shortest notice and will again undergo a physical examination and more tests, including blood and urine samples. The transplant doctors will be checking the donor organ while the recipient is evaluated and started on medications in preparation for transplantation.
Once the donor organ is certified health and compatible the recipient is taken to the operating room, put to sleep with an anesthetic, and one of the transplant surgeons will begin the process of preparing the chest cavity for removal of your heart. General anesthesia will be given so that you will sleep through the surgery. You also will receive immunosuppressive drugs before and during the procedure to prevent your body from rejecting the new heart.
While you are being prepared for surgery you will have intravenous lines and a catheter inserted in your neck to measure the pressure in your heart.
A major incision will be made down your chest which will split the breastbone (ribcage) into half. The main arteries are connected to a heart lung bypass machine to pump oxygenated blood and a ventilator to assist in breathing.
The method of heart transplant is called orthotopic surgery, where most of the recipient heart is removed with the back half of both upper chambers, called atria, left in place. The donor heart will be carefully trimmed and sewn to fit the remaining parts of the recipient’s heart. Then the front half of the donor heart is sewn to the back half of the recipient’s heart. The donor's aorta and pulmonary arteries are connected to the recipient. The heart is then weaned off the bypass machine and slowly the entire heart takes over the work of pumping blood. The incisions are then closed suitably.
After the operation, the patient will be taken to a special unit and hospital floor for recovery. Once the recovery is judged and certified, the patient is discharged, typically the hospitalization will be for a period of 1 week to 10 days. The duration of stay in the hospital will depend on the following factors:
As part of our defense mechanism to fight off infection and even cancer, our bodies have an "immune system" to recognize and eliminate foreign tissues such as viruses and bacteria. Unfortunately, our immune system also attacks transplanted organs. This is what happens when organs are rejected; they are recognized as foreign by the body. Rejection can be controlled with powerful "immunosuppressive" medications. If there is not enough immunosuppression the organ can reject acutely. Even when it seems that there is no active rejection, there may be more subtle chronic rejection that consists of a growth of tissue, something like scar tissue, which causes blockage of the blood vessels of the heart. The blockage of the vessels is the process that ultimately causes the transplanted heart to fail. It is this chronic rejection that is the major limiting factor for the long-term success of heart transplantation.
Unfortunately, immunosuppression is a double-edged sword. While immunosuppression blocks rejection, because it suppresses the immune system, transplant patients are more susceptible to infection and cancers of various types. Among older transplantation patients, as survival has improved, more patients are eventually dying from cancers.
The other Organ Transplant Procedures are
Few Major Hospitals for Heart Transplantation are
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