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Overview

Heart Transplant: Procedure, Recovery, Cost, Risk & Complication

What is Heart Transplant?

A heart transplant is a surgical procedure where a failing or diseased heart is replaced with a healthier heart. This treatment is usually recommended to patients whose conditions have failed to show any improvement even after medications and other surgeries. In most cases, a brain-dead patient is considered as a donor for a heart transplant.

Before a heart transplant, an assessment will be done for checking whether you are suitable for a heart transplant. You would be then put in the waiting list, where you have to wait till the time you get a suitable donor. It may take a few days to get a donor, but in some cases it may even take months or years.

Indication

A patient may need a heart transplant in the following conditions:

  • Coronary artery disease
  • Cardiomyopathy, a condition where your heart muscles get weakened
  • Heart valve disease
  • Congenital heart defect (problem in the structure of the heart from birth)
  • Abnormal rhythms of the heart that keep recurring and cannot be controlled by medications
  • Amyloidosis (deposit of abnormal proteins in organs and body tissues)
  • A previous heart transplant that has failed

What Procedure is followed :

Pre Procedure

The pre-procedure guidelines before undergoing a heart transplant are:

  • First and foremost, you will be evaluated to check for certain conditions like if you are healthy enough for undergoing the surgery and the lifelong medications that you need to take post-surgery.
  • While you will be put on the waiting list for a suitable heart donor, make sure that you are nearby as you can get a call any moment. You will be informed once the donor heart is available and you need to come to the hospital immediately.
  • Timing is an important factor here as the donor heart can survive only for 4-6 hours after taken out from the body.
  • Once you arrive at the hospital, you will be administered the pre-operative medicines and prepared for the surgery. The chest area will be shaved, and rubbed with an antiseptic lotion. The IV line will be started, for administering the anaesthesia.

During Procedure

Heart transplant surgery is basically an open heart surgery that may take several hours. General anaesthesia will be administered in this procedure. You will be connected with a heart-lung bypass machine to ensure there is proper blood flow during the whole operation. The surgeon first makes an incision in the chest, and opens the rib cage to get access to your heart. The diseased heart is then removed and the donor heart will be placed in its place. The surgeon will then attach the major blood vessels to the donor heart. Once the blood flow gets restored, the heart starts beating again. In some cases, an electric shock needs to be given for the heart to start beating properly.

Post Procedure

Post surgery, you will be shifted to the ICU where you have to stay for a few days. During this time, you will be closely monitored by the doctors to see how the donor heart is functioning, or watch out for any symptoms of rejection like fever, fatigue, shortness of breath, etc. You will be given medications for your pain. There would also be drainage tubes fitted so that the excess fluid can be removed from the chest cavity. Generally, you will have to spend 1-2 weeks at the hospital, although it depends on your rate of recovery.

There will be several follow-up tests and appointments with the doctor in the initial months. In the first few months after a heart transplant, you will also have to undergo biopsy test at regular intervals so that the doctor can analyse if your body is rejecting the donor heart or not.

Risk & Complication

The possible risks or complications of a heart transplant may include:

  • Bleeding or infection from the incision site
  • Formation of blood clots
  • A sudden stroke
  • Rejection of the donor heart by your body
  • Problems in the coronary arteries, where the walls of the arteries may thicken or harden, leading to heart failure or irregular heart rhythms
  • The medications that you have to take for the rest of your life can lead to health issues like high cholesterol, diabetes, high blood pressure, kidney damage or osteoporosis. The medicines can also increase your risk of cancer and infection, as it decreases the ability of your body to treat infections.

More Info

There will be several adjustments that you will need to make in your lifestyle after a heart transplant. There will be some medicines that you have to take for the rest of your life, which may make you more vulnerable to infection and develop health conditions like high cholesterol, high blood pressure or diabetes. Gradually, the dosage might decrease depending on your condition. Ensure that all the medications are taken regularly. Eating a healthy diet, exercising regularly and avoiding tobacco products are the basic changes that needs to be made in your daily life. Your doctor may also suggest a cardiac rehabilitation programme for you, involving exercising and diet guidelines to recover better after a transplant.

The cost of a heart transplant would be approximately Rs. 15 lakhs – Rs. 20 lakhs.

Popular Health Tips

Heart Transplant - When Is The Right Time

MCh (CTVS)
Cardiothoracic Vascular Surgery, Patna
Heart Transplant - When Is The Right Time

There are many people worldwide who suffer from heart problems (irrespective of their age and sex). While in most cases, the condition improves with proper treatment and medications, in few, the condition is beyond treatment. A heart transplant comes as a savior for such people. It gives them a new lease of life. The transplant involves replacing a heart that has stopped functioning normally (damaged or may be diseased) with a healthy heart (from the donor).

Over the years, heart transplant has undergone a sea of change. With the advancement of science and technology, the success rate in a heart transplant has seen an exponential rise.

People who need a heart transplant:
A heart transplant may be essential in the following cases.

  • A congenital heart disorder (a person born with a heart problem).
  • Defective or diseased heart valves.
  • Amyloidosis (a condition where amyloid fibrils get deposed in the tissues and organs of the body intracellularly or extracellularly).
  • Problems in the coronary artery.
  • Cardiomyopathy (A condition where the muscles of the heart become weak, thereby affecting the normal functioning of the heart).
  • A heart transplant that failed previously.
  • Ventricular Arrhythmias (a condition that originates in the ventricles, in ventricular arrhythmias, the heart rhythms are abnormally rapid).

However, under the following circumstances, a heart transplant may not be a wise idea

  • People with infections or chronic lung or kidney disorders.
  • A case of cancer in the past.
  • Age may be a deciding factor.The recovery from a heart transplant may not be 100% in an aged person.

The heart transplant procedure:
The first step in heart transplant is the availability of a suitable donor. In this case, a donor is a person whose brain is dead but the other organs, including the heart, is healthy and functioning properly. A surgeon performs three operations in a heart transplant.

  • The first operation is essentially the removal of the healthy heart from the donor body. The heart is kept in a cool place, preferably ice (to keep the heart alive and in good condition until the heart transplant takes place).
  • In the second operation, the recipient's damaged or diseased heart is operated out.The situation may, however, be complicated if the patient had a heart surgery in the past.
  • The third and the final surgery involves implanting the donor heart into the recipient body (the recipient's upper heart chambers and the atrial back wall are however not removed).
  • Once the implantation takes place (without any complications), the surgeons sew the heart into place.
  • The blood vessels are then connected back to the heart and the lungs. The heart starts beating again once it is warmed up.
  • To enable the patient to receive the nutrients and oxygen (during the heart transplant), the patient is put on a heart-lung machine.
  • If no complications develop after the transplant, the patient is discharged within a fortnight.

In some unfortunate cases, there may be organ rejection. The condition arises when the recipient's immune cells see the transplanted heart as non-self (foreign agents). If left unattended, it may damage the heart. Immunosuppressant drugs can help avert the rejection. However, it is important to monitor the patient closely for any infections that may arise to the administration of the immunosuppressants.

Heart Transplant - What To Expect Post Procedure?

Multi-Speciality Clinic
Cardiologist, Hyderabad
Heart Transplant - What To Expect Post Procedure?

A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't sufficiently improved.

While a heart transplant is a major operation, your chance of survival is good, with appropriate follow-up care.

When faced with a decision about having a heart transplant, know what to expect of the heart transplant process, the surgery itself, potential risks and follow-up care.

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 several conditions, including:

  1. A weakening of the heart muscle (cardiomyopathy)
  2. Coronary artery disease
  3. Heart valve disease
  4. A heart problem you're born with (congenital heart defect)
  5. Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
  6. Amyloidosis
  7. Failure of a previous heart transplant
  8. In children, heart failure is most often caused by either a congenital heart defect or a 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. Multiorgan transplants include:

  1. Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure.
  2. Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions.
  3. Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases, if the conditions aren't able to be treated by only a heart transplant or lung transplant.

Factors that may affect your eligibility for a heart transplant

A heart transplant isn't the right treatment for everyone. Certain factors may mean you're not a good candidate for a heart transplant. While each case is considered individually by a transplant center, a heart transplant may not be appropriate if you:

  1. Are an advanced age that would interfere with the ability to recover from transplant surgery
  2. Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
  3. Have an active infection
  4. Have a recent personal medical history of cancer
  5. Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking

What happens after the transplant?

Most people leave hospital within about four weeks of the operation, but depending on your condition, you may need to stay in hospital for longer.

In the first few months after your surgery you will need to spend a lot of time visiting the hospital – you might even need to stay near the transplant centre. Your transplant team will talk to you about practical arrangements for after your surgery.

Although you will be weak after the operation, recovery can be very quick. It is important to build up your level of activity gradually. You should avoid activities involving lifting and pushing until your breastbone is fully healed, which can take up to three or four months.

Once you feel fit and able, you can start doing things like light vacuuming or light gardening.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3228 people found this helpful

ECMO - Extracorporeal Membrane Oxygenation

MCH DNB (CTVS), Advanced fellowship, MS
Cardiologist, Delhi
Play video

 

I am Dr. Kewal Krishan. I am a cardiac surgeon at max hospital, Saket. I am director of heart transplant ventricular assist device program. We have a separate vertical. Its only vertical in this country.

A spate department for heart transplant ventricle assist device and ECMO. When I was trained in US at MIO clinic and mount san in New York and then I came back to India and we started this ECMO program. ECMO is a Extracorporeal membrane oxygenation. When your patient is on ventilator in ICU and they are told that we don’t have any other option. When your lungs are completely diseased because of swine flu or other pneumonia or some any reason. The ventilator despise 100% settings of ventilator a full ventrilatory support, they are not being oxygenated, the organs will dead and the patient will die. So what we do is we put these patients are referred to us to put the patient on ECMO. ECMO is basically takes out 5 litters of blood in a minute from the body and puts back the oxygenated blood. Weather your lungs are working or not for a few days we can be use this. This thing, this thing, this particular therapy can be used up to 28 days to 36 days and what we do is we put the patient on ECMO, the ventilator settings we keep to the down level so the hearts, the lungs they get, they take rest. And it can be used either for heart or for lungs or for both the organs and once the patients get better we wean the ECMO and we put the patient, we remove the ECMO and patient goes home safely. We have done so far 52 ECMOs . so probably this is the maximum number in the country. We have referral number center for ECMO in this north India and, and our results are close to, to the international results, 60 to 70% results. I am talking of those patients those who otherwise would have died had they not put on ECMO. So believe me it’s a very important tools to save many lives. If your patient is on ventilator and Dr. says now there is no chance for survival you should first, I think you should concern, consult for weather their patient can be put on ECMO and save their life. And that’s the way we save many lives because of far acute conditions.

Thank you very much and if you can, you can go more on detail on this you go on my website, kewalkrishan.com or you can go to Lybrate website.

2582 people found this helpful

How To Prepare Yourself for Heart Transplantation?

MBBS, MD - Medicine, DM - Cardiology
Cardiologist, Delhi
How To Prepare Yourself for Heart Transplantation?

A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't sufficiently improved.

While a heart transplant is a major operation, your chance of survival is good, with appropriate follow-up care.

When faced with a decision about having a heart transplant, know what to expect of the heart transplant process, the surgery itself, potential risks and follow-up care.

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 several conditions, including:

  1. A weakening of the heart muscle (cardiomyopathy)
  2. Coronary artery disease
  3. Heart valve disease
  4. A heart problem you're born with (congenital heart defect)
  5. Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
  6. Amyloidosis
  7. Failure of a previous heart transplant
  8. In children, heart failure is most often caused by either a congenital heart defect or a 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. Multiorgan transplants include:

  1. Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure.
  2. Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions.
  3. Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases, if the conditions aren't able to be treated by only a heart transplant or lung transplant.

Factors that may affect your eligibility for a heart transplant

A heart transplant isn't the right treatment for everyone. Certain factors may mean you're not a good candidate for a heart transplant. While each case is considered individually by a transplant center, a heart transplant may not be appropriate if you:

  1. Are an advanced age that would interfere with the ability to recover from transplant surgery
  2. Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
  3. Have an active infection
  4. Have a recent personal medical history of cancer
  5. Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking

What happens after the transplant?

Most people leave hospital within about four weeks of the operation, but depending on your condition, you may need to stay in hospital for longer.

In the first few months after your surgery you will need to spend a lot of time visiting the hospital – you might even need to stay near the transplant centre. Your transplant team will talk to you about practical arrangements for after your surgery.

Although you will be weak after the operation, recovery can be very quick. It is important to build up your level of activity gradually. You should avoid activities involving lifting and pushing until your breastbone is fully healed, which can take up to three or four months.

Once you feel fit and able, you can start doing things like light vacuuming or light gardening. If you wish to discuss about any specific problem, you can consult a Cardiologist.

3143 people found this helpful

Heart Transplant - When Is It That You Have To Go For It?

MCH DNB (CTVS), Advanced fellowship, MS
Cardiologist, Delhi
Heart Transplant - When Is It That You Have To Go For It?

There are many people worldwide who suffer from heart problems (irrespective of their age and sex). While in most cases, the condition improves with proper treatment and medications, in few, the condition is beyond treatment. A heart transplant comes as a savior for such people. It gives them a new lease of life. The transplant involves replacing a heart that has stopped functioning normally (damaged or may be diseased) with a healthy heart (from the donor).

Over the years, heart transplant has undergone a sea of change. With the advancement of science and technology, the success rate in a heart transplant has seen an exponential rise.

People who need a heart transplant:
A heart transplant may be essential in the following cases.

  • A congenital heart disorder (a person born with a heart problem).
  • Defective or diseased heart valves.
  • Amyloidosis (a condition where amyloid fibrils get deposed in the tissues and organs of the body intracellularly or extracellularly).
  • Problems in the coronary artery.
  • Cardiomyopathy (A condition where the muscles of the heart become weak, thereby affecting the normal functioning of the heart).
  • A heart transplant that failed previously.
  • Ventricular Arrhythmias (a condition that originates in the ventricles, in ventricular arrhythmias, the heart rhythms are abnormally rapid).


However, under the following circumstances, a heart transplant may not be a wise idea

  • People with infections or chronic lung or kidney disorders.
  • A case of cancer in the past.
  • Age may be a deciding factor.The recovery from a heart transplant may not be 100% in an aged person.

The heart transplant procedure:
The first step in heart transplant is the availability of a suitable donor. In this case, a donor is a person whose brain is dead but the other organs, including the heart, is healthy and functioning properly. A surgeon performs three operations in a heart transplant.

  • The first operation is essentially the removal of the healthy heart from the donor body. The heart is kept in a cool place, preferably ice (to keep the heart alive and in good condition until the heart transplant takes place).
  • In the second operation, the recipient's damaged or diseased heart is operated out.The situation may, however, be complicated if the patient had a heart surgery in the past.
  • The third and the final surgery involves implanting the donor heart into the recipient body (the recipient's upper heart chambers and the atrial back wall are however not removed).
  • Once the implantation takes place (without any complications), the surgeons sew the heart into place.
  • The blood vessels are then connected back to the heart and the lungs. The heart starts beating again once it is warmed up.
  • To enable the patient to receive the nutrients and oxygen (during the heart transplant), the patient is put on a heart-lung machine.
  • If no complications develop after the transplant, the patient is discharged within a fortnight.

In some unfortunate cases, there may be organ rejection. The condition arises when the recipient's immune cells see the transplanted heart as non-self (foreign agents). If left unattended, it may damage the heart. Immunosuppressant drugs can help avert the rejection. However, it is important to monitor the patient closely for any infections that may arise to the administration of the immunosuppressants. If you wish to discuss about any specific problem, you can consult a Cardiologist.

2589 people found this helpful

Popular Questions & Answers

Hi, before a month she had an operation of heart transplant now she is unable to go to washroom I mean like constipation.

BHMS
Homeopath, Faridabad
Hello, you want a solution for constipation then take bio combination no. 04, 4 tablets at a time, three times a day, 15 min. after meals. Alpha LIV, 2 tsp daily after dinner. Avoid the following foods that can cause constipation include: Chocolate Dairy products Red meat Bananas and Caffeine Tips to Prevent Constipation Have more fibres in your diet. 25 to 30 grams of daily intake can prevent constipation. Fibres help retain water in the stools thus making them softer and easier to expel. Whole grain cereals and breads Dried fruits, such as prunes and raisins Popcorn, nuts, and seeds Beans and legumes Raw fruits and vegetables Drink plenty of fluids, preferably water. 8 glasses a day will help. Have more if you are physically active. Prune (manukka) juice, and other fruit drinks are known to normalize bowel motility.
1 person found this helpful

Is there any solution for heart muscles weakening, I'm afraid that is it leads to a heart transplantation?

MBBS, MD-General Medicine, DM - Cardiology
Cardiologist, Secunderabad
Hello lybrate-user. Heart transplantation is the lasr resort, only after all the options are exausted. There can be quite improvement with proper treatment which includes diet, exercise and medications. Apart from this there are options for devices which can improve the pumping. If the heart weakness is due to a reversible cause then it can also be taken care of. So be optimistic and enjoy life.
15 people found this helpful

What are the precautions required for an ADS patient? Is there possibility of heart transplantation?

Homeopath, Buldhana
AIDS patients need to protect themselves from sources of infection. Also ensure not infecting others through their body fluid or mucosal membrane. Heat transplantation is possible theoretically however risks are very high of post operative infections. So not advisable.
1 person found this helpful

My father is 72 years old. Is heart failure patient no blockage in heart. Eco is showing 35. Doctor said heart transplant. Suggest Ayurveda medicine and doses for a day please.

International Academy of Classical Homeopathy, BHMS
Homeopath, Pune
U may take below course if your interested in homoeopathy Cratagus mother tincture for WK Cactus 3c 3tims day for WK Digital 12c as above.

Actually my mother is suffering from dilated cardiomyopathy with lbbb and she is in very critical condition. Right now she is admitted in a hospital in ranchi and there doctors are saying that when what will happen nobody knows. And the last option to get her out from this situation is heart transplant. But she is not fit to travel and also doctor will not refer. So is it possible that doctor will come to the patient with all their equipments like donor for heart transplant. Because in ranchi there is no option of heart transplant. Sir please anyone help me. Me and my family is in very critical situation.

MBBS, MD - Internal Medicine, DM - Cardiology, Cardiac Device Specialist (CCDS - Physician )
Cardiologist, Delhi
It will not be possible to give any conclusive advice without seeing the reports and understanding the general condition of your mother. And heart transplant is a major procedure, for which a patient has to be enrolled in a transplant programme and evaluated etc and it cannot be done at any random centre. It can only be done at designated transplant centres. She can be offered device therapy or LVAD depending on her condition and reports.

Table of Content

What is Heart Transplant?

Indication

What Procedure is followed :

Risk & Complication

More Info