Heart Transplants Explained

A heart transplant is a surgical procedure involving the exchange of a poorly functioning heart for one that performs more effectively.

Indications for a Heart Transplant

The possibility of needing a heart transplant is indicated in those who have severe heart disease or those suffering from end stage heart failure.

Conditions included in these categories are life threatening cardiac arrhythmias, advanced coronary artery disease that cannot be treated by bypass grafting or has failed following this procedure, those with life threatening congenital heart disease that cannot be treated by any other means, those with diseased heart valves and those with certain types of cardiomyopathy.

In effect, the existing heart is failing to meet the needs demanded of it by the patient and is causing a reduced life expectancy for the patient.

Where Does the Donor Heart Come From?

The heart that is to be introduced into the person receiving the transplant will have come from a recently deceased person or a patient who has been declared as brain dead. This process is agreed by at least two consultant physicians following a series of tests to ensure the diagnosis is correct.

The two people will be tested to see if the donor heart is to be suitable and the heart will be removed from the donor person by an operative procedure. The heart is then tested further and if found to be suitable, the recipient will be prepared for theatre immediately.

The family or next of kin to the donor must give consent on behalf of the donor to allow the organ to be used, this decision is often greatly eased if the donor has carried a donor information card or identification of his/her wishes.

What is Involved in the Operation?

Heart transplantation involves major surgery and the use of a general anaesthetic. The chest cavity is opened and, using the surgeon's chosen technique, the hearts are exchanged.

There are two main techniques for transplanting hearts, the first involves the recipient being placed onto a bypass machine whilst the damaged organ is stopped and removed and the donor heart is put in place. The second procedure is not as frequently used and is only indicated in certain circumstances and involves placing the ‘new’ heart in the recipient and attaching it as needed, without the need for removing the damaged organ. In effect the recipient will have two hearts, allowing the damaged heart to recover, or because of foreseen problems with the donor heart.

Success Rates

Organ transplants in general seem to have excellent rates of success. Figures suggest that heart transplant success rates exceed well over 75% in most cases.

Rates of success are significantly reduced if post-operative complications follow, such as wound infections or rejection of the new organ by the body.

Obviously, the longer a diseased heart remains in the body of the patient, the more work the new heart will have to do to make up for its previous occupants deficits.

Heart transplantation has been hailed by experts as one of the most successful medical breakthroughs of modern medicine. If the donor and recipient pass all tests without problem, the chance of success can be extremely promising.