Heart transplant

Alternative names:

cardiac transplant; transplant of the heart

Expectations after surgery:

Heart transplant prolongs the life of a patient who otherwise would die. About 80% of heart transplants are alive two years after the operation. The main problem, as with other transplants, is graft rejection. If rejection can be controlled, then survival can be increased up to 10 years for a person who otherwise would have died. Immunosuppressive drugs must be taken indefinitely. Relatively normal activities can resume as soon as the patient feels well enough and after consulting with his or her doctor. However, vigorous physical activities should be avoided.

The major problems are the same all major organ transplants face:

• finding a donor
• fighting the rejection effect
• the cost of the surgery

Finding a donor can be difficult. In heart transplant, the healthy heart must come from a fresh cadaver. This is different than a kidney transplant where a kidney can be donated by a family member. Also, timing is important because there is no good way to keep the recipient alive on an artificial heart while waiting for the right donor, as is possible with dialysis in kidney transplant (use of an artificial heart is still considered experimental).

Fighting rejection is an ongoing process. The body's immune system considers the transplanted organ as an infection and automatically fights it. Thus, to prevent rejection, organ transplant patients must take drugs (such as cyclosporine and corticosteroids) that suppress the body's immune response. The disadvantage of these drugs is that they weaken the body's natural defense against various infections.

Convalescence:

The recovery period averages 6 weeks. Move legs often to reduce the risk of deep venous thrombosis. The sutures or clips are removed about one week after surgery. Warm pads over the scar can reduce the pain.