About Heart Transplantation

About Heart Transplantation

What is transplantation?

Transplantation is the surgical placement of a human organ from a patient who has been declared clinically brain dead (cadaveric donor). When an organ from a cadaveric donor is available, an organ procurement organization is notified. After determining the suitability of the donor, the donor's family is approached regarding the option of organ donation. If the donor's family agrees to donate, blood work is obtained to rule out any possible infections.

The United Network for Organ Sharing (UNOS) is contacted and a list of potential recipients is generated. This list is determined by various factors, such as blood type, size, time waiting, and in some circumstances, severity of disease. The recipient transplant programs are contacted to offer the organ for the first recipient on the UNOS waiting list. Many times organs that are offered are not suitable and will be denied. The goal of transplantation is to provide you with an organ that will allow you the best opportunity for a better quality of life.

What is cardiac transplantation?

Cardiac transplantation is a procedure of last resort. This means that there are no other medical or surgical options that will improve your current heart condition. Heart transplantation involves the placement of a healthy heart from a cadaveric donor into the recipient with end-stage heart disease.

What is heart-lung transplantation?

Heart-lung transplantation is the surgical placement of a set of heart & lungs from a cadaveric donor into the recipient whose own heart and lungs are badly damaged from a disease process. Like heart transplantation, heart-lung transplantation is a procedure for patients for whom there are no other medical or surgical options.

About Your Heart

The heart is a muscle a little bigger than the size of your fist. It is located in the middle of your chest just behind the sternum, which is the flat bone at the center of your rib cage. Your heart is a pump that moves blood throughout your body.

Blood feeds the cells of your body. It does this by carrying oxygen to the cells so they can stay healthy and do work. The blood also carries carbon dioxide, which is a waste product of the cells, so that it can be removed from the body. Your heart has four chambers: the right atrium, the right ventricle, the left atrium, and the left ventricle. Blood coming from your head and body is filled with a large amount of carbon dioxide and very little oxygen. This blood enters the heart through a large vein known as the vena cava. The vena cava enters the heart at the right atrium. From there, the blood flows down to the right ventricle. The right ventricle squeezes the blood through the pulmonary arteries and into the lungs. In the lungs, the blood loses the carbon dioxide and picks up more oxygen. Then the blood goes back to the left atrium of the heart. From there, it flows down to the left ventricle. The left ventricle is the biggest and strongest chamber of the heart. It pumps the fresh blood out to the cells of the brain and body through the aorta.

Your heart beats because of an electric flow that is passed through its cells. The flow of electricity comes from the sinus node, which is a little bundle of nerve cells in the wall of the right atrium. Each time the sinus node sends out an electric flow, the heart cells along the path of electricity squeeze together, causing the pumping action of the heart. The electricity flows to the atria first and works its way down to the ventricles, making them pump just after the atria. When the cells of the ventricles squeeze together, blood is pumped to the lungs, head, and body.

What Happens When Your Own Heart Fails

Heart Disease and Failure

The two most common heart problems are coronary artery disease (the buildup of plaque in the arteries of the heart) and idiopathic cardiomyopathy (disease of the heart muscle without a known cause). As the heart problem gets worse, the heart grows weaker and is less able to pump oxygen-rich blood to the rest of the body. Because the heart must work harder to pump blood through the body, it tries to make up for this extra work by becoming enlarged. In time, the heart works so hard to pump blood that it may simply wear out, overcome by disease and unable to meet even the smallest pumping demands.

You may experience symptoms such as shortness of breath and fatigue with almost any exertion, and sometimes these symptoms may even be experienced while at rest. Swelling of the feet, legs, and abdomen are frequently seen and add to the discomfort of heart failure.

How to Treat Heart Disease and Failure

Several options are available to your doctor in treating your heart.

The first option is medical therapy with drugs. In some instances, medicines alone can be used to treat heart failure.

If your doctor feels it is necessary, there are also several other procedures that can be performed:

• Coronary artery bypass involves using blood vessels from other places in your body to "bypass" the blockages in your coronary arteries, which can help restore blood flow to your heart muscle.
• Angioplasty is a nonsurgical treatment designed to open clogged arteries.
• Heart valves can be repaired. This often improves heart function dramatically. Other times, the valve must be removed and replaced with a prosthetic, or artificial, valve made of metal or plastic.
• Cardiac size reduction involves removing a piece of living heart muscle from an enlarged heart to reduce the size of the heart, allowing the remaining heart muscle to pump more efficiently and vigorously.
• Pacemakers are used to treat a heart that beats too slowly. In addition, the FDA has recently approved advanced pacemakers that make both the heart's pumping chambers beat in perfect rhythm. Sometimes the natural pacemaker of the heart becomes diseased and does not keep the heart beating regularly.

At this time, there are mechanical devices that can also be surgically implanted to help improve heart function. When these therapies fail, transplantation becomes the only option. Heart transplantation is reserved only for patients with the most advanced forms of heart disease, who have no other available options. The best treatment for your heart failure will depend on your medical history, health status, and your personal situation. Together, you and your doctors can figure out which treatment is best for you.

Facts About Heart Transplants

The first truth is that the heart transplant involves more than just having an operation. A large portion of the care associated with the transplant comes before and after the surgery.

The second truth is that a lot depends on you. You will need to work closely with the transplant team to keep your new heart healthy. How long a new heart lasts depends on many factors--some you can control and others you cannot.

Before the transplant, you will need to work with the transplant team to speed your evaluation. After the transplant, you will need to keep in contact with your transplant team to help maintain lung function and ensure your good health.

A heart transplant is a partnership between the transplant center and you to keep you and your heart healthy.

Getting a Heart Transplant: What's Involved

There are five steps involved in getting a heart transplant.

A team of health-care professionals will do the following:

1. Find out if you are healthy enough to receive a new heart.
2. Find out if you are sick enough to need a new heart.
3. Prepare you for your operation. This can take a long time, and there is no guarantee that a heart will be found.
4. Perform a heart transplant operation.
5. Help you stay healthy after your heart transplant.

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Source: USC Cardiothoracic Surgery

Important Notice: HeartPatients.com does not provide medical advice, diagnosis or treatment. The information provided on this site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.

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