Heart Transplant
Contents
About Heart Transplant
A Heart Transplant is a life-saving surgical procedure in which a diseased or failing heart is replaced with a healthy heart from a deceased donor. It is primarily performed on patients with end-stage heart failure or severe cardiac conditions that have not responded to medication or other surgical treatments.
Heart transplantation significantly improves survival and quality of life in selected patients, restoring normal heart function and allowing for a return to regular activities.
Types of Heart Transplant
- Orthotopic Heart Transplant:
The most common technique where the patient’s heart is removed and replaced with a donor heart in the same anatomical position. - Heterotopic Heart Transplant (Piggyback Heart Transplant):
A rarely used method where the donor heart is connected alongside the patient’s own heart. This may be considered when the original heart is too weak to support life but cannot be removed due to other complications. - Pediatric Heart Transplant:
Performed in children with congenital heart defects or cardiomyopathy. Requires special evaluation due to growth, size matching, and developmental factors.
Conditions That May Require Heart Transplant
A heart transplant is considered for patients with severe or terminal heart conditions, including:
- End-stage heart failure (from any cause)
- Dilated cardiomyopathy
- Ischemic cardiomyopathy (due to coronary artery disease)
- Congenital heart defects (uncorrectable by other surgeries)
- Restrictive cardiomyopathy
- Arrhythmogenic right ventricular dysplasia
- Severe valve disease with irreversible damage
- Recurrent life-threatening arrhythmias unresponsive to treatment
Risk Factors
While a heart transplant can save lives, it comes with significant risks:
- Rejection: The body may attack the new heart. Immunosuppressive drugs are required lifelong to prevent this.
- Infection: Immunosuppressants increase vulnerability to viral, bacterial, and fungal infections.
- Organ Dysfunction: Medications may affect kidneys, liver, or other organs over time.
- Cancer: Long-term immunosuppression increases the risk of certain cancers, especially skin and lymphomas.
- Coronary Artery Vasculopathy (CAV): A form of chronic rejection where arteries in the new heart narrow over time.
- Bleeding or Blood Clots: May occur during or after surgery.
- Side Effects from Medications: Includes weight gain, diabetes, high blood pressure, and osteoporosis.
Investigations
Patients undergo extensive pre-transplant evaluation to determine eligibility and ensure readiness for surgery:
- Blood Tests: To assess organ function, infection status, and blood type.
- Echocardiogram & ECG: To evaluate heart function.
- Cardiac Catheterization: Measures pressures in the heart and checks for coronary artery disease.
- Chest X-ray and CT/MRI: For lung and heart imaging.
- Pulmonary Function Tests: Assess lung function.
- Psychological and Social Evaluation: To ensure emotional readiness and family support.
- HLA Typing & Panel Reactive Antibody (PRA) Testing: For donor matching and rejection risk.
Side Effects
After heart transplant surgery, patients may experience:
- Temporary pain or discomfort in the chest
- Swelling or fluid retention
- Muscle weakness or fatigue
- Side effects of immunosuppressive medications (nausea, tremors, mood changes)
- Risk of infection or mild rejection episodes
- Dietary and lifestyle adjustments
- Emotional stress and psychological adjustment
All patients require lifelong medical supervision and regular follow-up testing.
Success Rate
Heart transplants offer excellent long-term outcomes when performed at experienced centers with proper follow-up:
- 1-year survival rate: 85–90%
- 5-year survival rate: 70–75%
- Many patients live 10–20 years or more post-transplant with good quality of life
- Most patients can return to daily routines, work, and even moderate physical activity after 3 to 6 months of recovery
Strict medication adherence, cardiac rehabilitation, and lifestyle changes play a key role in long-term success.