Heart Transplant

What is a heart transplant?

A heart transplant is the surgical replacement of a diseased heart with a healthy heart from a donor. A heart transplant can prolong the life of a person with life-threatening heart disease. Heart transplants are typically done in people who have advanced heart failure that can’t be successfully treated with other procedures or medications.

The transplant involves transferring a healthy heart from a donor to the recipient. The donor is usually someone who has suffered brain death but whose heart is healthy. The donor must be a similar height and weight as the recipient, and the two must have the same blood type. However, the age, sex, and race of the two individuals can differ.

A transplant must take place within 4 hours of the time the healthy heart is removed from the donor. That’s why time-and location of the donor and recipient-are such critica! factors. People on the transplant waiting list usually carry a pager at all times. They must be at the hospital shortly after being paged.

A heart transplant is a major surgery that involves general anesthesia and a fairly long recovery period. In the United States, just over 2,000 heart transplants are done every year. Doctors could save many more lives if more people were willing to be donors.

Left ventricular assist device (LVAD)

Sometimes a person has a surgery before the heart transplant. This initial surgery is the implantation of a device called a left ventricular assist device (LVAD). The LVAD is necessary because the left ventricle (lower heart chamber) can become very weak from damage to the heart muscle. In sorne people the weakened heart is increasingly unable to pump enough blood out to the body.

A LVAD helps by taking over the work of the left ventricle. A tube on the LVAD takes blood entering the left ventricle and sends it to the LVAD pump. The LVAD uses the right amount of force to pump the blood in a blood vessel, which then sends blood throughout the body. The LVAD is removed during the heart transplant surgery.

An LVAD is used only for people who are on a waiting list for a heart transplant. So an LVAD is called a “bridge to transplant”. Until a heart is available for the person on the list, the LVAD can help keep the heart working properly.

How is the surgery done?

Your heart transplant surgery begins with an incision in the breastbone (sternum). Your doctor needs to operate on a completely still heart. So you receive medications to stop your heart. A heart-lung machine then does the job of both the heart and the lungs:

  • lt adds oxygen to your blood-as your lungs would do
  • lt pumps the blood back into, and throughout, your body-as your heart would do

The doctor then removes your diseased heart and attaches the donor heart to your blood vessels.

What can I expect?

Usually you are told not to eat or drink anything for a number of hours before your surgery. You lie on an exam table and an intravenous (IV) line is put into your arm. The IV delivers fluids and medications during the surgery. You are then wheeled into the operating room, where you receive medication that makes you unconscious during the surgery. After surgery you will be in the intensiva care unit (ICU) for several days. You stay in the hospital a total of about 2 weeks. People often have pain at the incision site for several weeks, but medication is provided for pain. At home, recovery usually takes another several months.

Heart transplants are associated with major risks, including infection and organ rejection. After the transplant, you’ll need to take many medications to stop your body from “rejecting” the new heart. Your immune system will likely never get used to the new organ. So you usually need to take sorne anti-rejection medications for the rest of your life.

To make an appointment with Dr. Bhakta,
call us at (760) 883-1600.

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