Treatments & Therapies

Heart Transplantation – Treatment, Effect & Risks

Heart transplant

heart transplant is an organ transplant from a donor to a recipient.

What is the heart transplant?

In a heart transplant, a donor ‘s still active heart is implanted in a recipient. Heart transplantation is especially necessary in heart failure when the survival rate is less than one year. This is calculated using a score, using the following parameters:

  • the heart rate
  • the maximum oxygen uptake
  • the ejection fraction
  • if there is a block image in the ECG
  • the pulmonary capillary closure pressure

Function, effect & goals

Chronic or acute cardiac insufficiency is always treated first with medication, which can stabilize the patient. In some cases, however, stabilization does not succeed, so that a heart transplant becomes necessary.

A transplant is particularly necessary when the heart muscle is irreversibly damaged, all treatment options have been exhausted and the life expectancy of the person affected is significantly reduced as a result. In this case, after consultation with the cardiologist , patients are placed on a waiting list for transplantation. The waiting time depends on the size, weight and blood group of the organ recipient. The time until the transplantation can possibly be bridged with an artificial heart, but this only supports the weak circulation of the patient. However, an artificial heart cannot be used in the longer term; the maximum term is around three years.

Transplants will be refused if the recipient is unwilling or unable to cooperate with the necessary investigations or treatments. Another important criterion for organ allocation is the prospect of success based on the Transplantation Act. If all the prerequisites for an operation are met, the patient is also reported to Eurotransplant, where all potential recipients of donor organs are recorded. On average, patients wait several months for a transplant, with very critical cases being given priority.

Due to the unpredictable availability of a suitable donor organ, an operation cannot be planned and is therefore always urgent. Therefore, interventions can also take place at weekends or at night. The organ recipient is immediately ordered to the hospital and the clinic organizes the organ removal or the transport of the donor organ, which is often hundreds of kilometers away. Because an explanted heart can only survive outside the body for a few hours, communication must be perfectly coordinated. After the donor heart has been removed, it is preserved in a four-degree cold solution and transported to the recipient.

The explanting doctors also check the quality of the organ. If there are concerns about the function of the donor heart, the operation can still be stopped without harming the recipient. In order to avoid long distances, a suitable recipient is first sought in the vicinity of the donor. The heart is only removed if the transplant can take place within the next four hours. When the donor heart arrives at the clinic, removal of the diseased heart begins. During this time, the blood supply to the organs is taken over by the heart-lung machine. The veins that lead to the systemic circulation or to the lungs are severed by the surgeon in such a way that part of the right or left atrium remains.

The donor heart is then sewn to the leftover tissue. The new heart is connected to the bloodstream and can then start pumping again. After the heart transplant, intensive therapy is carried out, which lasts about seven days. The organ recipients are maximally immunosuppressed so that rejection of the organ can be prevented. The risk of infection is highest during this period, so patients must be isolated. The rejection crises usually occur in stages.

If they occur about every two weeks for the first three months, they stabilize after some time. This is followed by rehabilitation on the normal ward, which lasts about three to four weeks. Regular checks are also necessary in the first year. The doctor removes tissue from the heart in order to be able to record the immune suppression . The tissue samples can be used to determine whether the organ will be rejected. In the case of a moderate or severe rejection reaction, patients are treated with cortisone .

Risks, side effects & dangers

A heart transplant is a procedure that carries certain risks. The surgical technique is no longer difficult these days, but bleeding , thrombosis and wound healing disorders can occur in the first few weeks after the operation. The immunosuppressive drugs also weaken the immune system , which increases the risk of possible infections. In addition, not all patients are suitable for a transplant; the risk rate is increased by the following circumstances:

It is important that the patients themselves observe their bodies very closely in order to notice any changes. Possible symptoms that indicate rejection include:

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.