Complex operation where a severely diseased heart is removed and replaced with a healthy heart obtained from a recently deceased donor.
Heart transplant is usually carried out for end stage heart failure and it is a rare procedure due to the lack of available donors. Heart transplant is the ultimate resort in the treatment of the following conditions:
Candidates for heart transplant are normally referred to tertiary heart centres for detailed investigation and assessment, including echocardiography and left and right cardiac catheterization, to exclude contraindications to the operation, e.g. kidney dysfunction which would be exacerbated by immunosuppressive medication needed following the transplant. Heart transplant is also not recommended in people with history of poor adherence to medication and hospital appointments due to the need for life-long follow up after the surgery.
Patients on waiting list for heart transplant need to be contactable 24/7 and get to hospital immediately upon request to minimize the delay between the retrieval and transplant of the donated heart. During the heart transplant the patient is put on heart bypass machine, the diseased heart is removed and then the new heart is connected to the main arteries and veins.
All heart transplant patients need a life-long care with frequent visits to hospital, regular tests and multiple medication. The actual operation is a major procedure but it is normally successful with a dramatic improvement in the quality of life of patients who were previously extremely incapacitated.
The challenge is a long term care where a correct level of immunosuppression should achieve a balance between prevention of rejection of the heart and side effects including susceptibility to kidney problems, osteoporosis, infections and cancer. This however needs to be considered in the context of bleak prognosis of terminal heart failure without heart transplant.