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Keyword how long does it take to do a heart transplant procedure
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heart transplant procedure step by stephttps://www.google.co.uk/search?num=60&hl=en&gl=gb&q=Heart+transplant+procedure+step+by+step&sa=X&ved=2ahUKEwiHvcOC_qX1AhUglYkEHfQ-BTsQ1QJ6BQjHARAB
heart transplant surgery survival ratehttps://www.google.co.uk/search?num=60&hl=en&gl=gb&q=Heart+transplant+surgery+survival+rate&sa=X&ved=2ahUKEwiHvcOC_qX1AhUglYkEHfQ-BTsQ1QJ6BQjKARAB
heart transplant life expectancy 2020https://www.google.co.uk/search?num=60&hl=en&gl=gb&q=Heart+transplant+life+expectancy+2020&sa=X&ved=2ahUKEwiHvcOC_qX1AhUglYkEHfQ-BTsQ1QJ6BQjLARAB
heart transplant waiting list ukhttps://www.google.co.uk/search?num=60&hl=en&gl=gb&q=Heart+transplant+waiting+list+UK&sa=X&ved=2ahUKEwiHvcOC_qX1AhUglYkEHfQ-BTsQ1QJ6BQjMARAB
how long can someone live without a heart transplanthttps://www.google.co.uk/search?num=60&hl=en&gl=gb&q=How+long+can+someone+live+without+a+heart+transplant&sa=X&ved=2ahUKEwiHvcOC_qX1AhUglYkEHfQ-BTsQ1QJ6BQjNARAB
how much is a heart transplant ukhttps://www.google.co.uk/search?num=60&hl=en&gl=gb&q=How+much+is+a+heart+transplant+UK&sa=X&ved=2ahUKEwiHvcOC_qX1AhUglYkEHfQ-BTsQ1QJ6BQjPARAB
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do you die during a heart transplanthttps://www.google.co.uk/search?num=60&hl=en&gl=gb&q=Do+you+die+during+a+heart+transplant&sa=X&ved=2ahUKEwiHvcOC_qX1AhUglYkEHfQ-BTsQ1QJ6BQjIARAB
Result 1
TitleHeart transplant - What happens - NHS
Urlhttps://www.nhs.uk/conditions/heart-transplant/what-happens/
DescriptionRead about what happens during and immediately after a heart transplant operation
Date
Organic Position
H1What happens - Heart transplant
H2After the operation
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BodyWhat happens - Heart transplant A heart transplant is carried out with you unconscious under general anaesthetic, and normally takes between 4 and 6 hours. You'll be connected to a heart-lung bypass machine, which will take over the functions of the heart and lungs while the transplant is being carried out. A thin, flexible tube called a catheter will also be inserted to drain your bladder during and after the operation. During the procedure: a cut (incision) is made down your chest over your breastbone and the bone is separated, allowing the surgeon to access your heart your heart is removed, leaving behind a section of the right and left atria, the 2 upper chambers of the heart the new heart is connected to the aorta, the main artery from the heart, the pulmonary artery and the remaining part of the atria You'll be taken off the bypass machine when your new heart starts beating. Your breastbone will be closed with metal wires, and the tissues and skin will be closed with stitches. After the operation. Once the transplant is complete, you'll be moved to an intensive care unit (ICU). A machine called a ventilator will assist you with your breathing, and a tube will be inserted into a vein to provide you with fluid and nutrients. These will normally be removed after a few days. You'll also be given pain relief as required. Most people are well enough to move from the ICU and into a hospital ward within a few days. You'll usually be able to leave hospital within 2 or 3 weeks, although you'll need to have regular follow-up appointments and take medicine to help stop your body rejecting your new heart. Find out more about living with a heart transplant Page last reviewed: 30 April 2019 Next review due: 30 April 2022
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TitleHeart transplant - NHS
Urlhttps://www.nhs.uk/conditions/heart-transplant/
DescriptionFind out why heart transplants are carried out, what the procedure involves, what the risks are, and what you can expect while you recover
Date
Organic Position2
H1Overview - Heart transplant
H2Why heart transplants are carried out
What happens during a heart transplant
Recovering from a heart transplant
Risks of a heart transplant
Outlook for heart transplants
NHS Organ Donor Register
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H2WithAnchorsWhy heart transplants are carried out
What happens during a heart transplant
Recovering from a heart transplant
Risks of a heart transplant
Outlook for heart transplants
NHS Organ Donor Register
BodyOverview - Heart transplant A heart transplant is an operation to replace a damaged or failing heart with a healthy heart from a donor who's recently died. It may be recommended when a person's life is at risk because their heart no longer works effectively. Why heart transplants are carried out. A heart transplant may be considered if you have severe heart failure and medical treatments are not helping. Conditions that may eventually require a heart transplant include: coronary heart disease – a build-up of fatty substances in the arteries supplying the heart, which block or interrupt blood flow to the heart cardiomyopathy – where the walls of the heart have become stretched, thickened or stiff congenital heart disease – birth defects that affect the normal workings of the heart If your doctor thinks you might benefit from a heart transplant, you'll need to have an in-depth assessment to check whether you're healthy enough to have one before being placed on a waiting list. Read more about who can have a heart transplant and being on the heart transplant waiting list. What happens during a heart transplant. A heart transplant needs to be carried out as soon as possible after a donor heart becomes available. The procedure is performed under general anaesthetic, where you're asleep. While it's carried out, a heart-lung bypass machine will be used to keep your blood circulating with oxygen-rich blood. A cut is made in the middle of the chest. Your own heart is then removed, and the donor heart is connected to the main arteries and veins. The new heart should then begin beating normally. Find out more about how a heart transplant is performed Recovering from a heart transplant. You'll usually need to stay in hospital for around 2 or 3 weeks after a heart transplant. Most people are able to start returning to many of their normal activities within a few months. Your transplant team can give you advice about how long you may need to avoid certain activities during your recovery. You'll need to have regular check-ups with your transplant team after the transplant. You'll also need to take medicines called immunosuppressants for the rest of your life.  Without these medicines, your body may recognise your new heart as foreign and attack it (rejection). Find out more about recovering from a heart transplant Risks of a heart transplant. A heart transplant is a complex and risky procedure. Possible complications include: the immune system recognising the transplanted heart as foreign and attacking it (rejection) the donated heart failing to work properly (graft failure) narrowing of the arteries supplying the heart (cardiac allograft vasculopathy) side effects from the immunosuppressant medication, such as an increased vulnerability to infections, weight gain and kidney problems Many of these problems are treatable, although sometimes another heart transplant may need to be carried out if possible. Find out more about the risks associated with a heart transplant Outlook for heart transplants. Most people can eventually return to their normal activities after a heart transplant and experience a significant improvement in their symptoms for many years. But it's a major operation and some of the complications can be life threatening. Overall: 80 to 90 in every 100 people will live at least a year 70 to 75 in every 100 people will live at least 5 years 50 in every 100 people will live at least 10 years Some people have survived for more than 25 years after a heart transplant. NHS Organ Donor Register. If you're interested in donating your organs after you die, you can join the NHS Organ Donor Register. Joining the NHS Organ Donor Register is quick and simple, and will only take a few minutes of your time. You can remove yourself from the register at any time and can specify what you're willing to donate. Page last reviewed: 30 April 2019 Next review due: 30 April 2022
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Result 4
TitleHeart Transplant | BHF
Urlhttps://www.bhf.org.uk/informationsupport/treatments/heart-transplant
DescriptionA heart transplant is when a diseased heart is replaced by a healthy human heart from a donor. It may be considered if you have severe heart failure
Date
Organic Position3
H1
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BodySkip to main content Close Home > Information & support > Treatments > Heart transplant
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TitleHeart Transplant Surgery: How to Prepare and What to Expect | UPMC
Urlhttps://www.upmc.com/services/transplant/heart/process/surgery
DescriptionWhen a donor heart becomes available, your transplant coordinator will call you. Here's how to prepare for surgery and what to expect during the procedure
Date
Organic Position4
H1Heart Transplant Surgery: Preparation and Procedure
H2Prepping for Your Heart Transplant
Contact the UPMC Heart Transplant Program
H3
H2WithAnchorsPrepping for Your Heart Transplant
Contact the UPMC Heart Transplant Program
BodyHeart Transplant Surgery: Preparation and Procedure When a donor heart becomes available, your transplant coordinator will call you. It's crucial that you get to the hospital right away. We ask people on the heart transplant waiting list to be within four hours of UPMC. Before coming to the hospital for your heart transplant: Do not eat or drink anything. Pack your phone and charger. Bring your medicines. If you have a ventricular assist device (VAD), bring your equipment. Prepping for Your Heart Transplant. When you arrive at UPMC, we will prep you for your heart transplant surgery. The donor team will inspect the heart to make sure it's good for transplant and a match for you. In the meantime — to make sure you're in good health with no active illnesses — you'll: Complete a medical history and physical examination Have blood work Get x-rays Before moving you to the OR, the anesthesiologist will speak with you about what to expect. You'll receive general anesthesia and sleep through the heart transplant procedure. You will also speak to one of the surgical team members to get consent for the transplant to take place. How Long Does Heart Transplant Surgery Take? The amount of time for a heart transplant depends on the complexity of your case and if you need other procedures. If you do not have a VAD, surgery should take three or four hours. If you have a VAD that needs to be removed, or you've had prior chest surgeries, it should take six to eight hours. You may be in the OR longer than the actual procedure because the transplant team must work with the donor site. How Long Do Heart Transplants Last? While the length of survival for a transplanted heart continues to improve, the current median amount of time at our center is nine years, with the longest ever recorded at our center being 36 years and 10 months. Heart Transplant Process: How Does a Heart Transplant Work? During your heart transplant, your surgeon and care team will: Connect you to a heart-lung machine. It does the work of your heart and takes the strain off your lungs. It pumps filtered, oxygen-rich blood into your body so your heart is still during the operation. Remove your diseased heart Replace it with the healthy donor heart How Does a Heart Start Beating After a Transplant? After a donor heart is placed into an open chest, the surgeon attaches it to the surrounding major blood vessels. It should usually start beating once blood flow is restored, but an electric shock can be used to get it started if necessary. How Long Can a Person Be on a Heart Lung Machine? Also called a cardiopulmonary bypass machine, this is what replaces the heart's pumping motion while it is outside of the body. It also adds oxygen to the blood and performs the job of the lungs. The machine can operate for hours. How Long Will I Be in the Hospital After My Heart Transplant Surgery? After your heart transplant, you will: Start taking anti-rejection drugs right away. When your body detects something new, your immune system begins working to fight what it views as a threat. Anti-rejection drugs suppress your immune system's natural response, so your body will accept the new organ. Be in the Cardiothoracic ICU for about three days before moving to a room on the transplant floor. Stay in the hospital for about 10-14 days, but this varies based on how sick you are prior to your transplant. During this time, the heart transplant team will: Watch for rejection, infection, or other problems. Teach you coughing and breathing exercises that you'll need to do often. These help keep your lungs clear and prevent pneumonia. Adjust your medications to find the right mix. Work with you and your caregiver to get ready for taking care of yourself at home. The nutritionist on your care team will also create and review an eating plan for you to follow at home. Before you leave the hospital, make sure you and your caregiver clearly understand: Your medicine schedule The meal plan and nutrition guidelines Any other instructions for at-home care Your follow-up care schedule (blood work, clinic visits, and testing) For people who need more help after heart transplant surgery, we may suggest spending time in inpatient rehab before going home. Please feel free to ask members of your UPMC heart transplant team to explain anything you're unsure of and answer any questions you may have. We're here for you through each stage of your transplant journey. Contact the UPMC Heart Transplant Program. To contact the UPMC Heart Transplant Program, please call 412-648-6202 or toll-free at 844-548-4591. You can also fill out the UPMC Heart Transplant Program contact form to make an appointment or refer a patient. UPMC Patient Portals Your health information, right at your fingertips. Select MyUPMC to access your UPMC health information. For patients of UPMC-affiliated doctors in Central Pa, select UPMC Central Pa Portal. Patients of UPMC Cole should select the UPMC Cole Connect Patient Portal. The portal for all UPMC patients EXCEPT those in Central Pa. Sign in to MyUPMC The portal for UPMC patients in Central Pa. Sign in to UPMC Central PA Portal The portal for UPMC Cole patients. Sign in to UPMC Cole Connect Patient Portal Get help choosing the right patient portal
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Result 6
TitleHeart Transplant Surgery: Procedure, Costs, Life Expectancy, and More
Urlhttps://www.healthline.com/health/heart-disease/transplants
DescriptionHeart transplant surgery is used to treat the most severe cases of heart disease. We’ll explain the procedure, recovery time, follow-up, and outlook
Date
Organic Position5
H1Heart Transplant Surgery
H2Candidacy for heart transplants
What’s the procedure?
What’s recovery like?
Follow-up after the surgery
What’s the outlook?
H3Read this next
H2WithAnchorsCandidacy for heart transplants
What’s the procedure?
What’s recovery like?
Follow-up after the surgery
What’s the outlook?
BodyHeart Transplant SurgeryMedically reviewed by Elaine K. Luo, M.D. — Written by Erica Roth — Updated on September 17, 2018 What is a heart transplant?A heart transplant is a surgical procedure used to treat the most serious cases of heart disease. This is a treatment option for people who are in the end stages of heart failure. Medication, lifestyle changes, and less invasive procedures haven’t succeeded. People must meet specific criteria to be considered a candidate for the procedure. Candidacy for heart transplants. Heart transplant candidates are those who’ve experienced heart disease or heart failure due to a variety of causes, including:a congenital defectcoronary artery diseasea valve dysfunction or diseasea weakened heart muscle, or cardiomyopathyEven if you have one of these conditions, there are still more factors that are used to determine your candidacy. The following will also be considered:Your age. Most prospective heart recipients must be under 65 years old.Your overall health. Multiple organ failure, cancer, or other serious medical conditions may take you off a transplant list.Your attitude. You must commit to changing your lifestyle. This includes exercising, eating healthy, and quitting smoking if you smoke.If you’re determined to be an ideal candidate for a heart transplant, you’ll be put on a waiting list until a donor heart that matches your blood and tissue type is available.An estimated 2,000 donor hearts become available in the United States each year. Yet, approximately 3,000 people are on a heart transplant waiting list at any given time, according to the University of Michigan. When a heart is found for you, surgery is performed as soon as possible while the organ is still viable. This is usually within four hours. What’s the procedure?Heart transplant surgery lasts for approximately four hours. During that time, you’ll be placed on a heart-lung machine to keep blood circulating throughout your body. Your surgeon will remove your heart, leaving the pulmonary vein openings and the back wall of the left atrium intact. They’ll do this to prepare you to receive the new heart.Once your doctor stitches the donor heart into place and the heart begins beating, you’ll be removed from the heart-lung machine. In most cases, the new heart will begin to beat as soon as blood flow is restored to it. Sometimes an electric shock is required to prompt a heartbeat. What’s recovery like?After your surgery is finished, you’ll be taken to the intensive care unit (ICU). You’ll be constantly monitored, given pain medication, and outfitted with drainage tubes to remove excess fluid from your chest cavity.After the first day or two after the procedure, you’ll most likely be moved from the ICU. However, you’ll remain in the hospital as you continue to heal. Hospital stays range from one to three weeks, based on your individual rate of recovery.You’ll be monitored for infection, and your medication management will begin. Antirejection medications are crucial to ensure that your body doesn’t reject your donor organ. You may be referred to a cardiac rehabilitation unit or center to help you adjust to your new life as a transplant recipientRecovery from a heart transplant can be a long process. For many people, a full recovery can span up to six months. Follow-up after the surgery. Frequent follow-up appointments are crucial to the long-term recovery and management of a heart transplant. Your medical team will perform blood tests, heart biopsies through catheterization, and echocardiograms on a monthly basis for the first year after the operation to ensure that your new heart is functioning properly. Your immunosuppressant medications will be adjusted if needed. You’ll also be asked if you’ve experienced any of the possible signs of rejection, including:feverfatigueshortness of breathweight gain due to fluid retentionreduced urine outputReport any changes in your health to your cardiac team so that your heart function can be monitored if required. Once a year has passed after the transplant, your need for frequent monitoring will decline, but you’ll still need yearly testing.If you’re female and want to start a family, consult your cardiologist. Pregnancy is safe for people who’ve had a heart transplant. However, expectant mothers who have preexisting heart disease or who’ve had a transplant are considered high risk. They may experience a greater chance of pregnancy-related complications and a higher risk of organ rejection. What’s the outlook?Receiving a new heart can improve your quality of life considerably, but you have to take good care of it. In addition to taking daily antirejection medications, you’ll need to follow a heart-healthy diet and lifestyle as prescribed by your doctor. This includes not smoking and exercising on a regular basis if you’re able.Survival rates for people who’ve had a heart transplant vary according to their overall health status, but averages remain high. Rejection is the main cause for a shortened life span. The Mayo Clinic estimates that the overall survival rate in the United States is about 88 percent after one year and 75 percent after five years. Last medically reviewed on February 2, 2018Medically reviewed by Elaine K. Luo, M.D. — Written by Erica Roth — Updated on September 17, 2018Read this next. What Is Pleural Effusion (Fluid in the Chest)?Medically reviewed by Adithya Cattamanchi, M.D.Pleural effusion, also called water on the lung, happens when fluid builds up between your lungs and chest cavity. Learn why this happens and how to…READ MOREOpen-Heart SurgeryMedically reviewed by Elaine K. Luo, M.D.Open-heart surgery is when the chest is cut open and surgery is performed on the muscles, valves, or arteries of the heart. Learn about this complex…READ MOREUnderstanding Postsurgery DepressionMedically reviewed by Timothy J. Legg, PhD, PsyDDepression after surgery is not uncommon. Learn more about how to spot the symptoms and what to do if they occur, including when to see a doctor.READ MOREWhat Causes Low Blood Pressure After Surgery?Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COIAny surgery comes with the potential for certain risks, even if it’s a routine procedure. One such risk is a change in your blood pressure. READ MOREEverything You Need to Know About the PacemakerMedically reviewed by Dr. Payal Kohli, M.D., FACCA pacemaker is implanted under the skin to help manage an irregular heartbeat. Discover who needs a pacemaker, what happens after surgery, and more.READ MOREEchocardiogramMedically reviewed by Dr. Payal Kohli, M.D., FACCAn echocardiogram test uses sound waves to produce live images of your heart. It's used to monitor your heart function. Learn more about what to…READ MORESimple Surgery Reduces Stroke Risk in People with Heart ArrhythmiaExperts say the small appendage can trap blood in the heart chamber and increase the risk of clots.READ MOREFoods to Eat and Avoid After a Heart AttackMedically reviewed by Jillian Kubala, MS, RDAfter a heart attack, your doctor will start you on a treatment plan to prevent a future heart attack or other complication. This will include making…READ MOREHeart Attack Facts, Statistics, and YouMedically reviewed by Dr. Payal Kohli, M.D., FACCA heart attack is unpredictable by nature, but it can be prevented and treated with modern medicine. Read on to learn more about what causes a heart…READ MOREHow Just Half a Tablespoon of Olive Oil a Day Can Improve Heart HealthResearchers say olive oil, as well as certain vegetable oils, are healthier for your heart than animal-based fats.READ MORE
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Result 7
Title8 Things To Know About Heart Transplants > News > Yale Medicine
Urlhttps://www.yalemedicine.org/news/8-things-to-know-about-heart-transplants
DescriptionFor people who are considering a heart transplant or have a loved one who needs one, here are some things to know about getting an organ and other advances in transplant
Date6 Oct 2020
Organic Position6
H18 Things To Know About Heart Transplants
H21. Each patient’s journey is different
2. A practice called ‘donation after cardiac death’ may increase the number of heart transplants
3. Anti-rejection drugs are customized for each patient
4. People can have multiple organ transplants
5. You can survive with a heart from someone who had a serious disease
6. The outlook has improved for transplant survivors
7. Follow-up care makes a difference
8. It takes a community to support a heart transplant patient
H3
H2WithAnchors1. Each patient’s journey is different
2. A practice called ‘donation after cardiac death’ may increase the number of heart transplants
3. Anti-rejection drugs are customized for each patient
4. People can have multiple organ transplants
5. You can survive with a heart from someone who had a serious disease
6. The outlook has improved for transplant survivors
7. Follow-up care makes a difference
8. It takes a community to support a heart transplant patient
Body8 Things To Know About Heart TransplantsBY KATHY KATELLA October 6, 2020New approaches could save more lives.A heart transplant may be the most dramatic surgery done in the operating room. Each step takes great precision, from the quick, careful journey to retrieve the heart to the preparation of the recipient, who may be gravely ill and bedridden. The best part is the outcome soon after the transplant, when the patient goes home and starts returning to his or her life—whether that means getting married, having babies, running in marathons, or simply breathing massive sighs of relief while strolling around the neighborhood without having to periodically stop to catch a breath. This is happening more frequently in Yale Medicine’s Advanced Heart Failure Program, which is one of the fastest-growing, highest volume programs in the country, and one of just a few in the United States willing to push the envelope on accepting donor hearts. Yale Medicine specialists performed 49 heart transplants in 2019, earning a spot among the top 10 programs in the country in volume. This year, the program continued to provide transplants even amid the COVID-19 pandemic. For people who are considering a heart transplant or have a loved one who needs one, here are some things to know about getting an organ and other advances in transplant.1. Each patient’s journey is different. Heart transplants are done in people of all ages, even children. “Heart failure can affect anyone; in fact, it is the number one cause of death and a leading cause of disability in the United States,” says Tariq Ahmad, MD, MPH, medical director of the Advanced Heart Failure Program. “We've had people in their 20s, 30s, and 40s—and our oldest transplant patient last year was 73 years old. One of our patients later completed a 100-mile bike ride up in Maine, and he's doing incredibly well.” “A routine heart transplant surgery can be performed in less than four hours, while some complex ones may take seven, eight, nine hours—or more, especially if we need to remove a heart pump or clean up scar tissue from previous surgeries,” says Arnar Geirsson, MD, chief of cardiac surgery. “Regardless, the basic procedure remains the same. The patient is given general anesthesia and connected to a bypass machine that takes over the heart’s function. Surgeons make an incision in the chest, divide the breastbone and remove the diseased heart. They sew the donor heart into place and connect it to the remnants of the old heart and the major blood vessels.” One issue is that many people waiting for hearts are critically ill, says Sounok Sen, MD, an advanced heart failure specialist. “Historically, there's this concept that people would be at home waiting for the call that a heart was available, and then they would come in and have a very smooth experience—and that still happens in a lot of cases,” he says. But given today’s shortage of available organs, the sickest patients are prioritized for transplants, so many patients waiting for a heart to become available are already in the hospital on various types of medicine or heart pumps, he says.  2. A practice called ‘donation after cardiac death’ may increase the number of heart transplants. United Network for Organ Sharing (UNOS), a private, non-profit organization under contract with the federal government to manage the organ transplant system in the U.S., allocates newly available hearts based on such priorities as medical urgency. Patients who are hospitalized or dependent on mechanical assist devices to help their heart function are at the top of the list. About 3,500 people in the U.S. are waiting for a heart, and many will wait more than six months. But some will die before a heart becomes available to them. That’s why one of the greatest breakthroughs in heart transplantation may be the practice of accepting donor hearts that most other programs do not have the expertise to accept. This means that more sick patients who are eligible (based on strict criteria) may be able to receive one. A limited number of programs in the U.S. are starting to do this. Yale Medicine is one of them.  “I remember we said to ourselves as a team: ‘We're going to switch gears now. We can be more aggressive and take some risks,'” says Muhammad Anwer, MD, associate director of the Center for Advanced Heart Failure at Yale New Haven Hospital and a key cardiac surgeon for heart transplantation. “Now all the data that's coming in is showing that the outcomes may be just as good with the more aggressive approach.” The vast majority of hearts used for transplant are retrieved as “donation after brain death,” or DBD. But Yale Medicine’s heart transplant surgeons are participating in a multi-site clinical trial that allows them to offer “donation after cardiac death,” or DCD, which is relatively new in the U.S., as a way to make more donated hearts usable. “During DBD heart transplant, the heart is still beating, allowing for a controlled procurement,” says Christopher Maulion, MD, who is spearheading the DCD program at Yale Medicine. DCD is a more intense process. DCD organs and recipients must meet strict eligibility criteria, and the process of retrieving the heart involves multiple doctors. “When you have a brain death donation, the heart is removed and simply transported on ice,” Dr. Maulion says. When a DCD heart becomes available, however, Drs. Maulion and Anwer, as well as two perfusionists are sent to retrieve it. Once the heart is removed, it is reanimated and preserved in a warm environment with circulating oxygenated blood. Nicknamed “heart in a box,” the technology for transporting a donated heart is called the Transmedics Organ Care System. Only a few transplant centers (those participating in the ongoing clinical trial) are able to use this system to procure and then transplant hearts.  While there is still more to learn, outcomes from DCD heart surgeries are proving to be comparable to those using organs from DBD donors. “DCD is the likely next chapter in cardiac transplantation,” Dr. Maulion says. “By being one of the few centers in the country that can offer DCD heart transplantation, Yale is in the position to offer transplants to more patients who may not have had the opportunity otherwise.” 3. Anti-rejection drugs are customized for each patient. Heart transplants wouldn’t be possible if it weren’t for the drugs that prevent people’s bodies from rejecting the transplanted organ. These drugs have vastly improved in the last 15 to 20 years. “Essentially, people are on two to three medicines for life,” says Dr. Ahmad. The drugs can have adverse effects, including high blood pressure, as well as blood sugar and kidney problems. “So, there’s a trade-off. But we’re very vigilant about monitoring for those types of things.” One notable advance is that doctors can now tailor an immunosuppression strategy for each patient, says Dr. Ahmad. “So, it’s not only just whether or not we have novel drugs. It’s also making sure we have a personalized immunosuppression strategy to match each patient. We’ve taken a personalized approach in terms of looking at what the risk will be for a particular recipient as far as their potentially rejecting the heart, and then tailoring treatment to them.” 4. People can have multiple organ transplants. Yale Medicine doctors have performed almost 10 heart–kidney transplants in the past two years, which is significant for almost any center, says Dr. Sen. “Many patients who have heart failure over time also develop kidney dysfunction,” he says. “Sometimes that can be a limiting factor in terms of being able to get a heart transplant. But we’ve tried to think ‘outside the box’ and be open to multi-organ transplant for certain cases.” Surgeons perform the heart transplant first and the kidney transplant a day or more later. The kidney surgeon must have expertise in performing kidney transplants in patients who are not stable, Dr. Ahmad says, explaining that heart transplant patients who have been in the intensive care unit have more complex needs than those who have been on dialysis and are otherwise healthy.  Heart transplant doctors work closely with Yale Medicine’s kidney transplant specialists on these patients. “Together, we’ve come up with pathways for how to manage patients before and after a heart–kidney transplant,” says Dr. Ahmad. “We are lucky to have some of the world's experts in organ transplantation at Yale, including Richard Formica, MD, president of the American Society of Transplantation and David Mulligan, MD, president of the Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS).” 5. You can survive with a heart from someone who had a serious disease. Another breakthrough in the past few years is the transplantation of hearts from donors who had hepatitis C, a viral disease that can cause fatal liver problems. “Even though other organ systems for those donors were transplanted, traditionally these hearts would not have been utilized,” says Dr. Sen. There's been a cultural shift around that; hepatitis C is now not viewed as an insurmountable problem. “With the advent of new therapies for hepatitis C that have a 99% or greater cure rate, those organs are now available to individuals who are willing to undergo the treatment afterwards. That has expanded the donor pool quite a bit as well,” he says. 6. The outlook has improved for transplant survivors. Though a successful heart transplant was a major medical milestone, in the early days, patients with these new hearts didn’t live that long. Now many people live for decades, with a median survival of 14 years, according to Dr. Ahmad. The one-year survival rate after a heart transplant at Yale Medicine is 93%, which is higher than the national average, says Dr. Ahmad. He adds that a transplant team’s experience with heart transplant is an important predictor of outcome. “It’s important for patients to know that physicians and surgeons at transplant programs are trained in centers that have lots of experience and large volumes, so they can be comfortable with the entire process, which is very complex,” says Daniel Jacoby, MD, director of the Comprehensive Heart Failure Program. “The need for expertise only begins with the surgery. Transplant patients have complex medical needs, but with the right care, they can do things once considered impossible. For instance, one of our transplant patients recently had a baby—a potentially high-risk and complicated medical situation. Our team has trained at the best programs in the country and brought the best of this experience to Yale. Such a set up only exists at a handful of places in the world. We're lucky to have it here.” 7. Follow-up care makes a difference. One reason patients can now live longer after transplantation is close monitoring and follow-up, especially in the several months after their surgery. “The thing about heart transplant is that you get rid of one disease, but you replace it with another,” Dr. Ahmad says. “Heart transplant patients become immuno-compromised. They can get infections and develop kidney problems.” Follow-up care is most intense in the first six months after a transplant, when doctors see patients frequently, says Dr. Sen. “We adjust their medications and do heart biopsies to make sure there are no signs of rejection,” he says. “After the first six to eight months, the follow-up becomes every three months, every six months, every year.” Some patients may also need to see other sub-specialists, such as infectious disease specialists and nephrologists. Anyone who has a heart transplant is at high risk for COVID-19 complications, so Yale Medicine doctors are in close contact with the 500 or so heart transplant patients they care for at Yale, advising them to be especially careful about taking measures to avoid the virus. “Our patients need to be incredibly careful about social distancing and not going out, especially during the first months following the procedure, because that's when you are most at risk for infections,” Dr. Ahmad says. 8. It takes a community to support a heart transplant patient. “In some ways, when you get a transplant, you become part of the transplant family. We plan to be with our patients all their lives,” says Dr. Ahmad. In the hospital, this team includes cardiologists who work hand-in-glove with the cardiac surgeons, as well as other surgeons, anesthesiologists, transplant coordinators, electrophysiologists, infectious disease specialists, nephrologists, nurses, and social workers. “The team supports patients not just medically, but also mentally, psychologically, and spiritually,” Dr. Jacoby says. Since so much recovery happens at home, it’s helpful to seek care at a transplant center close to home. Patients benefit from being geographically close to family and friends, Dr. Sen says. “The journey after transplant is often an amazing thing. Before the operation patients are very sick. Seven days after the surgery, they're walking out of the hospital, and they feel completely different,” he says. At that point, many patients are happy to have their loved ones around them for support as they get back to the business of living a normal and healthy life. [Read about Yale’s strategic changes in donor heart and recipient selection that, according to a recent study, “may significantly increase the number of heart transplants while maintaining short-term outcomes comparable with more conservative patient selection."]Read more Yale Medicine news [510,2449]{"namedChunks":["modules-news-news-details-components-NewsDetails-newsDetails"]} [6126,2449]{"namedChunks":["modules-news-news-details-components-NewsDetails-newsDetails"]}
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TitleHeart transplant - Mayo Clinic
Urlhttps://www.mayoclinic.org/tests-procedures/heart-transplant/about/pac-20384750
Description
Date16 Nov 2019
Organic Position7
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TitleHeart transplant surgery - Organ transplantation - NHS Blood and Transplant
Urlhttps://www.nhsbt.nhs.uk/organ-transplantation/heart/at-the-transplant-centre/heart-transplant-surgery/
DescriptionFind out what happens during a heart transplant operation
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Organic Position8
H1Heart transplant surgery
H2Key points
How is heart transplant surgery performed?
Heart transplant medicines
Recovery at the transplant centre
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H3How it works
Some things that might happen during your heart transplant surgery
Example of a surgical heart transplant technique
H2WithAnchorsKey points
How is heart transplant surgery performed?
Heart transplant medicines
Recovery at the transplant centre
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BodyHeart transplant surgery Find out what happens during the transplant operation Key points. Heart transplant surgery lasts around 4-6 hours You will be put to sleep under a general anaesthetic while the transplant takes place Donor hearts are transplanted in the same place in your chest as your own heart The operation can be performed a variety of ways, which will depend on your needs and the preference of the transplant surgeon How is heart transplant surgery performed? Donor hearts are transplanted in the same place in your chest as your own heart. This involves the removal of the diseased heart and replacement with the donor heart. How it works. Where the heart is in the body Your heart sits in the middle of your chest, with a slight tilt to the left. It is connected to the body through various arteries and veins, including: The aorta - the main and largest artery in the body Superior vena cava - a large vein that brings blood to the heart from your upper body Inferior vena cava - a large vein that brings blood to the heart from your lower body Pulmonary blood vessels - arteries and veins that connect to your lungs A heart in close up This is a close up of a heart showing the superior vena cava, aorta,  pulmonary artery and pulmonary veins. Arteries and veins run throughout the heart. In general, arteries take oxygenated blood away from the heart, while veins bring deoxygenated blood back to the heart. However, pulmonary blood vessels are the exception. Pulmonary arteries move deoxygenated blood from the heart to the lungs, and pulmonary veins carry oxygenated blood back to the heart from the lungs. Connecting a donor heart A donor heart is transplanted in the same place as your own heart. Your transplant surgeon will carefully join the donor arteries and veins surrounding the heart with your arteries and veins. Close up of a transplanted heart This shows how a transplanted heart connects to your blood vessels. You can also see the position of pipes from a bypass machine. This machine takes over the function of your heart and lungs during the operation. Some things that might happen during your heart transplant surgery. You will be attached to a heart-lung bypass machine A heart-lung bypass machine will take over the function of the heart and lungs and deliver oxygen to your body while the transplant takes place. Tubes will be inserted into your neck, arms and bladder You will have plastic tubes (lines or catheters) inserted into your neck, arms and bladder. Before the operation, the surgical and anaesthetic teams will explain where the tubes will be placed. What are the tubes for? Small tubes (lines) are inserted into your arms to enable fluid and medications to be given to you during and after the surgery. For most heart transplant operations, you’ll also have a tube inserted into the veins in your neck so that stronger medications can be given, if needed. This also lets the team looking give you extra fluid, if needed. A tube (catheter) will be inserted into your bladder via the urethra. Most heart transplant surgeons will insert a number of large plastic tubes (up to 5) into the area around the heart transplant to drain away any tissue fluid after the surgery. Risks Inserting tubes into you can lead to bleeding, infection, or damage to other structures such as blood vessels or nerves. These complications are very rare. Example of a surgical heart transplant technique . After you have been put to sleep under anaesthetic, the surgery will begin. You will be attached to a heart-lung bypass machine, which takes over the function of the heart and lungs and delivers oxygen to the body. The entire operation takes around 4-6 hours. Read more about the surgical technique Your chest is opened with an incision (cut) in the middle of the breast bone. Your diseased heart will be removed apart from a cuff of the left upper chamber (the left atrium) with the veins from the lungs attached to it. The donated heart is connected to the cuff of the old one, to the veins bringing blood back from the body to the heart, and to the main blood vessels carrying blood to the body (aorta) and lungs (pulmonary artery). You will have a catheter floated through your heart and into the pulmonary artery to monitor function after surgery, and other tubes in your veins to administer medicines that you need. Your urine will be collected via a tube placed in your urinary bladder and a breathing tube will be in your windpipe to allow you to be connected to a ventilator. Once the surgeons are confident that the heart is working well, the heart-lung bypass machine will be removed from the circulation. Your chest will be closed once the bleeding that occurs in all such surgery has settled to the satisfaction of the surgeons. More information. Heart transplant medicines. Get advice on the medicines you might need after a transplant and common side effects. What medicines will you need? Recovery at the transplant centre . What can you expect after heart transplant surgery and when can you go home? What happens after surgery? Go to the next page in this section: Recovery at the transplant centre > Related content. Being admitted to the heart transplant centre Recovery at the transplant centre Taking care of yourself at home Risks from the donated heart Patient and donor stories Medical terms explained. Biopsy This is when a very small piece of tissue is taken for analysis. It is used to diagnose rejection. View all medical terms You may also be interested in. Medical terms explained Receiving a heart Warning signs after a heart transplant
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TitleHeart Transplant | Johns Hopkins Medicine
Urlhttps://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/heart-transplant
DescriptionA heart transplant is surgery done to remove the diseased heart from a person and replace it with a healthy one from an organ donor
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H1Heart Transplant
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What is a heart transplant?
Why might I need a heart transplant?
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How do I get ready for a heart transplant?
What happens during a heart transplant?
What happens after a heart transplant?
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BodyHeart Transplant Share on Facebook Share on Twitter Share on Linkedin Share on Pinterest Share via Email Print this Page What is a heart transplant? . A heart transplant is surgery to remove the diseased heart from a person and replace it with a healthy one from an organ donor. To remove the heart from the donor, two or more healthcare providers must declare the donor brain-dead. Before you can be put on a waiting list for a heart transplant, a healthcare provider makes the decision that this is the best treatment choice for your heart failure. A healthcare team also makes sure you are otherwise healthy enough to go through the transplant process. Why might I need a heart transplant? . You may need a heart transplant if your heart is failing and other treatments are not effective. End-stage heart failure is a disease in which the heart muscle is failing severely in its attempt to pump blood through the body. It means other treatments are no longer working. End-stage heart failure is the final stage of heart failure. Despite its name, a diagnosis of heart failure does not mean the heart is about to stop beating. The term failure means the heart muscle is failing to pump blood normally because it is damaged or very weak, or both. Some causes of heart failure include: Heart attack (myocardial infarction or MI) Viral infection of the heart muscle High blood pressure Heart valve disease Heart defects present at birth (congenital) Irregular heartbeats ( arrhythmias ) High blood pressure in the lungs ( pulmonary hypertension ) Alcoholism or drug abuse Chronic lung diseases, such as emphysema or chronic obstructive pulmonary disease (COPD) Heart muscle is enlarged, thick, and stiff ( cardiomyopathy ) Low red blood cell count ( anemia ) Your healthcare provider may have other reasons to recommend a heart transplant. What are the risks of a heart transplant? . As with any surgery, complications may occur. Potential risks of a heart transplant may include: Infection Bleeding during or after the surgery Blood clots that can cause heart attack, stroke, or lung problems Breathing problems Kidney failure Coronary allograft vasculopathy (CAV). This is a problem with the blood vessels that carry blood to the heart muscle itself. They become thick and hard. This can cause serious heart muscle damage. Failure of the donor heart Death Your body's immune system may reject the new heart. Rejection is your body's normal reaction to a foreign object or tissue. When you get a new heart, your immune system reacts to what it sees as a foreign threat and attacks the new organ. To allow the transplanted organ to survive in a new body, you will need to take medicines. The medicines will trick the immune system into accepting the transplant and keep it from attacking it. You will need to take the medicines to prevent or treat rejection for the rest of your life. These drugs have side effects too. The side effects will depend on the specific medicines you take. Current or repeated infection that does not get better with treatment Poor blood circulation throughout the body, including the brain Metastatic cancer. This is when cancer has spread from the place it started to one or more other places in the body. Severe health problems that would make you unable to tolerate the surgery Serious health problems other than heart disease that would not get better after transplant Noncompliance with treatment regimen. For instance, not following your healthcare provider's directions, not taking medicines as prescribed, or missing appointments. Drug or alcohol abuse There may be other risks depending on your specific health condition. Be sure to discuss any concerns with your healthcare provider before the surgery. How do I get ready for a heart transplant? . Not everyone is a candidate for heart transplant. Because of the wide range of information needed to know if a person is eligible for transplant, a transplant team will review the evaluation. The team includes a transplant surgeon, a transplant cardiologist (doctor specializing in the treatment of the heart), nurse practitioners or physician assistants, one or more transplant nurses, a social worker, and a psychiatrist or psychologist. Other team members may include a dietitian, a chaplain, hospital administrator, and an anesthesiologist (doctor who uses medicines to keep you asleep during surgery). The transplant evaluation process will include: Psychological and social evaluation. Some psychological and social issues that are involved in organ transplant include stress, financial issues, and support from family or significant others. These factors can greatly affect how you do after the transplant. Blood tests. You will need blood tests to help find a good donor match and help improve the chances that the donor heart will not be rejected. Diagnostic tests. You will need tests to assess your lungs as well as your overall health. These tests may include X-rays, ultrasound procedures, CT scan, pulmonary function tests (PFTs), and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram. Other preparations. You will get several vaccines to decrease the chances of developing infections that can affect the transplanted heart. The transplant team will consider all the information from interviews, your health history, the findings from your physical exam, and your diagnostic test results when deciding if you are eligible for a heart transplant. Once you have been accepted as a transplant candidate, you will be placed on the United Network for Organ Sharing list. When a donor organ becomes available, candidates are selected based on the severity of their condition, body size, and blood type. If the heart is to be yours, you will need to go to the hospital right away so you can get ready for the transplant. (Most hearts must be transplanted within 4 hours after they’ve been removed from the donor.) These things will need to be done before the transplant: Your healthcare provider will explain the procedure and let you ask questions. You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if anything is unclear. You should not eat or drink anything (fast) as soon as you have been told that a heart has become available. You may be given medicine to help you relax (sedative). Based on your health condition, your healthcare provider may request other specific preparation. What happens during a heart transplant? . A heart transplant requires open heart surgery and a stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practice. Generally, a heart transplant follows this process: You will be asked to remove any jewelry or other objects that may interfere with the procedure. You will change into a hospital gown. A healthcare professional will start an intravenous (IV) line in your hand or arm to inject medicine and to give IV fluids. Additional catheters will be put in blood vessels in your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples. Other sites for the additional catheters include the under the collarbone and the groin. A soft, flexible tube (Foley catheter) will be put into your bladder to drain urine. A tube will be put through your mouth or nose into your stomach to drain stomach fluids. If there is a lot of hair on your chest, it may be shaved. Heart transplant surgery will be done while you are in a deep asleep (under general anesthesia). Once you are asleep, a breathing tube will be put through your mouth into your lungs. The tube will be attached to a machine (ventilator) that will breathe for you during the surgery. The anesthesiologist will watch your heart rate, blood pressure, and blood oxygen level during the surgery. The skin over your chest will be cleaned with an antiseptic solution. The surgeon will make a cut (incision) down the center of your chest from just below the Adam's apple to just above the navel. The surgeon will cut the breastbone (sternum) in half. He or she will separate the two halves of the breastbone and spread them apart to reach your heart. The surgeon will put tubes into your chest so that your blood can be pumped through your body by a heart-lung (cardiopulmonary bypass) machine while your heart is stopped and replaced. Once the blood has been completely diverted into the bypass machine and is being pumped by the machine, your doctor will remove the diseased heart. The surgeon will sew the donor heart into place. Once your new heart is in place, he or she will connect the blood vessels carefully so there are no leaks. When your new heart is fully connected, the blood circulating through the bypass machine will be allowed back into the heart and the tubes to the machine are removed. Your surgeon will shock the heart with small paddles to restart the heartbeat. Once your new heart starts to beat, the healthcare team will watch the heart to see how it’s working and make sure there are no leaks. Wires for pacing may be put into the heart. Your surgeon can attach these wires to a pacemaker outside your body for a short time to pace your new heart, if needed, during the initial recovery period. The surgeon will rejoin the sternum and sew it together with small wires. The surgeon will sew the skin over the sternum back together. He or she will use sutures or surgical staples to close the incision. Tubes will be put into your chest to drain blood and other fluids from around the heart. These tubes will be connected to a suction device to drain fluids away from the heart as it heals. A sterile bandage or dressing will be applied. What happens after a heart transplant? . In the hospital . After the surgery, someone will take you to the recovery room or the intensive care unit (ICU) and monitor you closely for several days. A nurse will connect you to machines that will display your electrocardiogram (ECG) tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. Heart transplant surgery requires a hospital stay of 7 to 14 days, or even longer. You will have a tube in your throat that connects to a breathing machine (ventilator) until you are stable enough to breathe on your own. The breathing tube may stay in for a few hours up to several days, depending on your case. As you recover and start to breathe on your own, the breathing machine will be adjusted to allow you to take over more of the breathing. When you are able to breathe completely on your own and are able to cough, your doctor will remove the breathing tube. After the breathing tube is out, a nurse will help you cough and take deep breaths every 2 hours. This will be uncomfortable due to soreness, but it is extremely important that you do this to keep mucus from collecting in your lungs and possibly causing pneumonia. Your nurse will show you how to hug a pillow tightly against your chest while coughing to help ease the discomfort. You may get pain medicine as needed, either by a nurse, or by giving it yourself by pushing a button attached to a device connected to your IV line. You may have a thin, plastic tube that goes through your nose and into your stomach to remove air that you swallow. The tube will be taken out when your bowels are working normally. You will not be able to eat or drink until the tube is removed. Blood samples will be taken often to monitor your new heart, as well as other body functions. These include your lungs, kidneys, liver, and blood system. You may be on special IV medicines to help your blood pressure and your heart, and to control any problems with bleeding. As your condition stabilizes, your doctor will gradually decrease, then stop, these medicines. If you have pacing wires in your heart, he or she will remove those too. Once your doctor removes the breathing and stomach tubes and you are stable, you may start to drink liquids. You can gradually add more solid foods as you can handle them. Your healthcare team will closely watch your anti-rejection (immunosuppression) medicines to make sure you are getting the right dose and the best combination of medicines. Nurses, respiratory therapists, and physical therapists will work with you as you begin physical therapy and breathing exercises. When your healthcare provider decides you are ready, you will be moved from the ICU to a private room on a surgical unit or transplant unit. Your recovery will continue there. You can gradually increase your activity as you get out of bed and walk around for longer periods. You can eat solid foods as tolerated. Nurses, pharmacists, dietitians, physical therapists, and other members of the transplant team will teach you what you will need to do to take care of yourself when you go home. Your healthcare team will arrange for you to go home and schedule a follow-up visit with your healthcare provider. At home . Once you are home, it will be important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. During a follow-up visit, your doctor will remove the sutures or surgical staples, if they were not removed before leaving the hospital. Do not drive until your healthcare provider tells you it's OK. Other activity restrictions may apply. You will need frequent follow-up visits after transplant. These visits may include blood tests, chest X-rays, and biopsy. In a biopsy, your doctor uses a thin needle to remove tissue from the heart so he or she can examine it under a microscope. The transplant team will explain the schedule for these visits and tests. The rehab program will continue for many months. Tell your healthcare provider right away if you have any of the following: Fever, chills, or both. These may be a sign of infection or rejection. Redness, swelling, bleeding, or drainage from the incision site or any of the catheter sites Increase in pain around the incision site Trouble breathing Excessive fatigue Low blood pressure Your healthcare provider may give you other instructions after the procedure, depending on your own case. To allow the transplanted heart to survive in your body, you will need to take medicines for the rest of your life to fight rejection. Each person may react differently to medicines, and side effects can be serious. Your healthcare provider will tailor medicine plans to meet your needs. You may get several anti-rejection medicines at first. The doses of these medicines may change often, depending on your response. Because anti-rejection medicines affect the immune system, you will be at higher risk for infections. It's important to keep a balance between preventing rejection and making you very susceptible to infection. Some of the infections you will be especially susceptible to include oral yeast infection (thrush), herpes , and respiratory viruses. You should avoid contact with crowds and anyone who has an infection for the first few months after your surgery. Regular dental care also is important. Your healthcare provider or dentist may prescribe antibiotics before any dental work to help prevent infections. To watch for signs of rejection, you will likely get routine right heart biopsies. A biopsy is typically done once a week in the early period after a transplant, then gradually changed to monthly or longer intervals. The biopsy procedures may eventually stop. The right heart biopsy procedure may be done as an outpatient or as an inpatient if you are already in the hospital. The procedure involves a right heart catheterization. A special catheter is threaded through a vein in your neck or groin and into the right atrium of your heart. Your doctor takes 4 to 6 tiny tissue samples through the catheter and checks them for signs of rejection. If your doctor finds signs of rejection, he or she may adjust your anti-rejection medicine. The biopsy procedure has its own instructions and risks, and your healthcare provider will discuss these with you. Related. 6 Myths Keeping You from Becoming an Organ Donor Hand and Arm Transplant Behind Hand and Arm Transplants Can I Get a Liver Transplant if I Have This Pre-Existing Condition? Request an Appointment. Find a Doctor Find a Doctor See More Related. Living Organ Donation 6 Myths Keeping You from Becoming an Organ Donor Transplant Hand and Arm Transplant Hand and arm transplant Behind Hand and Arm Transplants Related Topics.
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TitleTransplant Process | Heart Transplant
Urlhttps://my.clevelandclinic.org/departments/transplant/programs/heart/process
DescriptionTransplant Process | Heart Transplant
Date1 May 2019
Organic Position10
H1Transplant Process
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BodyTransplant Process Phone 216.445.1844 Contact Us A heart transplant is only done when it is absolutely necessary and likely to have long-term success. The process of getting accepted into Cleveland Clinic’s heart transplant program involves several steps to ensure the best possible outcomes for every patient. Step 1: Referral to the program There are two ways to be referred to Cleveland Clinic’s heart transplant program – by your doctor or you can refer yourself. To start the referral process, call the pre-transplant office at: 216.444.8351 or toll-free 800.223.2273 ext. 48351. Step 2: Transplant Evaluation Every patient interested in a heart transplant must have a comprehensive evaluation. The evaluation is done to find out exactly how advanced your heart disease is and to create the best plan of care for you. The evaluation takes 3 to 4 days and includes tests and procedures, meeting the members of the transplant team and getting information about all possible medical and surgical treatment options, including heart transplant. The team members will talk to you about many aspects of heart transplantation, including: How patients are selected for the heart transplant program Your support system and any issues that may affect your ability to be selected for a transplant Financial responsibilities associated with a transplant The importance of following your plan of care before and after your transplant Tests that you may have during your evaluation include: Blood tests Chest X-ray Urine test EKG Echocardiogram (echo) Cardiac stress test CT scan MRI Right heart catheterization Biopsy Ultrasound Pulmonary function test Endoscopy General health screening Psychosocial evaluation You will get detailed information about your evaluation and the testing after they are scheduled. After you complete your evaluation, your test results and other information will be reviewed by a committee to determine if you are a good candidate for a heart transplant and in need of one at this time. If you are accepted into Cleveland Clinic’s heart transplant program, your information will be forwarded to the Ohio Solid Organ Transplant Consortium (OSOTC) for approval. Your insurance company must also approve the transplant. After you are fully approved for a transplant, you will be placed on the United Network for Organ Sharing (UNOS) national waiting list. Step 3: Waiting for transplant Being placed on the UNOS waiting list does not guarantee you will get a heart transplant. It is critical that you follow your plan of care and do not miss any follow-up appointments. The organs used for transplant are based on criteria from UNOS and include: How sick you are How long you have been waiting for a transplant Your height and weight Your blood type Step 4: Getting a transplant The heart transplant national allocation system is based on medical urgency and currently has 6 active tiers. The first 3 tiers are the most urgent and usually require hospitalization and life support while the other tiers are for more stable patients. Details of each tier are below.  Status 1 Venous-arterial Extracorporeal Membrane Oxygenation (VA ECMO) Surgically implanted, non-endovascular Biventricular assist device (Bi-VAD) Mechanical circulatory support (MCS) with ventricular arrhythmias Status 2 Surgically implanted, non-endovascular left ventricular assist device (LVAD) Intra-aortic balloon pump (IABP) Ventricular arrhythmias requiring electrical cardioversion despite IV antiarrhythmics MCS with device malfunction/failure Total artificial heart, Bi-VAD, right ventricular assist device, or ventricular assist device for single ventricle pts. Percutaneous endovascular MCS Status 3 Outpatient LVAD for 30 days Multiple inotropes or single high-dose inotrope with hemodynamic monitoring VA ECMO after 7 days; percutaneous endovascular MCS or IABP after 14 days Surgically implanted, non-endovascular LVAD after 14 days (hospitalized) MCS with one of the following: device infection hemolysis pump thrombosis right heart failure mucosal bleeding aortic insufficiency Status 4 Outpatient LVAD Inotropes without hemodynamic monitoring Retransplant Diagnosis of one of the following: Congenital heart disease Ischemic heart disease with intractable angina Hypertrophic cardiomyopathy Restrictive cardiomyopathy Mucosal bleeding Amyloidosis Status 5 On the waitlist for at least one other organ at the same hospital Status 6 All remaining active candidates Step 5: After your transplant Your recovery in the hospital You will stay in the hospital about 12 days after your heart transplant. Your stay may be shorter or longer, depending on how quickly you recover. Your recovery starts in a cardiovascular intensive care unit (CVICU), where you will be closely monitored around the clock. You will complete your recovery on a special heart transplant patient recovery floor. Your recovery after you leave the hospital The goal of your recovery is to have an active life; however you will need to limit some activities as you continue your recovery at home. Your doctor will talk to you about these restrictions and when you will be able to get back to a normal routine. You will have regular follow-up appointments, testing and biopsies to check for any signs of organ rejection, infection or other problems. If you do have a problem, you may need to have more frequent visits or be admitted to the hospital for treatment or surgery. Following your plan of care The success of your transplant depends very heavily on how well you follow your plan of care. This includes: Taking all medications exactly as prescribed Keeping all follow-up appointments Having blood tests or other tests on time Following your recommended diet and fluid guidelines Following your activity guidelines Following all other medical advice and instructions from your transplant team Contacting your post-transplant coordinator right away is you have any issues or concerns Preventing infection Your risk of infection and cancer are higher after a heart transplant because one of the medications you need to take weakens your immune system. It is important to avoid being around people who have an infection and to call your doctor right away if you have any signs of infection. Your doctor will talk to you about what these signs and symptoms are. Heart Transplant Rejection Organ rejection is one of the risks of a heart transplant procedure. It is possible that your body will reject your new heart right away or over time. Regular biopsies and follow-up visits help your transplant team know if there are any signs of organ rejection. Your doctor will talk to you about the different types of rejection and the appropriate treatments for each. If your new heart is not expected to work, you may be placed back on the waiting list for a new heart. Phone 216.445.1844 Contact Us Facebook Twitter YouTube Instagram LinkedIn Pinterest Snapchat
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TitleHeart Transplantation Procedure - Health Encyclopedia - University of Rochester Medical Center
Urlhttps://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=P07974
Description
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Body/www.googletagmanager.com/ns.htmlid=GTM-W2QNSJ" height="0" width="0" style="display:none;visibility:hidden" title="GTM">
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TitleExperience a Heart Transplant in 360° | Heart Transplant | UT Southwestern Medical Center
Urlhttps://utswmed.org/conditions-treatments/heart-transplant/experience-heart-transplant-360/
DescriptionExperience a Heart Transplant in 360°
Date
Organic Position12
H1Experience a Heart Transplant in 360°
H2Our Surgeons
What to Expect During a Heart Transplant
H3UT Southwestern 360° Heart Transplant
Matthias Peltz, M.D
John Murala, M.D
Heart Transplant Program Video
The gift of a new heart
H2WithAnchorsOur Surgeons
What to Expect During a Heart Transplant
BodyExperience a Heart Transplant in 360° Appointment New Patient Appointment or 214-645-5505 Appointment New Patient Appointment or 214-645-5505 Explore Heart Transplant The first human-to-human heart transplant electrified the world in December 1967. But now 50 years later, the activities involved in a heart transplant procedure are still a mystery to most people. Now, UT Southwestern is offering an unprecedented 360˚ view.Join us for a remarkable experience and witness a heart transplant as it’s never been seen outside the operating room before – from the delivery of the donated heart to the initial surgical incision to the final close. UT Southwestern 360° Heart Transplant. A breathtaking view of a lifesaving procedure. Witness medical history with UT Southwestern.This video is graphic in nature. Viewer discretion is advised.Best viewed on the latest versions of Google Chrome, Microsoft Edge, and Firefox. 3D features on iPhone require the Vimeo app. “About 3,000 people have a heart transplant every year. It’s never routine, and time is usually of the essence. But it’s always exciting to see that first heartbeat again from the donor heart.” Our Surgeons. Our team’s specialized skills and training enable us to treat even the most complex cases of heart failure, including patients with other serious medical conditions and those in need of a simultaneous heart-lung or heart-kidney transplantation. We are one of the few medical centers in Texas that have performed a heart-liver transplant, a complicated procedure in which a newly implanted heart must withstand the stress of a liver transplant and the toxins released from the donor organ. UT Southwestern accepts many patients who have been turned away by other centers. Matthias Peltz, M.D. Dr. Peltz, Associate Professor of Cardiovascular and Thoracic Surgery and Surgical Director of Cardiac Transplantation at UT Southwestern, is a board-certified cardiothoracic surgeon and treats patients with surgical heart disease. He is especially interested in coronary artery bypass grafting and heart transplantation. Meet Dr. Peltz John Murala, M.D. Dr. Murala, Assistant Professor of Cardiovascular and Thoracic Surgery, is a fellowship-trained cardiothoracic surgeon specializing in heart transplant surgery, lung transplant surgery, adult congenital heart surgery, and advanced cardiac therapies. He also specializes in Ex vivo lung perfusion (EVLP) or artificial lung support. Meet Dr. Murala Our team carefully coordinates the heart transplant surgery. The process involves removing the heart from the donor, preparing it for implant, and suturing the new organ into the recipient. Heart Transplant Program Video. As a leading transplant center in North Texas, we have the experience and expertise that lead to excellent patient outcomes. Our three-year survival rate surpasses the national average for heart transplantation. Learn about our Heart Transplant Program What to Expect During a Heart Transplant. The goal of heart transplantation is to both prolong and improve quality of life. After a thorough evaluation, if our multidisciplinary team believes that a heart transplant is a patient’s best treatment option – and the patient wishes to pursue this option – his or her name is added to the national United Network for Organ Sharing (UNOS) waiting list. Wait times can range from days to months.When a suitable donor is found, most patients are in the operating room within hours. Time is of the essence.After transplant, extensive after care is needed to provide the best outcome. Our transplant team provides patients with extended medical management, care, and support.Learn more about the heart transplant process. The gift of a new heart. Gary Thomas’ heart was only functioning at 8 percent when he was placed on a transplant list. One year later, after undergoing a heart transplant that was filmed in 360 degree format and broadcast around the world, Thomas is thankful for his second chance at life.
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TitleWhen Your Child Needs a Heart Transplant (for Parents) - Nemours KidsHealth
Urlhttps://kidshealth.org/en/parents/heart-transplant.html
DescriptionIf your child needs a heart transplant, you're probably feeling lots of emotions. Fortunately, many kids who undergo heart transplants go on to live normal, healthy lives
Date
Organic Position13
H1When Your Child Needs a Heart Transplant
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H3What Is a Heart Transplant?
What Happens Before a Heart Transplant?
What Happens During Heart Transplant Surgery?
What Happens After Heart Transplant Surgery?
What Problems Can Happen?
Looking Ahead
How Can I Help My Child?
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BodyWhen Your Child Needs a Heart Transplant Reviewed by: Easton Kernich, MSN, NP-C Heart Transplant Program at Nemours Children's Health Listen Play Stop   Volume   mp3 Settings Close Player Larger text sizeLarge text sizeRegular text size Print en español Si su hijo necesita un trasplante de corazón What Is a Heart Transplant? A heart transplant is a surgery in which doctors remove a person's sick heart and replace it with a healthy donor heart. Transplants are done when a child's heart does not work well and he or she won't survive without a new one. Doctors sometimes call this heart failure, or end-stage pediatric heart disease. They usually first try to treat heart failure with medicine, surgery, or other procedures. If those don't work, a child might need a heart transplant. Transplanted hearts come from organ donors who have agreed (or their guardians have agreed) to donate their organs when they die. They choose to donate the organs because they want to help someone else who is sick. Many kids who have heart transplants go on to live normal, healthy lives after they recover from surgery. They will take medicines for the rest of their lives to prevent the body from rejecting the heart. Rejecting means that the body's immune cells attack the new heart because they sense that it's foreign. What Happens Before a Heart Transplant? If your child needs a heart transplant, your doctor will refer you to a transplant center. There, you'll meet the members of the transplant team, which usually includes: surgeons cardiologists (heart doctors) a transplant coordinator nurses dietitians psychologists social workers The health care team will check to make sure that your child is healthy enough to have surgery and take the medicines needed after it. The team will do tests such as: blood tests: to determine blood type an echocardiogram: a test in which sound waves make an image of the heart an electrocardiogram (also known as an ECG or EKG): a test that records the electrical activity of the heart and can help find arrhythmias and heart muscle damage cardiac catheterization: a procedure in which a thin, plastic tube called a catheteris put into a blood vessel and then threaded through to the heart so doctors can view the heart and its chambers The doctor also might do a biopsy, removing a tiny piece of tissue from the heart to examine under a microscope. The transplant evaluation lets the team learn as much about your child as possible. But it's also a time for you and your child to learn about what will happen before, during, and after the transplant. The transplant team is there to provide information and support. Be sure to ask if you don't understand something. If the transplant team decides your child is a good candidate, the next step is to find a heart. Your child's name will go on an organ waiting list. This list has the names of everyone who is waiting for a heart or other organs. Your child might have to wait to find a heart that is a good match. The need for new hearts is far greater than the number donated, so this can take a long time. You'll stay in close touch with the doctors and the rest of the health care team. Make sure they know how to reach you at all times. When a heart is available, you'll need to move quickly. Keep a bag packed and be ready to go to the transplant hospital at a moment's notice. While you wait for a transplant, keep your child as healthy as possible. That way, he or she will be ready for transplant surgery when the time comes. Help your child: eat healthy foods take all medicines as directed keep all medical appointments Tell your doctor and the transplant center right away if is any change in your child's health. What Happens During Heart Transplant Surgery? When you get to the hospital, the transplant team will prepare your child for surgery. They may run a few tests to be sure that the new heart is a good match. Then, your child goes to an operating room. In the operating room, your child will get anesthesia to sleep through the operation. The surgeon makes an incision (cut) in the chest and removes the sick heart. The new heart is placed in the chest, and the surgeon connects it by sewing its blood vessels to the blood vessels in your child's body. So that doctors can check heart function, the incision might not be closed right away. Most heart transplant surgeries last between 4 and 6 hours. Someone on the transplant team will keep you informed about how the surgery is going while you wait. p What Happens After Heart Transplant Surgery? After heart transplant surgery, your child be in the cardiac intensive care unit (CICU). You can visit your child there for brief periods. Your child will get medicine for pain. He or she will stay asleep on the ventilator with a breathing tube in place until the doctors know that the new heart is working well. This may take a few days. How long your child will be in the CICU depends on his or her condition. Generally, the stay is 7 to 10 days. When ready, your child will be transferred to the general cardiac ward. The transplant team will continue to care for and closely watch your child. Most children stay in the hospital at least 3 to 4 weeks after surgery. During this time, kids and their families learn how to care for the new heart. Be sure you understand the doctors' instructions because your child will need to follow them carefully. In the weeks after your child goes home, you'll return to the hospital many times so that the doctors can make sure that everything is going well. What Problems Can Happen? One of the most common problems after transplant surgery is rejection. Rejection happens because the body doesn't recognize the new heart and doesn't know that it is helpful. So the immune system tries to attack it. Medicines (called immunosuppressants, or anti-rejection medicines) help to control this reaction. In a sense, they trick the body into accepting the new heart. Taking them can make your child more likely to get infections, especially in the days right after surgery. So keep your child away from sick people, and have everyone at home wash their hands well and often. The risk of rejection is greatest in the first few weeks after transplant surgery. But the body never completely accepts the new heart. So anti-rejection medicines are taken for life. Usually, the amount of immunosuppressants taken is reduced as the body gets used to the new heart. Rarely, the body refuses to accept the new organ and another transplant is needed. Looking Ahead. Many kids who have heart transplants live normal, healthy lives after they recover from surgery. Some feel better than they ever have before. It's very important for you and your child to do everything possible to keep the new heart healthy. Make sure that your child takes all medicines as directed, and encourage him or her to get plenty of rest, exercise regularly, and eat well. Also, watch your child for signs of infection or rejection, including: fever tiredness trouble breathing vomiting weight gain poor appetite Call your doctor right away if these or any other problems happen. Your child will have regular checkups so doctors can watch for problems. At first, these visits might happen weekly. You'll go less often over time. Eventually, checkups might be needed only once or twice a year. How Can I Help My Child? Having a serious condition can be hard for kids. Surgery and immunosuppressant therapy can add to the stress. Talk to your child about these changes and how you will work them into your routine. Make sure to find time to do fun things together with family and friends. For teens, immunosuppressant therapy can be a challenge. These medicines can cause: more acne weight gain These side effects are a major reason why teens are at risk for not taking their medicines after a transplant. This can be dangerous and even lead to rejection of the new heart. So be sure to talk about the importance of taking all medicines as directed. To help: Be there for your child to talk to. If your child needs more support, make an appointment with a therapist or counselor. Find a support group. They're a great way for kids and teens to relieve stress and connect with others who are going through similar challenges. Online resources include Transplant Living. Get support for yourself too. It can be a huge relief to talk about your feelings with other people who know what you're going through. Ask the transplant care team if they know of support groups for families. Reviewed by: Easton Kernich, MSN, NP-C Date reviewed: November 2018 /content/kidshealth/misc/medicalcodes/parents/articles/heart-transplant
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TitleHeart Transplant Surgery | Stanford Health Care
Urlhttps://stanfordhealthcare.org/medical-treatments/h/heart-transplant/what-to-expect/surgery.html
DescriptionLearn all about the heart transplant surgery process, beginning after a donor heart becomes available
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BodyTransplant Surgery. As soon as a donor heart becomes available you will be contacted by the transplant surgeon. Once you arrive at the hospital you will have an IV placed, blood drawn, and receive a chest x-ray. The surgeon and an anesthesiologist will see you and take your medical history. The surgeon will review the surgical procedure and the risks of the operation with you and your family. There is usually several hours of wait time between notification of donor availability and the actual procedure. Once it is time for your operation, a team of anesthesiologists will take you to the operating room where you will have additional special IVs placed. You will then be given medications to put you to sleep. A breathing tube will be placed into your airway to help you breathe and a urinary catheter will be placed to drain your bladder during the surgery. As the surgery begins an incision will be made in the midline of your chest. A heart-lung bypass machine will take over the work of the heart and lungs. While this is occurring another team of surgeons will travel to the donor's hospital. Once there, the team will examine the donor's heart to make absolutely certain that it is a suitable match. Once the donor team arrives with your new heart the diseased heart will be removed and replaced with the healthy donor organ. The operation usually lasts between five and six hours, but can last longer if you have had previous open-heart surgery or have a left ventricular assist device in place. Previous Section Next Section Home Close Doctors Clinics & Locations Conditions & Treatments Clinical Trials MyHealth Login Patients & Visitors Billing Insurance Financial Assistance Medical Records Contact Us Video Visits Get a Second Opinion COVID-19 Resource Center Healthcare Professionals Referring Physicians Nursing Allied Healthcare About Us Quality & Safety Careers Newsroom Make a Donation Stanford Health Care Now Close
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TitleFAQ: Heart Transplant | Patient Education | UCSF Health
Urlhttps://www.ucsfhealth.org/education/faq-heart-transplant
DescriptionFind answers to common questions about heart transplants, from how to know if you need a transplant to how long the waiting list might be
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H2How do I know if I need a transplant?
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Will my insurance pay for the transplant and follow-up care?
Is there a support group for patients going through transplant?
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H2WithAnchorsHow do I know if I need a transplant?
How will a transplant change my life?
Is the evaluation very difficult?
How long is the waiting list?
What happens when an organ is available?
Is the surgery very complicated?
How long will I be hospitalized after the transplant?
Do I have to stay near the hospital after the transplant?
Will I have pain after the surgery?
Can my family stay with me?
What will my scars look like?
What medications will I take after the transplant surgery?
When can I drive?
When can I return to work?
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Will my insurance pay for the transplant and follow-up care?
Is there a support group for patients going through transplant?
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BodyFAQ: Heart Transplant Related Conditions Heart Transplant Heart Failure How do I know if I need a transplant? How will a transplant change my life? Is the evaluation very difficult? How long is the waiting list? What happens when an organ is available? Is the surgery very complicated? How long will I be hospitalized after the transplant? Do I have to stay near the hospital after the transplant? Will I have pain after the surgery? Can my family stay with me? What will my scars look like? What medications will I take after the transplant surgery? When can I drive? When can I return to work? How long does it take to fully recover? Will my insurance pay for the transplant and follow-up care? Is there a support group for patients going through transplant? How do I know if I need a transplant? Some patients with severe heart disease may benefit from transplantation. Your cardiologist or pulmonary medicine specialist may refer you to a transplant center for an evaluation. The purpose of the evaluation is two-fold: To determine the severity of your disease and whether there are any more conventional treatments To determine whether you would be able to survive the transplant operation and have a good long-term result afterwards How will a transplant change my life? A successful transplant will dramatically improve your symptoms of heart disease. Many transplant recipients can perform the same physical activities and enjoy the same quality of life as those without transplants. All transplant recipients, however, are committed to daily drug treatment and close medical supervision for the rest of their lives. Is the evaluation very difficult? The transplant evaluation is very thorough. In addition to specific heart assessment, tests are performed to determine the function of all the major organ systems, screen for infectious diseases and cancer, and try and predict how well you and your family will cope with the rigors of the transplant regimen. Many of the tests, even the complex ones, are fairly standardized and can be performed in your local community. Some tests may require you to be briefly admitted to a hospital. Every potential candidate must make at least one outpatient visit to UCSF Medical Center to meet with the transplant doctors, coordinators and social worker. Typically, most of the evaluation can be completed within a week or two. The transplant team meets weekly to discuss patient evaluations and make decisions on appropriate treatment. Patients who are felt to be good candidates for transplantation are then put on a national waiting list. How long is the waiting list? Unfortunately, the waiting times for heart transplants are long – often more than six months. Each patient on our waiting list returns for an outpatient visit to our transplant clinic every two to three months, or more frequently if necessary. While many patients can wait at home, sometimes it is necessary for patients to be admitted to the hospital in order to remain in satisfactory condition until transplantation. What happens when an organ is available? When the transplant team decides that a potential donor is suitable for one of our recipients, we contact the patient as soon as possible. Since it is not possible to predict when a suitable organ will become available and there is a limited amount of time to recover the organs successfully, it is very important that we be able to locate recipients quickly and get them into the hospital in a timely fashion. Is the surgery very complicated? This depends on each patient's specific situation. During the evaluation interview, the transplant surgeon will review the details of the surgical procedure, the risks of the procedure and the expected recovery after surgery. How long will I be hospitalized after the transplant? This depends on your specific situation. Although patients can recover sufficiently after heart transplantation to be discharged within 10 days, it is more typical for patients to be hospitalized for two weeks or more. Do I have to stay near the hospital after the transplant? We require all patients to be within 30 minutes driving distance of the transplant center for the first six weeks post discharge. The frequency of follow-up visits and lab tests during this interval can be a problem for patients who live far away. The social worker can help you locate suitable guest housing in the area. Will I have pain after the surgery? Generally, most patients do not report a lot of pain after heart transplant surgery. The incision does cause pain or discomfort when you cough. We will give you pain medication and specific instructions to lessen the pain. Can my family stay with me? Your family can accompany you until you go into the transplant surgery. While you are in the intensive care unit, family members may not stay in your room. If you need assistance finding guest housing, a social worker will help you. We have very open visiting hours and encourage family members to spend time with you. However, in order to protect you from infection, anyone who is ill – with a cold or flu, for example – should not visit. What will my scars look like? The scar is down the center of the chest. It starts at the noch, or top of the sternal bone, just under your neck, and ends just past the end of the sternal bone. Initially the scar is more prominent. Over time, it will fade to a very light, thin line. What medications will I take after the transplant surgery? You will be on three main immunosuppressive, or anti-rejection, medications after your heart transplant. Along with the immunosuppressive medications you will need to take several medications that help protect your body from infection. When can I drive? After heart transplantation, you can drive when your sternum, or breastbone, is fully healed. This takes about six weeks. When can I return to work? You may return to work two to three months after the transplant surgery. How long does it take to fully recover? It generally takes three to six months to fully recover from heart transplant surgery. However, age and previous medical problems may cause a longer recovery period. Will my insurance pay for the transplant and follow-up care? We have a financial counselor who will verify your insurance coverage. We will obtain authorization for your transplant and follow-up care. Is there a support group for patients going through transplant? We have support groups for patients on the waiting list as well as for after the transplant. You will be notified of the support group meetings and the topic each month. UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider. Related clinics . Heart Transplant Program 400 Parnassus Ave., Fifth Floor San Francisco, CA 94143 (415) 353-4145 Thursdays, 8 a.m. - 5 p.m. Recommended reading . How the Heart Works The heart is muscular and hollow, constantly pumping blood to deliver oxygen and nutrients to the body and is comprised of four compartments. Learn more. Share. Share on Facebook Share on Twitter Email Link Copy Link
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TitleHeart Transplant - St Vincent's Heart Health
Urlhttps://www.svhhearthealth.com.au/procedures/procedures-treatments/heart-transplant
DescriptionInformation about heart transplant, including how to prepare and what happens during and after the surgery
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TitleHeart Transplant: What to Expect at Home
Urlhttps://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk5351
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TitleHeart transplant surgery | Heart and Stroke Foundation
Urlhttps://www.heartandstroke.ca/heart-disease/treatments/surgery-and-other-procedures/heart-transplant-surgery
DescriptionLearn more about the risks, outlook, preparation, and what to expect from heart transplant surgery
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BodyHeart transplant surgery Share Facebook Twitter Email Print What is heart transplant surgery? Heart transplant surgery is the removal of a failing heart and pre-existing hardware (such as an implantable cardio defibrillator or pacemakers) and its replacement by a donor heart. Why is it done? Heart transplant is used to treat severe, end-stage heart failure. This heart failure may be the result of damage to the heart from: Coronary artery disease, such as a heart attack. Severe, untreated hypertension (hypertensive heart disease). Heart valve problems. Infections, such as viruses. Alcohol and illicit drug use. Inherited heart disease. Congenital heart disease (a malformation of the heart a person is born with). Unknown (idiopathic). For severely ill patients, a mechanical heart (mechanical assist device) may be used temporarily while waiting for a donor heart. What is done? During the operation: A bypass machine will be used to pump blood to the rest of your body. Most of the old, failing heart will be removed. The posterior walls of both upper chambers (atria) are left in place and the new heart is attached to this remaining tissue. The blood vessels leading in and out of the heart are also attached to the new heart. (As a precaution, pacing wires may be placed on the surface of the heart, which can be connected to an external pacemaker, if necessary. Prior to discharge, these wires will be removed.) The new heart is then shocked so it will start beating and the chest is closed. What can you expect? Before the operation Once it is determined that you require a new heart, you will be evaluated to determine whether you are a good candidate for heart transplant. If you are, your name will be put on the heart transplant waiting list. Your position on the list will depend upon how ill you are, and may be moved up over time if your health changes. Once on the waiting list, you will receive a pager so you can be contacted immediately when a suitable heart becomes available. Since the donor heart has to be transplanted within hours of donation, you may want to stay prepared by making a travel plan ahead and packing a suitcase with your medication for a hospital stay. Preparation for surgery includes: blood work an electrocardiogram (ECG) a chest X-ray a urine sample an intravenous line for measuring pressure in the lung arteries. During the operation A transplant is conducted under a general anesthetic so you will be asleep throughout the procedure. Once you are sedated, the surgeons will place: a tube down your windpipe, which will be connected to a breathing machine called a respirator to support your breathing during the surgery. a tube into your stomach to stop liquid and air from collecting in your stomach so you will not feel sick and bloated when you wake up. a tube into your bladder to collect urine. The surgery usually takes about 3 to 5 hours, but it can vary. After the operation When you awaken, you will be in the intensive care unit (ICU) or cardiovascular intensive care unit (CVICU). Once you are awake and able to breathe adequately, you will be detached from the ventilator and the tube down your windpipe will be removed. Pain medication will be given to you, either intravenously or as pills. As you recover, you will be transferred to a step-down unit and then to a regular room. You can expect to stay in the hospital at least two to three weeks after surgery. Drugs to suppress your immune system (immunosuppressive therapy) will be administered to prevent your body from rejecting the donor heart. A rehabilitation program will be designed to help your recovery. At home Upon returning home, you should watch for possible signs of infection, such as:  fever sore throat shortness of breath coughing cold sores flu-like symptoms or feeling unwell redness, swelling or drainage from your incision. Possible signs of rejection of the donor heart include: shortness of breath weight gain fever fatigue. Most patients continue to receive follow-up care for several months after they return home. Cardiac rehabilitation Cardiac rehab is a personalised program of exercise, education and counselling to help you recover from heart disease. Rehab will help you regain your strength and reduce your risk of having other problems in the future. Talk to your doctor about rehab. Lifestyle changes can help Healthy choices can help you manage heart disease. Get practical tips and advice from Heart & Stroke experts on how to get healthy. Learn how to: Eat well Get moving Maintain a healthy weight Stop smoking Manage your stress    Talk to your healthcare provider about the lifestyle changes that will benefit you the most. Related information It’s normal to feel worried or afraid after a diagnosis of heart disease. Find someone you can turn to for emotional support like a family member, friend, doctor, mental health worker or support group. Talking about your emotions and feelings could be an important part of your journey to recovery.  The recovery & support  section is full of practical advice and tips to support you on your recovery journey. Find peer support resources here. Download or order our free book Living Well With Heart Diseases. Join our community of survivors by signing up for our recovery newsletter. You will get the latest research news, information, tips and strategies to help you manage your recovery.  To find useful services to help you on your journey with heart disease, see the Heart & Stroke services and resources listing.  
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TitleHeart transplantation - Wikipedia
Urlhttps://en.wikipedia.org/wiki/Heart_transplantation
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BodyHeart transplantation From Wikipedia, the free encyclopedia Jump to navigation Jump to search Surgical transplant procedure This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed.Find sources: "Heart transplantation" – news · newspapers · books · scholar · JSTOR (January 2020) (Learn how and when to remove this template message) Heart transplantationland illustrating the placement of a donor heart in an orthotopic procedure. Notice how the back of the patient's left atrium and great vessels are left in place.SpecialtycardiologyICD-9-CM37.51MeSHD016027MedlinePlus003003[edit on Wikidata] A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. As of 2018[update], the most common procedure is to take a functioning heart, with or without both lungs, from a recently deceased organ donor (brain death is the standard[1]) and implant it into the patient. The patient's own heart is either removed and replaced with the donor heart (orthotopic procedure) or, much less commonly, the recipient's diseased heart is left in place to support the donor heart (heterotopic, or "piggyback", transplant procedure). Approximately 3,500 heart transplants are performed each year worldwide, more than half of which are in the US.[2] Post-operative survival periods average 15 years.[3] Heart transplantation is not considered to be a cure for heart disease; rather it is a life-saving treatment intended to improve the quality and duration of life for a recipient.[4] Contents. 1 History 2 Contraindications 3 Complications 3.1 Rejection 4 Prognosis 5 See also 6 References 7 External links History[edit]. American medical researcher Simon Flexner was one of the first people to mention the possibility of heart transplantation. In 1907, he wrote the paper "Tendencies in Pathology," in which he said that it would be possible one day by surgery to replace diseased human organs – including arteries, stomach, kidneys and heart.[5] Not having a human donor heart available, James D. Hardy of the University of Mississippi Medical Center transplanted the heart of a chimpanzee into the chest of dying Boyd Rush in the early morning of Jan. 24, 1964. Hardy used a defibrillator to shock the heart to restart beating. This heart did beat in Rush's chest for 60 to 90 minutes (sources differ), and then Rush died without regaining consciousness.[6][7][8] Although Hardy was a respected surgeon who had performed the world's first human-to-human lung transplant a year earlier,[9][10] author Donald McRae states that Hardy could feel the "icy disdain" from fellow surgeons at the Sixth International Transplantation Conference several weeks after this attempt with the chimpanzee heart.[11] Hardy had been inspired by the limited success of Keith Reemtsma at Tulane University in transplanting chimpanzee kidneys into human patients with kidney failure.[12] The consent form Hardy asked Rush's stepsister to sign did not include the possibility that a chimpanzee heart might be used, although Hardy stated that he did include this in verbal discussions.[7][12][13] A xenotransplantation is the technical term for the transplant of an organ or tissue from one species to another. The world's first human-to-human heart transplant was performed by South African cardiac surgeon Christiaan Barnard utilizing the techniques developed by American surgeons Norman Shumway and Richard Lower.[14][15] Patient Louis Washkansky received this transplant on December 3, 1967, at the Groote Schuur Hospital in Cape Town, South Africa. Washkansky, however, died 18 days later from pneumonia.[14][16][17] On December 6, 1967, at Maimonides Hospital in Brooklyn, New York, Adrian Kantrowitz performed the world's first pediatric heart transplant.[14][18] The infant's new heart stopped beating after 7 hours and could not be restarted. At a following press conference, Kantrowitz emphasized that he did not consider the operation a success.[19] Norman Shumway performed the first adult heart transplant in the United States on January 6, 1968, at the Stanford University Hospital.[14] A team led by Donald Ross performed the first heart transplant in the United Kingdom on May 3, 1968.[20] These were allotransplants, the technical term for a transplant from a non-genetically identical individual of the same species. Brain death is the current ethical standard for when a heart donation can be allowed. Worldwide, more than 100 transplants were performed by various doctors during 1968.[21] Only a third of these patients lived longer than three months.[22] The next big breakthrough came in 1983 when cyclosporine entered widespread usage. This drug enabled much smaller amounts of corticosteroids to be used to prevent many cases of rejection (the "corticosteroid-sparing" effect of cyclosporine).[23] On June 9, 1984, "JP" Lovette IV of Denver, Colorado, became the world's first successful pediatric heart transplant. Columbia-Presbyterian Medical Center surgeons transplanted the heart of 4-year-old John Nathan Ford of Harlem into 4-year-old JP a day after the Harlem child died of injuries received in a fall from a fire escape at his home. JP was born with multiple heart defects. The transplant was done by a surgical team led by Dr. Eric A. Rose, director of cardiac transplantation at New York–Presbyterian Hospital. Drs. Keith Reemtsma and Fred Bowman also were members of the team for the six-hour operation.[24] In 1988, the first "domino" heart transplant was performed, in which a patient in need of a lung transplant with a healthy heart will receive a heart-lung transplant, and their original heart will be transplanted into someone else.[25] Worldwide, about 3,500 heart transplants are performed annually. The vast majority of these are performed in the United States (2,000–2,300 annually).[2] Cedars-Sinai Medical Center in Los Angeles, California, currently is the largest heart transplant center in the world, having performed 132 adult transplants in 2015 alone.[26] About 800,000 people have NYHA Class IV heart failure symptoms indicating advanced heart failure.[27] The great disparity between the number of patients needing transplants and the number of procedures being performed spurred research into the transplantation of non-human hearts into humans after 1993. Xenografts from other species and artificial hearts are two less successful alternatives to allografts.[3] The ability of medical teams to perform transplants continues to expand. For example, Sri Lanka's first heart transplant was successfully performed at the Kandy General Hospital on July 7, 2017.[28] In recent years, donor heart preservation has improved and Organ Care System is being used in some centers in order to reduce the harmful effect of cold storage.[29] During heart transplant, the vagus nerve is severed, thus removing parasympathetic influence over the myocardium. However, some limited return of sympathetic nerves has been demonstrated in humans.[30]{{{1}}} Recently, Australian researchers found a way to give more time for a heart to survive prior to the transplant, almost double the time.[31] Contraindications[edit]. Some patients are less suitable for a heart transplant, especially if they suffer from other circulatory conditions related to their heart condition. The following conditions in a patient increase the chances of complications. Absolute contraindications: Advanced kidney, lung, or liver disease[citation needed] Active cancer if it is likely to impact the survival of the patient Life-threatening diseases unrelated to the cause of heart failure, including acute infection or systemic disease such as systemic lupus erythematosus, sarcoidosis, or amyloidosis Vascular disease of the neck and leg arteries. High pulmonary vascular resistance – over 5 or 6 Wood units. Relative contraindications: Insulin-dependent diabetes with severe organ dysfunction Recent thromboembolism such as stroke Severe obesity Age over 65 years (some variation between centers) – older patients are usually evaluated on an individual basis. Active substance use disorder, such as alcohol, recreational drugs or tobacco smoking (which increases the chance of lung disease) [32] Patients who are in need of a heart transplant but do not qualify may be candidates for an artificial heart[2] or a left ventricular assist device (LVAD). Complications[edit]. Potential complications include:[33] Post-operative complications include infection, sepsis. The surgery death rate was 5–10% in 2011.[34] Acute or chronic graft rejection Cardiac allograft vasculopathy Atrial arrhythmia Lymphoproliferative malignancy Increased risk of secondary infections due to immunosuppressive medication Serum sickness due to anti-thymocyte globulin Tricuspid valve regurgitation Repeated endomyocardial biopsy can cause Bleeding and thrombosis [35] Rejection[edit]. Since the transplanted heart originates from another organism, the recipient's immune system typically attempts to reject it. The risk of rejection never fully goes away, and the patient will be on immunosuppressive drugs for the rest of their life. These drugs may cause unwanted side effects, such as an increased likelihood of infections or the development of certain cancers. Recipients can acquire kidney disease from a heart transplant due to the side effects of immunosuppressant medications. Many recent advances in reducing complications due to tissue rejection stem from mouse heart transplant procedures.[36] People who have had heart transplants are monitored in various ways to test for the development of rejection.[37] Prognosis[edit]. The prognosis for heart transplant patients following the orthotopic procedure has improved over the past 20 years, and as of June 5, 2009 the survival rates were:[38] 1 year: 88.0% (males), 86.2% (females) 3 years: 79.3% (males), 77.2% (females) 5 years: 73.2% (males), 69.0% (females) In 2007, researchers from the Johns Hopkins University School of Medicine discovered that "men receiving female hearts had a 15% increase in the risk of adjusted cumulative mortality" over five years compared to men receiving male hearts. Survival rates for women did not significantly differ based on male or female donors.[39] See also[edit]. Artificial heart Biological pacemaker Xenotransplantation References[edit]. ^ Kilic A, Emani S, Sai-Sudhakar CB, Higgins RS, Whitson BA, et al. (2014). "Donor selection in heart transplantation". Journal of Thoracic Disease. 6 (8): 1097–1104. doi:10.3978/j.issn.2072-1439.2014.03.23. PMC 4133543. PMID 25132976. ^ a b c Cook JA, Shah KB, Quader MA, et al. (2015). "The total artificial heart". Journal of Thoracic Disease. 7 (12): 2172–80. doi:10.3978/j.issn.2072-1439.2015.10.70. PMC 4703693. PMID 26793338. ^ a b Till Lehmann (director) (2007). The Heart-Makers: The Future of Transplant Medicine (documentary film). Germany: LOOKS film and television. ^ Burch M.; Aurora P. (2004). "Current status of paediatric heart, lung, and heart-lung transplantation". Archives of Disease in Childhood. 89 (4): 386–89. doi:10.1136/adc.2002.017186. PMC 1719883. PMID 15033856. ^ May Transplant the Human Heart (.PDF), The New York Times, January 2, 1908. ^ Hardy James D.; Chavez Carlos M.; Kurrus Fred D.; Neely William A.; Eraslan Sadan; Turner M. Don; Fabian Leonard W.; Labecki Thaddeus D. (1964). "Heart Transplantation in Man". JAMA. 188 (13). doi:10.1001/jama.1964.03060390034008. ^ a b Every Second Counts: The Race to Transplant the First Human Heart, Donald McRae, New York: Penguin (Berkley/Putnam), 2006, Ch. 7 "Mississippi Gambling", pp. 123–27. This source states the heartbeat for approximately one hour. ^ James D. Hardy, 84, Dies; Paved Way for Transplants, Obituary, New York Times (Associated Press), Feb. 21, 2003. This source states the transplanted chimpanzee heartbeat for 90 minutes. ^ Hardy James D (1963). "Lung Homotransplantation in Man". JAMA. 186 (12): 1065–74. doi:10.1001/jama.1963.63710120001010. PMID 14061414. See also Griscom NT (1963). "Lung Transplantation". JAMA. 186 (12): 1088. doi:10.1001/jama.1963.03710120070015. PMID 14061420. in same issue. ^ Second Wind: Oral Histories of Lung Transplant Survivors, Mary Jo Festle, Palgrave MacMillan, 2012. ^ Every Second Counts, McRae, page 126, top. ^ a b Cooper DK (2012). "A brief history of cross-species organ transplantation". Proc (Bayl Univ Med Cent). 25 (1): 49–57. doi:10.1080/08998280.2012.11928783. PMC 3246856. PMID 22275786. ' … the consent form for Hardy's operation – which, in view of the patient's semi-comatose condition, was signed by a close relative – stipulated that no heart transplant had ever been performed, but made no mention of the fact that an animal heart might be used for the procedure. Such was the medicolegal situation at that time that this "informed" consent was not considered in any way inadequate. . ' ^ Xenotransplantation: Law and Ethics, Sheila McLean, Laura Williamson, University of Glasgow, UK, Ashgate Publishing, 2005, p. 50. ^ a b c d McRae, D. (2006). Every Second Counts: The Race to Transplant the First Human Heart, New York: Penguin (Berkley/Putnam). ^ Norman Shumway: Father of heart transplantation who also performed the world's first heart-lung transplant, Obituary, The Independent [UK], 16 Feb. 2006. ^ "Memories of the Heart". Daily Intelligencer. Doylestown, Pennsylvania. November 29, 1987. p. A–18. ^ "Pneumonia Blamed in Transplant Patient's Death". The New York Times. 1967-12-21. Retrieved 2018-01-08. ^ Lyons, Richard D. "Heart Transplant Fails to Save 2-Week-old Baby in Brooklyn; Heart Transplant Fails to Save Baby Infants' Surgery Harder Working Side by Side Gives Colleague Credit", The New York Times, December 7, 1967. Accessed November 19, 2008. ^ Heart: An American Medical Odyssey, Dick Cheney, Richard B. Cheney, Jonathan Reiner, MD, with Liz Cheney, Scribner (division of Simon & Schuster), 2013. "Three days later, on December 6, 1967, Dr. Adrian Kantrowitz" ^ Tilli Tansey; Lois Reynolds, eds. (1999). Early heart transplant surgery in the UK. Wellcome Witnesses to Contemporary Medicine. History of Modern Biomedicine Research Group. ISBN 978-1-84129-007-2. Wikidata Q29581627. ^ Major Medical Milestones Leading Up To the First Human Heart Transplantation, Kate Elzinga, from Proceedings of the 18th Annual History of Medicine Days Conference 2009: The University of Calgary Faculty of Medicine, Alberta, Canada, Cambridge Scholars Publishing, 2011. " . . following Barnard's landmark heart transplantation on December 3, 1967, 107 human heart transplants were performed by 64 surgical teams in 24 countries in 1968. . " ^ The Adrian Kantrowitz Papers, Replacing Hearts: Left Ventricle Assist Devices and Transplants, 1960–1970, National Institutes of Health, U.S. National Library of Medicine. ^ Transplantation of the heart: An overview of 40 years' clinical and research experience at Groote Schuur Hospital and the University of Cape Town, South African Medical Journal, "Part I. Surgical experience and clinical studies." J Hassoulas, Vol. 102, No. 6 (2012). ^ "Talk About a Guy With a Lot of Heart 1st kid to get new ticker wants to be doc" NY Daily News, 13 April 2003 ^ Raffa, G.M.; Pellegrini, C.; Viganò, M. (November 2010). "Domino Heart Transplantation: Long-Term Outcome of Recipients and Their Living Donors: Single Center Experience". Transplantation Proceedings. 42 (9): 3688–93. doi:10.1016/j.transproceed.2010.09.002. PMID 21094839. ^ "SRTR – Scientific Registry of Transplant Recipients". www.srtr.org. Archived from the original on 2016-10-25. Retrieved 2016-10-24. ^ Reiner Körfer (interviewee) (2007). The Heart-Makers: The Future of Transplant Medicine (documentary film). Germany: LOOKS film and television. ^ First ever heart transplant in Sri Lanka successful, Hiru News, 9 July 2017. ^ Verzelloni Sef, A; Sef, D; Garcia Saez, D; Trkulja, V; Walker, C; Mitchell, J; McGovern, I; Stock, U (1 August 2021). "Heart Transplantation in Adult Congenital Heart Disease with the Organ Care System Use: A 4-Year Single-Center Experience". ASAIO Journal. 67 (8): 862–868. doi:10.1097/MAT.0000000000001482. PMID 34039886. S2CID 235217756. ^ Arrowood, James A.; Minisi, Anthony J.; Goudreau, Evelyne; Davis, Annette B.; King, Anne L. (1997-11-18). "Absence of Parasympathetic Control of Heart Rate After Human Orthotopic Cardiac Transplantation". Circulation. 96 (10): 3492–98. doi:10.1161/01.CIR.96.10.3492. ISSN 0009-7322. PMID 9396446. ^ https://au.news.yahoo.com/donor-hearts-given-longer-life-210410507.html ^ Mehra MR, Canter CE, Hannan MM, Semigran MJ, Uber PA, et al. The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: A 10-year update. J Heart Lung Transplant. 2016 Jan. 35 (1):1–23. ^ Ludhwani, Dipesh; Fan, Ji; Kanmanthareddy, Arun (2020). "Heart Transplantation Rejection". StatPearls. PMID 30725742. Retrieved 25 June 2020 – via NCBI Bookshelf. Cite journal requires |journal= (help) Last Update: December 23, 2019. ^ Jung SH, Kim JJ, Choo SJ, Yun TJ, Chung CH, Lee JW (2011). "Long-term mortality in adult orthotopic heart transplant recipients". J. Korean Med. Sci. 26 (5): 599–603. doi:10.3346/jkms.2011.26.5.599. PMC 3082109. PMID 21532848. ^ Rizk J, Mehra MR. Anticoagulation management strategies in heart transplantation. Prog Cardiovasc Dis. 2020;63(3):210–18. doi:10.1016/j.pcad.2020.02.002 ^ Bishay R (2011). "The 'Mighty Mouse' Model in Experimental Cardiac Transplantation". Hypothesis. 9 (1): e5. ^ Costanzo MR, Dipchand A, Starling R, Anderson A, Chan M, Desai S, Fedson S, Fisher P, et al. (2010). "The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients". The Journal of Heart and Lung Transplantation. 29 (8): 914–56. doi:10.1016/j.healun.2010.05.034. PMID 20643330. ^ Heart Disease and Stroke Statistics – 2012 Update The American Heart Association. Retrieved 27 November 2012. ^ Weiss, E. S.; Allen, J. G.; Patel, N. D.; Russell, S. D.; Baumgartner, W. A.; Shah, A. S.; Conte, J. V. (2009). "The Impact of Donor-Recipient Sex Matching on Survival After Orthotopic Heart Transplantation: Analysis of 18 000 Transplants in the Modern Era". Circulation: Heart Failure. 2 (5): 401–08. doi:10.1161/CIRCHEARTFAILURE.108.844183. PMID 19808369. External links[edit]. Standard orthotopic heart transplantation – Masters of Cardiothoracic Surgery Series Video with Comments First U.S. Human-to-Human Heart Transplant at Wayne State University Library contains high-definition images from this procedure, performed by Dr. Adrian Kantrowitz. Official Heart Transplant Museum – Heart Of Cape Town Photograph of first U.S. heart transplant Western Cape government; South Africa (21 February 2005). "Chris Barnard Performs World's First Heart Transplant". Cape Gateway. Retrieved 2007-01-10. Department of Cardiothoracic Surgery. "Patient's Guide to Heart Transplant Surgery". University of Southern California. Retrieved 2007-01-10. Nancy Reid (22 September 2005). "Heart transplant: How is it performed?". Healthwise. Archived from the original on 1 May 2007. Retrieved 2007-01-10. The Adrian Kantrowitz Papers Profiles in Science from the National Library of Medicine for Adrian Kantrowitz, the first to perform a pediatric heart transplant Orthotopic heart transplantation: the bicaval technique [1] NIH [2] Yale Medicine Heart Transplant Dr. Kewal Krishan Heart Transplant Expert in Delhi vteTests and procedures involving the heartCardiac surgery  · Interventional cardiology  · Cardiology diagnostic tests and procedures  · Cardiac imagingSurgeryHeart valvesand septa Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Percutaneous aortic valve replacement Mitral valve replacement Percutaneous pulmonary valve implantation production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock–Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of the great vessels Arterial switch operation Mustard procedure Senning procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock–Taussig shunt SVC to the right PA Glenn procedure Cardiac vessels CHD Angioplasty Bypass/Coronary artery bypass MIDCAB Off-pump CAB TECAB Coronary stent Bare-metal stent Drug-eluting stent Bentall procedure Valve-sparing aortic root replacement LeCompte maneuver Other Pericardium Pericardiocentesis Pericardial window Pericardiectomy Myocardium Cardiomyoplasty Dor procedure Septal myectomy Ventricular reduction Alcohol septal ablation Conduction system Maze procedure Cox maze and minimaze Catheter ablation Cryoablation Radiofrequency ablation Pacemaker insertion Left atrial appendage occlusion Cardiotomy Heart transplantation Tests Electrophysiology Electrocardiography Vectorcardiography Holter monitor Implantable loop recorder Cardiac stress test Bruce protocol Electrophysiology study Cardiac imaging Angiocardiography Echocardiography TTE TEE Myocardial perfusion imaging Cardiovascular MRI Ventriculography Radionuclide ventriculography Cardiac catheterization/Coronary catheterization Cardiac CT Cardiac PET sound Phonocardiogram Function tests Impedance cardiography Ballistocardiography Cardiotocography Pacing Cardioversion Transcutaneous pacing Category vteOrgan transplantationTypes Allotransplantation ABOi Autotransplantation Xenotransplantation Organs and tissues Bone Bone marrow Brain Corneal Face Hand Head Heart Heart–lung Intestine Kidney Liver Living donor Lung Pancreas Islet cell Penis Skin Spleen Thymus Uterus Vagina Medical grafting Bone grafting Skin grafting Vascular grafting Organ donation Non-heart-beating donation Organ harvesting Organ trade Complications Graft-versus-host disease Post-transplant lymphoproliferative disorder Transplant rejection Transplant networksand government departments BC Transplant Society Eurotransplant Gift of Life Marrow Registry Human Tissue Authority LifeSharers National Marrow Donor Program NOD-Lb National Transplant Organization NHS Blood and Transplant Trillium Gift of Life Network United Network for Organ Sharing Advocacy organizations Anthony Nolan Blood Cancer UK DKMS Donate Life America Halachic Organ Donor Society Kidney Foundation of Canada National Kidney Foundation ORGANIZE Joint societies American Society of Nephrology American Society of Transplantation Canadian Society of Transplantation Countries Organ transplantation in China Organ donation in India Organ transplantation in Israel Organ transplantation in Japan Gurgaon kidney scandal PeopleHeart Christiaan Barnard James D. 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Title
Urlhttps://www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/transplant-institute/heart-transplant/heart-transplant-process/post-heart-transplant-surgery
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TitleThe first human heart transplant and further advances in cardiac transplantation at Groote Schuur Hospital and the University of Cape Town
Urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4200566/
Description
Dateby JG Brink · 2009 · Cited by 73
Organic Position21
H1PMC
H2Summary
Summary
The first transplant
The second transplant
Orthotopic heart transplantation
The development of heterotopic heart transplantation
Heterotopic heart transplantation: the clinical programme
Xenotransplantation
Hypothermic perfusion storage of the donor heart
Investigations into the haemodynamic and metabolic effects of brain death
Brain death and ethical issues
Christiaan Barnard in retirement
Acknowledgments
References
Formats:
Share
H3Johan G Brink
Joannis Hassoulas
Summary
Fig. 1
Fig. 2
Table 1
H2WithAnchorsSummary
Summary
The first transplant
The second transplant
Orthotopic heart transplantation
The development of heterotopic heart transplantation
Heterotopic heart transplantation: the clinical programme
Xenotransplantation
Hypothermic perfusion storage of the donor heart
Investigations into the haemodynamic and metabolic effects of brain death
Brain death and ethical issues
Christiaan Barnard in retirement
Acknowledgments
References
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BodyPMC US National Library of Medicine National Institutes of Health Advanced Journal list Help Try out PMC Labs and tell us what you think. Learn More. Journal ListCardiovasc J Afrv.20(1); 2009 FebPMC4200566 Cardiovasc J Afr. 2009 Feb; 20(1): 31–35. PMCID: PMC4200566PMID: 19287813The first human heart transplant and further advances in cardiac transplantation at Groote Schuur Hospital and the University of Cape TownJohan G Brink, MB ChB, FCS (SA) (Cardthor)Johan G Brink, Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Groote Schuur and Associated Academic Hospitals, Cape Town;Johan G Brink. Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Groote Schuur and Associated Academic Hospitals, Cape TownFind articles by Johan G BrinkJoannis Hassoulas, MB ChB, MMed (Thor Surg), MDJoannis Hassoulas, Department of Cardiac Surgery, Medical School, University of Crete, Heraklion, Crete, Greece;Joannis Hassoulas. Department of Cardiac Surgery, Medical School, University of Crete, Heraklion, Crete, GreeceFind articles by Joannis HassoulasAuthor information Article notes Copyright and License information DisclaimerJohan G Brink: [email protected] Received 2008 Dec 7; Accepted 2009 Jan 28.Copyright © 2010 Clinics Cardive PublishingThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been cited by other articles in PMC.Summary. Summary. Christiaan (Chris) Barnard was born in 1922 and qualified in medicine at the University of Cape Town in 1946. Following surgical training in South Africa and the USA, Barnard established a successful open-heart surgery programme at Groote Schuur Hospital and the University of Cape Town in 1958. In 1967, he led the team that performed the world’s first human-to-human heart transplant. The article describing this remarkable achievement was published in the South African Medical Journal just three weeks after the event and is one of the most cited articles in the cardiovascular field. In the lay media as well, this first transplant remains the most publicised event in world medical history.Although the first heart transplant patient survived only 18 days, four of Groote Schuur Hospital’s first 10 patients survived for more than one year, two living for 13 and 23 years, respectively. This relative success amid many failures worldwide did much to generate guarded optimism that heart transplantation would eventually become a viable therapeutic option.This first heart transplant and subsequent ongoing research in cardiac transplantation at the University of Cape Town and in a few other dedicated centres over the subsequent 15 years laid the foundation for heart transplantation to become a well-established form of therapy for end-stage cardiac disease. During this period from 1968 to 1983, Chris Barnard and his team continued to make major contributions to organ transplantation, notably the development of the heterotopic (‘piggy-back’) heart transplants; advancing the concept of brain death, organ donation and other related ethical issues; better preservation and protection of the donor heart (including hypothermic perfusion storage of the heart; studies on the haemodynamic and metabolic effects of brain death; and even early attempts at xenotransplantation.Summary. Christiaan Barnard with his team, performed the world’s first human-to-human heart transplant operation on 3 December 1967. It was a major historical event and a significant breakthrough for medical science. The article describing this remarkable achievement, titled ‘A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town’ was published just three weeks after the event in a special edition of the South African Medical Journal.1 This must rank as one of the most rapidly published medical reports of all time.Media coverage around the world of this event and subsequent transplants was front page and appeared daily for weeks and months on end, describing all aspects in detail and giving progress reports on the postoperative course of the patients. This degree of public acclaim had not been previously experienced by any other physician or surgeon and nor would it be experienced subsequently. This was in part because the dramatic nature of the operation had captured the public’s imagination, but was equally a response to Chris Barnard’s youthful good looks and charismatic personality (Fig. 1). Barnard’s name and that of the University of Cape Town and Groote Schuur Hospital (Fig. 2) are inextricably associated with the first heart transplantFig. 1.Open in a separate windowChristiaan Barnard.Fig. 2.Open in a separate windowGroote Schuur at the time of the first transplant.The first transplant. On the night of 2/3 December 1967, Barnard performed the world’s first human-to-human orthotopic heart transplant in his patient, Louis Washkansky. Today, when heart transplantation has become a relatively routine and commonplace procedure, one may be inclined to underestimate Barnard’s immense courage in undertaking this first operation. Washkansky, a 53-year-old man with severe coronary insufficiency, was far from an ideal recipient by today’s standards, being a diabetic and a smoker with peripheral vascular disease. Furthermore, his massive dependent oedema had required drainage by needles placed into the subcutaneous tissues of the lower legs, and these puncture sites and accompanying stasis ulcers had become infected.On 2 December, a young white woman, Denise Darvall, sustained a massive head injury after being hit by a car and was certified as having a lethal brain injury without any chance of recovery, by the neurosurgeon who had been called to treat the patient and who eventually referred her as an organ donor. There were no laws relating to brain death and organ transplantation in South Africa at that time, as elsewhere, and Barnard elected to take no chances. He invited the State’s forensic pathologist to the operating room, where ventilation of the donor (already prepared and draped for surgery) was discontinued. The blood pressure steadily fell and the heart arrested. The medical examiner pronounced that death had occurred. Barnard’s assistants then rapidly opened the chest, initiated pump-oxygenator support, cooled the heart to a low temperature and excised it.The recipient had been prepared in the adjacent operating room and Barnard proceeded with the transplant. The enormity of what he was attempting was impressed upon him when, for the first time in his life, he looked into the chest and saw an empty pericardial cavity. The procedure went well and the heart functioned satisfactorily. No photographs were taken during the operation and so there is no visual record of this historic surgical procedure.Within 48 hours the world’s press had descended on Cape Town and Barnard had become a household name. This intense public interest resulted in the appearance of Barnard and his transplant on the front covers of Time, Life, Newsweek and many other major foreign magazines within two to three weeks of the transplant. The world’s most publicised medical event had taken place.Washkansky’s daily progress was followed intensely around the world, with almost every aspect of his care being made public. His early recovery was excellent, and the team was impressed with how rapidly the patient’s peripheral oedema was lost as his new heart functioned strongly. This excellent progress continued for almost two weeks, when Washkansky’s condition began to deteriorate and he developed radiographic infiltrates in the lungs. The surgical team was uncertain whether these were due to pulmonary oedema associated with cardiac failure from rejection, or with infection. Mistakenly, they initially elected to treat for rejection, intensifying the immunosuppressive therapy. This step was a lethal error as the patient had developed bilateral pneumonia, which was aggravated by the enhanced immunosuppression, and he unfortunately succumbed from severe pneumonia and septicaemia on the 18th day post-operatively.The second transplant. Not daunted by this failure, Barnard immediately selected his second patient, a 59-year-old local dental surgeon named Philip Blaiberg. The operation was performed on 2 January 1968. On this occasion, the surgical technique was slightly modified from the approach developed in dogs by Shumway and the Stanford group.2 The incision in the donor right atrium was extended from the inferior vena cava into the atrial appendage, thus avoiding the area of the sinus node.3 This modification has been utilised by nearly all surgical groups subsequently.Blaiberg did well and was the first heart transplant patient to leave hospital. Media attention was enormous and his return to a relatively normal life was followed intensely over many months. It was Blaiberg’s success, perhaps more than any other single factor, that led to guarded optimism that heart transplantation would eventually prove a valuable treatment option. Blaiberg was the shining beacon, whereas the majority of other attempts at heart transplantation worldwide in the late 1960s and early 1970s seemed doomed to early failure. Blaiberg eventually died 19 months after his transplant. His autopsy demonstrated severe and widespread coronary artery disease. This was the first example of transplant coronary artery disease that now dominates as the major cause of graft failure after the first post-transplant year.4The persistence of media coverage of heart transplantation at Groote Schuur gave Chris Barnard immense public and professional recognition on one hand, but on the other also evoked mixed and even heated reaction at times, regarding the question of ethics in organ transplantation. There were those critics who believed that this form of therapy was an unjustifiable and unethical form of palliation. Others responded with tremendous enthusiasm, as reflected by the fact that over one hundred heart transplants were performed in various centres all over world within the next year (1968).However, the rather poor results following this experience, with a two-year survival of only 11%, had a negative effect on the initial enthusiasm over heart transplantation (Table 1). Only a few institutions maintained active heart transplant programmes, Cape Town being one of these. Barnard stated in 1970: ‘To curb transplantation at this stage would be to strangle one of the most promising and exciting fronts of medical endeavour of this century. From the experience gained in the problems of rejection, methods of immunological control will be improved and vital organ replacement will become a routine and life-saving procedure. To deny medicine its full thrust in this direction would be irresponsibly shortsighted. Indeed, it is difficult not to conclude that withdrawal from this new frontier would be professionally unethical. We have only to continue transplantation on a most active scale.’Table 1. Worldwide Heart Transplant Results 1968–1970YearNumber of transplants1-month survival1-year survival2-year survival196810254191019694828761970161043Total166923019Survival (%)551811Open in a separate windowDuring the 1970s, Barnard’s programme, together with those at Stanford (under Norman Shumway), the Medical College of Virginia, and Hôpital La Pitie in Paris, were the only major centres continuously performing heart transplantation, and therefore the only centres where advances in heart transplantation were pioneered.Orthotopic heart transplantation. Between December 1967 and November 1974, exclusively orthotopic heart transplantation was performed. Ten such heart transplants were performed at Groote Schuur Hospital. The results, although poor by today’s standards, were exceptional when one considers the primitive nature of the immunosuppressive therapy available at the time (azathioprine, corticosteroids and antilymphocyte serum), and the team’s lack of experience in diagnosing and treating rejection episodes.Of the 10 orthotopic heart transplants, four lived for more than 18 months, two of whom became long-term survivors. Dorothy Fisher lived for over 13 years and Dirk van Zyl lived for over 23 years.5 The remarkable fact about Dirk van Zyl is not only the longevity of survival but the excellent recovery from the operation. Within three months he returned to work and did not miss a single day’s work for the next 15 years, at which time he retired.This early experience established sound criteria for the selection of recipients who would derive maximum benefit from heart transplantation. Experience was also obtained in methods of diagnosis and treatment of the acute rejection.The development of heterotopic heart transplantation. In 1973, Barnard performed a heart transplant and the donor heart failed to function satisfactorily, so the patient died in the operating theatre. When Barnard came out to break the sad news, he was asked why he could not put the old heart back, as at least it had kept the patient alive. This struck Barnard as a distinct possibility. If the patient’s own heart had been left in place, and the transplant was inserted as an auxiliary pump, failure of the donor heart may not have caused the patient’s demise. Furthermore, during severe rejection episodes, which were common in those early days and a major cause of the poor results at the time, the native heart might be able to maintain the circulation while rejection was reversed by increased therapy.Barnard set Jacques Losman, a junior surgeon on his team, to develop the surgical technique of heterotopic heart transplantation in the animal laboratory. The concept was for a second heart to be placed in the right chest and for the two hearts to function in parallel.6 Two techniques were developed in the laboratory, in one of which the donor heart assisted the left ventricle only and another in which biventricular assist was provided. Only two left ventricular assist procedures were performed in patients, the remaining operations involving biventricular support.Heterotopic heart transplantation: the clinical programme. Forty-nine consecutive heterotopic heart transplants were performed in Cape Town between 1974 and 1983, with moderately good results for that era.7 Three of the first five patients survived more than 10 years. During this time it became clear that if irreversible rejection and failure of the donor heart developed, excision and replacement of the donor heart was not only technically difficult, but associated with significant morbidity. At the ‘re-transplant’ operation, it was preferable to replace the patient’s native heart by performing an orthotopic transplant, leaving the original heterotopic transplant in situ, even if it were no longer functioning. This prevented the necessity of dissecting the donor heart from the right lung, to which it might be tightly adherent.Two 14-year-old boys, both of whom initially received heterotopic transplants, underwent a second (orthotopic) heart transplant for graft atherosclerosis, and were therefore the first patients in the world to have two donor hearts in their chest at the same time. The first of these remains well, 29 and 26 years after the hetero- and orthotopic transplants, respectively. In the other, the second transplant also eventually failed and he underwent a third transplant, again in the orthotopic site, and thus became one of the few humans to have had four hearts in his lifetime.With the introduction of cyclosporine and the greatly reduced incidence of severe life-threatening rejection episodes, Barnard’s group resumed orthotopic heart transplantation. Heterotopic heart transplantation now has only a very small role, in, for example, the treatment of patients with fixed increased pulmonary vascular resistance, or when there is donor–recipient heart size mismatch.8Xenotransplantation. The ability of the heterotopic heart to provide temporary circulatory support to a failing native heart, in the hope that the native heart would recover, was extended into the realm of xenotransplantation. On two occasions in 1977, when a patient’s left ventricle failed acutely after routine open-heart surgery and when no human donor organ was available, Barnard transplanted an animal heart heterotopically. On the first occasion, a baboon heart was transplanted, but this failed to support the circulation sufficiently, the patient dying some six hours after transplantation. In the second patient, a chimpanzee heart successfully maintained life until irreversible rejection occurred four days later, the recipient’s native heart having failed to recover during this period.9 Further attempts at xenotransplantation were abandoned and even now, more than 30 years later, xenotransplantation remains an elusive holy grail despite decades of research.Hypothermic perfusion storage of the donor heart. Largely through the work of a young biochemist working in Barnard’s department, Winston Wicomb, a hypothermic perfusion system for storing hearts ex vivo for up to 48 hours was developed. A baboon’s heart could be stored by hypothermic perfusion and then replaced in the original baboon, which had been kept alive during this period by an orthotopic cardiac allograft. Some baboons were followed for up to two years after these procedures and showed normal cardiac function and myocardial histology throughout this period.10With the success of this storage system in the laboratory, Barnard encouraged his team to use it in the clinical transplant programme. This would enable the transportation of hearts from distant centres in South Africa, which had hitherto been impossible, all donor hearts being procured locally in Cape Town. The device was used successfully on several occasions.11 However, in contrast to the experience in animals, it was commonly found that the human transplanted hearts had delayed graft function which often took many hours to recover. It was believed that this phenomenon of delayed function suggested temporary depletion of myocardial energy stores, related to the fact that, whereas in the baboon experiments the heart had been removed from a healthy anaesthetised animal, in the clinical situation the heart had been excised from a brain-dead subject.Investigations into the haemodynamic and metabolic effects of brain death. This alerted the team to the fact that brain death must have a detrimental effect on myocardial function, and led to extensive investigations into the haemodynamic and metabolic changes during and after brain death, and the implications of these changes. This work was the first comprehensive study investigating the effects of brain death.12-14 The major haemodynamic changes that take place as brain death was developing, some of which had been previously recorded by Harvey Cushing in 1902, were monitored.It was documented that these could have a detrimental effect on subsequent myocardial function and were sometimes associated with histopathological features of myocardial injury. Previously unrecognised major endocrine changes that occur following brain death were documented. These include a massive catecholamine surge and a depletion of thyroid hormones and insulin, and other neuro-hormonal effects. These were associated with a loss of myocardial energy stores and other detrimental effects on cardiac function. Experimental studies in baboons indicated that aerobic metabolism soon ceases after brain death, and life is sustained by anaerobic metabolism.15The concept of hormone-replacement therapy was proposed, particularly with regard to thyroid hormone replacement, which experimentally was reported to be beneficial to the maintenance and improvement of myocardial function. Subsequently, this therapy was administered to a number of human heart donors, with documented improvement in haemodynamic function.16 In recent years, hormonal therapy of the potential organ donor has gained increasing acceptance worldwide.17Brain death and ethical issues. As previously mentioned, there were no laws relating to brain death at the time of the first transplant. This undoubtedly helped to accelerate the growth of bioethics and to wrestle from the medical profession the monopoly over medical ethics, which they previously held. In February 1968, three months after the first heart transplant, a bill was introduced in the US Congress to ‘establish a commission to assess and report on the ethical, legal, social and political implications of medical advances’. It was evident that transplantation had raised serious ethical and legal questions for society.Doctors were still very much committed to the view that the profession should make the decisions about contentious issues such as the moment of death and when to stop certain treatment. Most of the medical witnesses who appeared before the congressional hearings were opposed to the bill. Many did not resent input from philosophers or theologians but most felt that doctors ought to retain control and have the final say. None was more outspoken than Christiaan Barnard whose opposition to the proposal was ‘unqualified, almost nasty, perhaps reflecting the fact that in South Africa a doctor’s authority was still unchallenged or that he was not dependant on Congress or the National Institute of Health (NIH) for funding’.The debates surrounding brain death and related ethical issues continued for many years and in 1981 the President’s commission in the United States declared that individual death depended on either irreversible cessation of circulatory and respiratory functions or irreversible cessation of all functions of the entire brain. In 1976 the UK Conference of Royal Medical Colleges accepted the view that damage to the brainstem was the crucial factor causing profound irreversible coma, and this became the definition of brain death.18Barnard was also a champion of the disadvantaged and the poor, and an opponent of racism and apartheid, who welcomed its demise. He did his best to not allow racial segregation of patients within his department, in defiance of Government policy to segregate patients in hospitals according to race, as elsewhere in South Africa. Nevertheless nationalist politicians undoubtedly exploited him in the years following the first transplant, in order to improve the image of South Africa around the world, a time when repression was at its fiercest within the country and the worldwide condemnation of the apartheid regime was on the increase.Raymond Hoffenberg, a colleague of Barnard’s and an exceptional academic doctor did not allow himself to be exploited by the Government and took a firm stand against the injustices which were perpetrated on its citizens in order to maintain apartheid; he was served with a banning order which forced him into voluntary exile a few weeks after Barnard’s surgical triumph. He went on to be a leading physician in Britain, eventually becoming president of the Royal College of Physicians and being knighted by the Queen.Christiaan Barnard in retirement. By the early 1980s, Barnard was tiring of the stresses and strains of clinical heart surgery and was losing interest in running a busy department. Furthermore, rheumatoid arthritis in several joints was causing him constant pain and making it increasingly difficult to operate to his satisfaction. In 1983, at the age of 61, he took early retirement from Groote Schuur Hospital and the University of Cape Town.Barnard took the opportunity to pen an autobiography, One Life, which sold widely throughout the world.19 He generously donated the royalties to the Chris Barnard Fund which supported research into heart disease and organ transplantation at the University of Cape Town, and from which many subsequent researchers have benefitted significantly.Soon after announcing his retirement, Barnard was invited to act as a consultant at Baptist Medical Center in Oklahoma City, where a new heart transplant programme was being planned. He spent six months a year for a number of years in Oklahoma, advising on the establishment of this programme, although not participating in the actual surgery. He finally retired from medicine in 1988 and settled back in Cape Town. He remained active as an international speaker on medical matters of general interest and continued to travel widely. He died during one of his travels on the island of Cyprus on 2 September 2001.Chris Barnard’s department at Groote Schuur Hospital and the University of Cape Town has subsequently taken his name and has maintained an active heart transplant programme despite financial constraints imposed by the present Government’s reprioritisation of health expenditure on primary and preventative healthcare in a new post-apartheid South Africa, and the negative impact of HIV and AIDS on the healthcare sytem.20 Groote Schuur and associated academic hospitals are still the only public hospitals undertaking heart transplantation in Africa.While no longer actively involved in basic laboratory transplant research, the Chris Barnard Division of Cardiothoracic Surgery at the University of Cape Town still has an internationally renowned cardiovascular research laboratory, directing its current research into methods of improving the surgical management of cardiac valvular and coronary diseases, which are more relevant to the cardiovascular diseases common in the African population. The most recent advance from this research unit has been the development of an external support for venous conduits used for coronary artery bypass grafting, which promises to increase the long-term patency of these grafts, and an international clinical trial using this mesh is currently underway.21Acknowledgments. The authors acknowledge that this article is based on a more detailed and previously published article on Christiaan Barnard and the University of Cape Town’s contribution to heart transplantation.22References. 1. Barnard CN. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town. S Afr Med J. 1967;41(48):1271–1274. [PubMed] [Google Scholar]2. Lower RR, Shumway NE. Studies on orthotopic transplantation of the canine heart. Surg Forum. 11;18:1960. [PubMed] [Google Scholar]3. Barnard CN. What we have learned about heart transplants. J Thorac Cardiovasc Surg. 1968;56:457–468. [PubMed] [Google Scholar]4. Thompson JG. Atheroma in a transplanted heart. Lancet. 1969;ii:1088–1092. [PubMed] [Google Scholar]5. Brink J. Twenty-three year survival after orthotopic heart transplantation. J Heart Lung Transplant. 1996;15:430–431. [PubMed] [Google Scholar]6. Barnard CN, Losman JG. Left ventricular bypass. S Afr Med J. 1975;49:303–312. [PubMed] [Google Scholar]7. Hassoulas J, Barnard CN. Heterotopic cardiac transplantation: A seven year experience at Groote Schuur Hospital. S Afr Med J. 1984;65:675–682. [PubMed] [Google Scholar]8. Cooper DKC, Novitzky D, Becerra E, Reichart B. Are there indications for heterotopic heart transplantation in 1986? Thorac Cardiovasc Surg. 1986;34:300–304. [PubMed] [Google Scholar]9. Barnard CN, Wolpowitz A, Losman JG. Heterotopic cardiac transplantation with a xenograft for assistance of the left heart in cardiogenic shock after cardiopulmonary bypass. S Afr Med J. 1977;52:1035–1039. [PubMed] [Google Scholar]10. Wicomb WN, Rose AG, Cooper DKC, Novitzky D. Hemodynamic and myocardial histological and ultrastructural studies in baboons three to twenty-seven months following autotransplantation of hearts stored by hypothermic perfusion for 24 or 48 hours. J Heart Transplant. 1986;5:122–129. [PubMed] [Google Scholar]11. Wicomb WN, Cooper DKC, Novitzky D, Barnard CN. Cardiac transplantation following storage of the donor heart by a portable hypothermic perfusion system. Ann Thorac Surg. 1984;37:243–248. [PubMed] [Google Scholar]12. Novitzky D, Wicomb WN, Cooper DKC, Rose AG, Fraser RC, Barnard CN. Electrocardiographic hemodynamic and endocrine changes occurring during experimental brain death in the Chacma baboon. J Heart Transplant. 1984;4:63–69. [Google Scholar]13. Cooper DKC, Wicomb WN, Barnard CN. Storage of the donor heart by a portable hypothermic perfusion system: experimental development and clinical experience. J Heart Transplant. 1983;2:104–110. [Google Scholar]14. Wicomb WN, Cooper DKC, Lanza RP, Novitsky D. The effects of brain death and 24 hours storage by hypothermic perfusion on donor heart function in the pig. J Thorac Cardiovasc Surg. 1986;91:896–909. [PubMed] [Google Scholar]15. Novitzky D, Cooper DKC, Morrell D, Isaacs S. Change from aerobic to anaerobic metabolism after brain death and reversal following triiodothyronine (T3) therapy. Transplantation. 1988;45:32–36. [PubMed] [Google Scholar]16. Novitzky D, Cooper DKC, Reichart B. Hemodynamic and metabolic responses to hormonal therapy in brain-dead potential organ donors. Transplantation. 1987;43:852–854. [PubMed] [Google Scholar]17. Novitzky D, Wicomb WN, Cooper DKC. From the past to the present and to the future. The scientific rationale for hormonal therapy of the brain-dead organ donor and the organ recipient. UNOS Update. 2004 May-Jun; [Google Scholar]18. et al. Diagnosis of Brain Death. Br Med J. 1976;ii:1187–1188. [PMC free article] [PubMed] [Google Scholar]19. Barnard CN, Pepper CB. One Life. London: Harrap; 1969. [Google Scholar]20. Benatar S. Health care reform and the crisis of HIV and AIDS in South Africa. N Engl J Med. 2004;351(1):81–92C. [PubMed] [Google Scholar]21. Zilla P, Human P, Wolf M, Lichtenberg W, Rafiee N, Bezuidenhout D. et al. Constrictive external nitinol meshes inhibit vein graft intimal hyperplasia in non-human primates. J Thorac Cardiovasc Surg. 2008;136(3):717–725. [PubMed] [Google Scholar]22. Brink JG, Cooper DK. Heart transplantation: the contributions of Christiaan Barnard and the University of Cape Town/Groote Schuur Hospital. Wld J Surg. 2005;29(8):953–961. [PubMed] [Google Scholar]Articles from Cardiovascular Journal of Africa are provided here courtesy of Clinics Cardive Publishing (Pty) Ltd. Formats:. Article | PubReader | ePub (beta) | PDF (1.3M) | CiteShare. Facebook Twitter Google+ Support Center Support Center External link. Please review our privacy policy. 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Result 23
TitleDepartment of Surgery - Heart Transplant
Urlhttps://surgery.ucsf.edu/conditions--procedures/heart-transplant.aspx
Description
Date
Organic Position22
H1Heart Transplant
H2Overview
Who Needs a Heart Transplant?
What To Expect Before a Heart Transplant
What To Expect After a Heart Transplant
What Are the Risks of a Heart Transplant?
Links to Other Information About Heart Transplant
Heart Transplant Program
H3The Heart Transplant Process
Who Is Eligible for a Heart Transplant?
The Heart Transplant Waiting List
The Donor Heart
Waiting Times
Ongoing Medical Treatment
Contact With the Transplant Center During the Wait
Staying in the Hospital
Watching for Signs of Rejection
Preventing Rejection
Managing Transplant Medicines and Their Side Effects
Preventing Infection
Pregnancy
Emotional Issues and Support
Failure of the Donor Heart
Primary Graft Dysfunction
Rejection of the Donor Heart
Cardiac Allograft Vasculopathy
Complications From Medicines
Infection
Cancer
Other Complications
Complications From Not Following a Lifelong Care Plan
NHLBI Resources
Non-NHLBI Resources
Clinical Trials
Clinics & Appointments
Heart Transplant Program
Clinical Team
Patient Stories
Related News
H2WithAnchorsOverview
Who Needs a Heart Transplant?
What To Expect Before a Heart Transplant
What To Expect After a Heart Transplant
What Are the Risks of a Heart Transplant?
Links to Other Information About Heart Transplant
Heart Transplant Program
BodyHeart TransplantA heart transplant is a surgery to remove a person's diseased heart and replace it with a healthy heart from a deceased donor. Most heart transplants are done on patients who have end-stage heart failure. Heart failure is a condition in which the heart is damaged or weak. As a result, it can't pump enough blood to meet the body's needs. "End-stage" means the condition is so severe that all treatments, other than a heart transplant, have failed. Overview. Heart transplants are done as a life-saving measure for end-stage heart failure. Because donor hearts are in short supply, patients who need heart transplants go through a careful selection process. They must be sick enough to need a new heart, yet healthy enough to receive it. Survival rates for people receiving heart transplants have improved, especially in the first year after the transplant. About 88 percent of patients survive the first year after transplant surgery, and 75 percent survive for 5 years. The 10-year survival rate is about 56 percent. After the surgery, most heart transplant patients can return to their normal levels of activity. However, less than 30 percent return to work for many different reasons. The Heart Transplant Process. The heart transplant process starts when doctors refer a patient who has end-stage heart failure to a heart transplant center. Staff members at the center assess whether the patient is eligible for the surgery. If the patient is eligible, he or she is placed on a waiting list for a donor heart. Heart transplant surgery is done in a hospital when a suitable donor heart is found. After the transplant, the patient is started on a lifelong health care plan. The plan involves multiple medicines and frequent medical checkups. Who Needs a Heart Transplant? Most patients referred to heart transplant centers have end-stage heart failure. Their heart failure might have been caused by: Coronary heart disease. Hereditary conditions. Viral infections of the heart. Damaged heart valves and muscles. (Alcohol, pregnancy, and certain medicines can damage the heart valves and muscles.) Most patients considered for heart transplants have tried other, less drastic treatments. They also have been hospitalized many times for heart failure. Who Is Eligible for a Heart Transplant? The specialists at the heart transplant center will assess whether a patient is eligible for a transplant. Specialists often include a: Cardiologist (a doctor who specializes in diagnosing and treating heart problems) Cardiovascular surgeon (a doctor who does the transplant surgery) Transplant coordinator (a person who arranges aspects of the surgery, such as transportation of the donor heart) Social worker Dietitian Psychiatrist In general, patients selected for heart transplants have severe end-stage heart failure, but are healthy enough to have the transplant. Heart failure is considered “end stage” when all possible treatments—such as medicines, implanted devices, and surgery—have failed. Certain conditions and factors make it less likely that a heart transplant will work well. Examples include: Advanced age. There is no widely accepted upper age limit for a heart transplant. However, most transplant surgeries are done on patients younger than 70 years old. Poor blood circulation throughout the body, including the brain. Kidney, lung, or liver diseases that can't be reversed. A history of cancer or malignant tumors. Inability or unwillingness to follow a lifelong care plan after a transplant. Pulmonary hypertension (high blood pressure in the lungs) that can't be reversed. Active infection throughout the body. Diabetes with end organ damage (damage of major organs). Patients who have one or more of the above conditions might not be eligible for heart transplant surgery. What To Expect Before a Heart Transplant. The Heart Transplant Waiting List. Patients who are eligible for a heart transplant are added to a waiting list for a donor heart. This waiting list is part of a national allocation system for donor organs. The Organ Procurement and Transplantation Network (OPTN) runs this system. OPTN has policies in place to make sure donor hearts are given out fairly. These policies are based on urgency of need, available organs, and the location of the patient who is receiving the heart (the recipient). Organs are matched for blood type and size of donor and recipient. The Donor Heart. Guidelines for how a donor heart is selected require that the donor meet the legal requirement for brain death and that the correct consent forms are signed. Guidelines suggest that the donor should be younger than 65 years old, have little or no history of heart disease or trauma to the chest, and not be exposed to hepatitis or HIV. The guidelines recommend that the donor heart should not be without blood circulation for more than 4 hours. Waiting Times. About 3,000 people in the United States are on the waiting list for a heart transplant on any given day. About 2,000 donor hearts are available each year. Wait times vary from days to several months and will depend on a recipient's blood type and condition. A person might be taken off the list for some time if he or she has a serious medical event, such as a stroke, infection, or kidney failure. Time spent on the waiting list plays a part in who receives a donor heart. For example, if two patients have equal need, the one who has been waiting longer will likely get the first available donor heart. Ongoing Medical Treatment. Patients on the waiting list for a donor heart get ongoing treatment for heart failure and other medical conditions. For example, doctors may treat them for arrhythmias (irregular heartbeats). Arrhythmias can cause sudden cardiac arrest in people who have heart failure. The doctors at the transplant centers may place implantable cardioverter defibrillators (ICDs) in patients before surgery. ICDs are small devices that are placed in the chest or abdomen. They help control life-threatening arrhythmias. Another possible treatment for waiting list patients is a ventricular assist device (VAD). A VAD is a mechanical pump that helps support heart function and blood flow. Routine outpatient care for waiting list patients may include frequent exercise testing, testing the strength of the heartbeat, and right cardiac catheterization (a test to measure blood pressure in the right side of the heart). You also might start a cardiac rehabilitation (rehab) program. Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems. The program can help improve your physical condition before the transplant. Also, you will learn the types of exercises used in the program, which will help you take part in cardiac rehab after the transplant. Contact With the Transplant Center During the Wait. Patients on the waiting list often are in close contact with their transplant centers. Most donor hearts must be transplanted within 4 hours after removal from the donor. At some heart transplant centers, patients get a pager so the center can contact them at any time. They're asked to tell the transplant center staff if they're going out of town. Patients often need to be prepared to arrive at the hospital within 2 hours of being notified about a donor heart. Not all patients who are called to the hospital will get a heart transplant. Sometimes, at the last minute, doctors find that a donor heart isn't suitable for a patient. Other times, patients from the waiting list are called to come in as possible backups, in case something happens with the selected recipient. What To Expect After a Heart Transplant. Staying in the Hospital. The amount of time a heart transplant recipient spends in the hospital varies. Recovery often involves 1 to 2 weeks in the hospital and 3 months of monitoring by the transplant team at the heart transplant center. Monitoring may include frequent blood tests, lung function tests, EKGs (electrocardiograms), echocardiograms, and biopsies of the heart tissue. A heart biopsy is a standard test that can show whether your body is rejecting the new heart. This test is often done in the weeks after a transplant. During a heart biopsy, a tiny grabbing device is inserted into a vein in the neck or groin (upper thigh). The device is threaded through the vein to the right atrium of the new heart to take a small tissue sample. The tissue sample is checked for signs of rejection. While in the hospital, your health care team may suggest that you start a cardiac rehabilitation (rehab) program. Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems. Cardiac rehab includes counseling, education, and exercise training to help you recover. Rehab may start with a member of the rehab team helping you sit up in a chair or take a few steps. Over time, you'll increase your activity level. Watching for Signs of Rejection. Your body will regard your new heart as a foreign object. You’ll need medicine to prevent your immune system from attacking the heart. You and the transplant team will work together to protect the new heart. You’ll watch for signs and symptoms that your body is rejecting the organ. These signs and symptoms include: Shortness of breath Fever Fatigue (tiredness) Weight gain (retaining fluid in the body) Reduced amounts of urine (problems in the kidneys can cause this sign) You and the team also will work together to manage the transplant medicines and their side effects, prevent infections, and continue treatment of ongoing medical conditions. Your doctors may ask you to check your temperature, blood pressure, and pulse when you go home. Preventing Rejection. You'll need to take medicine to suppress your immune system so that it doesn't reject the new heart. These medicines are called immunosuppressants. Immunosuppressants are a combination of medicines that are tailored to your situation. Often, they include cyclosporine, tacrolimus, MMF (mycophenolate mofetil), and steroids (such as prednisone). Your doctors may need to change or adjust your transplant medicines if they aren't working well or if you have too many side effects. Managing Transplant Medicines and Their Side Effects. You'll have to manage multiple medicines after having a heart transplant. It's helpful to set up a routine for taking medicines at the same time each day and for refilling prescriptions. It's crucial to never run out of medicine. Always using the same pharmacy may help. Keep a list of all your medicines with you at all times in case of an accident. When traveling, keep extra doses of medicine with you (not packed in your luggage). Bring your medicines with you to all doctor visits. Side effects from medicines can be serious. Side effects include risk of infection, diabetes, osteoporosis (thinning of the bones), high blood pressure, kidney disease, and cancer—especially lymphoma and skin cancer. Discuss any side effects of the medicines with your transplant team. Your doctors may change or adjust your medicines if you're having problems. Make sure your doctors know all of the medicines you're taking. Preventing Infection. Some transplant medicines can increase your risk of infection. You may be asked to watch for signs of infection, including fever, sore throat, cold sores, and flu-like symptoms. Signs of possible chest or lung infections include shortness of breath, cough, and a change in the color of sputum (spit). Watching closely for these signs is important because transplant medicines can sometimes mask them. Also, pay close attention to signs of infection at the site of your incision (cut). These signs can include redness, swelling, or drainage. Ask your doctor what steps you should take to reduce your risk of infection. For example, your doctor may suggest that you avoid contact with animals or crowds of people in the first few months after your transplant. Regular dental care also is important. Your doctor or dentist may prescribe antibiotics before any dental work to prevent infections. Pregnancy. Many successful pregnancies have occurred after heart transplant surgeries; however, special care is needed. If you've had a heart transplant, talk with your doctor before planning a pregnancy. Emotional Issues and Support. Having a heart transplant may cause fear, anxiety, and stress. While you're waiting for a heart transplant, you may worry that you won't live long enough to get a new heart. After surgery, you may feel overwhelmed, depressed, or worried about complications. All of these feelings are normal for someone going through major heart surgery. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you’re very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to life after a heart transplant. You can see how other people who have had the surgery have coped with it. Talk with your doctor about local support groups or check with an area medical center. Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you. What Are the Risks of a Heart Transplant? Although heart transplant surgery is a life-saving measure, it has many risks. Careful monitoring, treatment, and regular medical care can prevent or help manage some of these risks. The risks of having a heart transplant include: Failure of the donor heart Complications from medicines Infection Cancer Problems that arise from not following a lifelong care plan after surgery Failure of the Donor Heart. Over time, the new heart may fail due to the same reasons that caused the original heart to fail. Failure of the donor heart also can occur if your body rejects the donor heart or if cardiac allograft vasculopathy (CAV) develops. CAV is a blood vessel disease. Patients who have a heart transplant that fails can be considered for another transplant (called a retransplant). Primary Graft Dysfunction. The most frequent cause of death in the first 30 days after transplant is primary graft dysfunction. This occurs if the new donor heart fails and isn't able to function. Factors such as shock or trauma to the donor heart or narrow blood vessels in the recipient's lungs can cause primary graft dysfunction. Doctors may prescribe medicines (for example, inhaled nitric oxide and intravenous nitrates) to treat this condition. Rejection of the Donor Heart. Rejection is one of the leading causes of death in the first year after transplant. The recipient's immune system sees the new heart as a foreign object and attacks it. During the first year, heart transplant patients have an average of one to three episodes of rejection. Rejection is most likely to occur within 6 months of the transplant surgery. Cardiac Allograft Vasculopathy. CAV is a chronic (ongoing) disease in which the walls of the coronary arteries in the new heart become thick, hard, and less stretchy. CAV can destroy blood circulation in the new heart and cause serious damage. CAV is a leading cause of donor heart failure and death in the years following transplant surgery. CAV can cause heart attack, heart failure, dangerous arrhythmias, and sudden cardiac arrest. To detect CAV, your doctor may recommend coronary angiography yearly and other tests, such as stress echocardiography or intravascular ultrasound. Complications From Medicines. Taking daily medicines that stop the immune system from attacking the new heart is crucial, even though the medicines have serious side effects. Cyclosporine and other medicines can cause kidney damage. Kidney damage affects more than 25 percent of patients in the first year after transplant.  Infection. When the immune system—the body's defense system—is suppressed, the risk of infection increases. Infection is a major cause of hospital admission for heart transplant patients. It also is a leading cause of death in the first year after transplant. Cancer. Suppressing the immune system leaves patients at risk for cancers and malignancies. Malignancies are a major cause of late death in heart transplant patients. The most common malignancies are tumors of the skin and lips (patients at highest risk are older, male, and fair-skinned) and malignancies in the lymph system, such as non-Hodgkin's lymphoma. Other Complications. High blood pressure develops in more than 70 percent of heart transplant patients in the first year after transplant and in nearly 95 percent of patients within 5 years. High levels of cholesterol and triglycerides in the blood develop in more than 50 percent of heart transplant patients in the first year after transplant and in 84 percent of patients within 5 years. Osteoporosis can develop or worsen in heart transplant patients. This condition thins and weakens the bones. Complications From Not Following a Lifelong Care Plan. Not following a lifelong care plan increases the risk of all heart transplant complications. Heart transplant patients are asked to closely follow their doctors' instructions and check their own health status throughout their lives. Lifelong health care includes taking multiple medicines on a strict schedule, watching for signs and symptoms of complications, going to all medical checkups, and making healthy lifestyle changes (such as quitting smoking). Links to Other Information About Heart Transplant. NHLBI Resources. Cardiac Rehabilitation (Health Topics) Heart Failure (Health Topics) Heart Surgery (Health Topics) Ventricular Assist Device (Health Topics) Non-NHLBI Resources. Heart Transplant (MedlinePlus) Organ Procurement and Transplantation Network (U.S. Department of Health and Human Services) Clinical Trials. Children and Clinical Studies Clinical Trials (Health Topics) Current Research (ClinicalTrials.gov) NHLBI Clinical Trials NIH Clinical Research Trials and You (National Institutes of Health) ResearchMatch(link is external) (funded by the National Institutes of Health) Clinics & Appointments. Heart Transplant Program. 400 Parnassus Ave., 6th FloorSan Francisco, CA 94143(415) 353-4145 Phone(415) 353-4166 Fax Hours: Thursday 8 a.m. – 5 p.m.Maps, Directions & ParkingRequest an AppointmentRefer a PatientHeart Transplant Program. 400 Parnassus Ave., 6th FloorSan Francisco, CA 94143(415) 353-4145 Phone(415) 353-4166 Fax Hours: Thursday 8 a.m. – 5 p.m.  Google Map & Directions Campus & Parking Map Multi-Lingual Driving Directions Directions by UCSF Destination UCSF Medical Center Patient Info Clinical Team. Tobias Deuse, M.D.Cardiac & Heart/Lung Transplant SurgeonKai Ihnken, M.D.Cardiac & Heart Transplant SurgeonGeorg M. Wieselthaler, M.D.Cardiac & Heart Transplant SurgeonPatient Stories. I Feel Incredibly Lucky to Be AliveRelated News. Sonja Schrepfer Receives CIRM Grant to Develop Hypo-Immunogenic Cardiac Patches for Myocardial Regeneration
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TitleHeart Transplant for Children
Urlhttps://www.stanfordchildrens.org/en/topic/default?id=heart-transplant-for-children-90-P01796
DescriptionA heart transplant is a surgery to replace a diseased heart with a healthy one from an organ donor. Organ donors are adults or children who have become critically ill, often because because of injury. They will not live because of their illness or injury
Date
Organic Position23
H1Heart Transplant for Children
H2What is a heart transplant for a child?
Why might my child need a heart transplant?
What are the risks of a heart transplant for a child?
How do I get my child ready for a heart transplant?
What happens during a heart transplant for a child?
What happens after a heart transplant for a child?
Next steps
H3Related Topics
About
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H2WithAnchorsWhat is a heart transplant for a child?
Why might my child need a heart transplant?
What are the risks of a heart transplant for a child?
How do I get my child ready for a heart transplant?
What happens during a heart transplant for a child?
What happens after a heart transplant for a child?
Next steps
BodyHeart Transplant for Children What is a heart transplant for a child? A heart transplant is surgery to replace a diseased heart with a healthy one from an organ donor. Organ donors are adults or children who have become critically ill, often because of injury. They will not live because of their illness or injury. If the donor is an adult, he or she may have agreed to be an organ donor before becoming ill. Parents or spouses can also agree to donate a relative's organs. Donors can come from any part of the U.S. Why might my child need a heart transplant? Heart transplants are recommended for children who have serious heart problems. These children are not able to live without having their heart replaced. Illnesses that affect the heart in this way include complex heart disease present at birth (congenital). They also include heart muscle disease (cardiomyopathy) that may be caused by many problems. What are the risks of a heart transplant for a child? There are risks with any surgery, especially major surgery like this. Risks include: Failure of the transplanted heart Infection, especially from anti-rejection medicines Heart failure Bleeding Blood clots Lung problems How do I get my child ready for a heart transplant? Many tests are done before the heart transplant. These include blood tests that will make it more likely that the donor heart will not be rejected. Other tests are done to make sure your child and your family are emotionally ready for the transplant. Your child will need your support during this process. If your child is a good candidate for a heart transplant, he or she will be put on the United Network for Organ Sharing (UNOS) list. Sometimes children wait only a few days or weeks before getting a donor organ. It may also take months or years before a suitable donor organ is available. During this time, your child's healthcare provider and the transplant team will closely follow your child. You can also get help from support groups during this difficult waiting time. Each transplant team has its own guidelines about how you will be told when a donor organ is available. In most cases, you will be called when an organ is available. You will be told to come to the hospital right away so your child can get ready the transplant. This call can come at any time, so you should always be ready to go to the hospital.  What happens during a heart transplant for a child? Once at the hospital, your child will have tests to confirm the match of the organ. Once the test results are available and your child is ready, he or she will go to the operating room. The transplant surgery may take 4 or more hours. The time it takes depends on many things. During the surgery, a member of the transplant team will tell you about the progress of the transplant. The general steps of heart transplant surgery are: Just before the surgery starts, your child will get sleep medicine (general anesthesia).  The surgeon uses the open-heart method. This means he or she makes a large cut (incision) into your child's chest. The breastbone is spread to reach the heart. Your child is connected to a heart-lung bypass machine. The machine acts as your child's heart and lungs. It pumps blood through your child's body during surgery.  The surgeon will remove your child's heart. He or she will then put the new heart in your child's chest and stitch it into place. What happens after a heart transplant for a child? After the surgery, your child will go to the intensive care unit (ICU) to be watched closely. The length of time your child will spend in the ICU will vary. Your transplant team will help you learn how to care for your child during this time. This will include information about medicines, activity, follow-up, diet, and any other specific instructions from your child's transplant team. Rejection is a normal reaction of the body to a foreign object. The body's immune system makes antibodies to try to destroy the new organ. Anti-rejection medicines are used to help prevent this from happening. These are the most common symptoms of rejection: Fever Decreased urine or fewer wet diapers than usual Fast heart rate Fast breathing rate Weight gain Tiredness Irritability Poor appetite Your child's transplant team will tell you who to call right away if any of these symptoms happen. Your child will need to take anti-rejection medicines for the rest of his or her life. Because anti-rejection medicines weaken the immune system, children who get transplants will be at higher risk for infections. Your child will have blood tests to measure the level of anti-rejection medicine. For example, blood tests will be done to check white blood cell counts. The risk for infection is higher during in the first few months after surgery. This is because higher doses of anti-rejection medicines are given during this time. Your child will most likely take medicines to prevent other infections. Your child is at increased risk for infections such as oral yeast infections (thrush), herpes, and respiratory viruses. Your child will be closely followed after leaving the hospital. Follow-up visits may include: Complete physical exam Blood tests Echocardiogram Cardiac catheterization Heart biopsy to check for rejection Continued education for you and your child Medicine changes Your child will need lifelong follow-up with transplant specialists. Make sure you keep all appointments. It is especially important that you report any signs of rejection right away. Next steps. Before you agree to the test or the procedure for your child make sure you know: The name of the test or procedure The reason your child is having the test or procedure What results to expect and what they mean The risks and benefits of the test or procedure When and where your child is to have the test or procedure Who will do the procedure and what that person’s qualifications are What would happen if your child did not have the test or procedure Any alternative tests or procedures to think about When and how will you get the results Who to call after the test or procedure if you have questions or your child has problems How much will you have to pay for the test or procedure Related Topics. Heart Transplant for ChildrenThe Heart nutch_noindex About Us Contact MyChart Login Careers Blog Refer a Patient Notice of Nondiscrimination Terms of Use Privacy Policy Code of Conduct © 2021 Stanford Children's Health About. About Us Our Hospital Patient Stories Blog News Send a Greeting Card New Hospital Careers Connect. Donate Refer a Patient Contact Us Pay Your Bill Find. Doctors Locations Services Classes Also Find Us on:. facebook twitter youtube linkedin Stanford Medicine Stanford University Stanford Health Care Lucile Packard Foundation Notice of Nondiscrimination Terms of Use Privacy Policy Code of Conduct © 2021 Stanford Children's Health /nutch_noindexshareprint
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TitleHeart Transplant Rejection | Cedars-Sinai
Urlhttps://www.cedars-sinai.org/health-library/diseases-and-conditions/h/heart-transplant-rejection.html
DescriptionYour immune system's job is to seek out destroy foreign substances in the body. It destroys bacteria and viruses to help keep you healthy. Normally, this is a good thing, but sometimes the immune system's response can lead to problems
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H1Heart Transplant Rejection
H2What is heart transplant rejection?
What causes heart transplant rejection?
Who is at risk for heart transplant rejection?
What are the symptoms of heart transplant rejection?
How is heart transplant rejection diagnosed?
How is heart transplant rejection treated?
What are possible complications of heart transplant rejection?
What can I do to prevent heart transplant rejection?
Living with a heart transplant
When should I call my healthcare provider?
Key points about heart transplant rejection
Next steps
H3Need Help?
H2WithAnchorsWhat is heart transplant rejection?
What causes heart transplant rejection?
Who is at risk for heart transplant rejection?
What are the symptoms of heart transplant rejection?
How is heart transplant rejection diagnosed?
How is heart transplant rejection treated?
What are possible complications of heart transplant rejection?
What can I do to prevent heart transplant rejection?
Living with a heart transplant
When should I call my healthcare provider?
Key points about heart transplant rejection
Next steps
BodyHeart Transplant Rejection Not what you're looking for? Start New Search ABOUT CAUSES DIAGNOSIS TREATMENT NEXT STEPS What is heart transplant rejection? Your immune system’s job is to seek out and destroy foreign substances in the body. It destroys bacteria and viruses to help keep you healthy. Normally, this is a good thing. But sometimes the immune system’s response can lead to problems. During a heart transplant, a surgeon removes your badly working heart and replaces it with a healthy heart from a donor. The immune system sees the new heart as a foreign object and can start to attack it. This is known as transplant rejection. When you have a heart transplant, you will need to take certain medicines for the rest of your life. These help to prevent rejection of the new heart by your immune system. Transplant rejection is very common. It’s common even in people who take all their medicines as prescribed. The most common type of heart transplant rejection is called acute cellular rejection. This happens when your T-cells (part of your immune system) attack the cells of your new heart. It happens most often in the first 3 to 6 months after transplant. Humoral rejection is a less common type. It’s also known as acute antibody rejection. It can develop during the first month after transplantation. Or it can happen as late as months to years after transplant. With humoral rejection, antibodies injure the blood vessels in your body, including your coronary arteries. This can cause problems with blood flow to the heart. Heart transplant rejection can also be long-term (chronic). Coronary artery vasculopathy is a form of chronic rejection. It affects the coronary arteries. These supply the heart muscle with oxygen and nutrients. In coronary artery vasculopathy, the inner lining of the blood vessel thickens. This can lead to less blood going to the heart muscle. Your healthcare provider may prescribe certain medicines to prevent and treat this type of rejection. What causes heart transplant rejection? Heart transplant rejection can happen in a normally functioning immune system. Failing to take anti-rejection medicines as prescribed can cause transplant rejection. But many people who take their medicines as prescribed still have rejection. No one knows for sure why this happens. Who is at risk for heart transplant rejection? Certain things increase the chances of both short-term (acute) and chronic heart transplant rejection. One of the most important factors is a genetic mismatch between the heart donor and heart recipient. Younger heart recipients are also at greater risk for both kinds of rejection. Other things that specifically increase the chances of acute transplant rejection include: Time after transplantation. Rejection risk is highest several weeks after the transplant and then starts to decrease. Being a female heart recipient or female heart donor Being an African-American heart recipient Some factors that specifically increase the chances of chronic rejection include: High cholesterol Cytomegalovirus infection Older heart donor Male donor Younger recipient History of acute heart rejection Coronary heart disease in the donor or the recipient Insulin resistance What are the symptoms of heart transplant rejection? Some of the symptoms of acute heart transplant rejection include: Feeling tired or weak Fever or chills Shortness of breath Fast or irregular heartbeat Drop in blood pressure Swelling of your feet, hands, or ankles Sudden weight gain Flu-like aches and pains Reduced amounts of urine Dizziness or fainting Nausea or loss of appetite It's common for rejection to happen without any symptoms at all. Because of very intense rules for screening after transplant, many cases are found before symptoms develop. This is one reason why it is so important to make all your follow-up visits. Chronic heart transplant rejection often has no symptoms at all. The first symptom might be a heart attack. How is heart transplant rejection diagnosed? Diagnosis starts with a recent health history, physical exam, and blood tests. Often a healthcare provider will diagnose acute rejection with a heart biopsy. You may have multiple routine biopsies after a heart transplant. This helps them to watch for rejection. These biopsies often show signs of transplant rejection before you have any symptoms. Finding a rejection early increases the chances it can be treated. Sometimes healthcare providers spot acute rejection with a blood test. This test checks for certain genes tied to transplant rejection. Your healthcare provider might use other standard tests to evaluate your heart function. Some examples include: Electrocardiogram (ECG) to monitor the heart rhythm Echocardiogram to evaluate heart function Other tests are sometimes needed for the diagnosis of chronic rejection. These tests help provide a better look at the blood vessels. These may include: Coronary angiography Intravascular ultrasound Cardiac stress testing How is heart transplant rejection treated? Treatment depends on a number of factors. These include the severity of the rejection, symptoms, current medicines, and the type of rejection. Some options for treating acute cellular transplant rejection include: Increasing the dose of or how often you take a current anti-rejection medicine Changing to a different anti-rejection medicine Adding other medicines that suppress the immune system. This might be prednisone or a similar steroid. For more severe cases, you may need treatment with medicines given by IV (intravenous) Plasmapheresis is the main treatment for rejection caused by antibodies. This is called acute humoral rejection. Plasmapheresis filters the blood and removes the harmful antibodies. Sometimes light therapy to treat the white cells in removed blood is used (photophoresis). The treated blood is then returned to you. Increasing the dose of anti-rejection medicines is another way to treat chronic rejection. If the damage is more severe, you may have a lot of blockages in the coronary arteries. For this, you may need angioplasty or open heart surgery. These procedures help blood flow better in the coronary arteries. Rarely, chronic rejection needs another transplant. Living a heart-healthy lifestyle can decrease the risk of developing chronic rejection in the form of coronary artery vasculopathy. After you get treatment for rejection, you will need to be closely monitored. You might need follow-up tests to see how you respond. Medicines used to prevent rejection do suppress the immune system. This increases the risk for infection. Your risk of heart failure also increases with rejection. Because of these possible complications, your healthcare provider may: Give you antibiotic and antiviral medicines. These are needed if you are using certain anti-rejection medicines. They don’t treat the rejection itself, but they may help to prevent infection. Give you medicines to treat heart failure, such as beta-blockers. You may need these if the rejection is severely affecting your new heart. What are possible complications of heart transplant rejection? . In rare cases, heart transplant rejection can cause complications such as: Failure of the new donor heart Heart rhythms problems. Some of these can cause sudden death. Heart attack What can I do to prevent heart transplant rejection? You can reduce your chances of having heart transplant rejection and complications from rejection. Here are some things you can do: Take all of your medicines exactly as prescribed. Have an adequate supply of your medicines on hand at all times. Check your weight, blood pressure, and temperature as advised by your healthcare provider. Keep all scheduled healthcare provider appointments. Have your lab work and other tests done on time. Contact your transplant team right away if you have any signs of transplant rejection. Follow up on any tests with your transplant team. Live a heart-healthy lifestyle, including regular exercise and a healthy diet. Don't use tobacco products and limit alcohol. Stay current on vaccines for the flu and pneumonia, along with tetanus boosters as needed. Living with a heart transplant . Your healthcare provider may have more instructions about how to manage your condition. This might include: Living a healthy lifestyle. Eat a heart-healthy diet and get enough exercise. Don't use tobacco products, illegal drugs, or too much alcohol. Stay at a healthy weight. Taking other medicines for your heart. These might include medicines to reduce cholesterol, lower your blood pressure, or help manage your blood glucose. Some of these medicines might help lower the chances of chronic rejection as well. When should I call my healthcare provider? Call your transplant team right away if you have any signs of rejection. Also call if you generally don't feel well. Don't wait until your next scheduled appointment. Key points about heart transplant rejection. Heart transplant rejection is very common after heart transplant surgery. Rejection can be acute or chronic. The immune system attacks the donated heart, leading to symptoms. Follow all of your healthcare provider’s instructions carefully. This will help decrease your chances of rejection. It will also make it easier for your healthcare provider to detect rejection early, when he or she can treat it more easily. Know what symptoms might be signs of heart transplant rejection. Tell your transplant team about any symptoms right away. You will need close monitoring to check for signs of rejection. The risks of acute rejection lessen with time, but rejection is always a risk. You will always need anti-rejection medicines to help prevent transplant rejection. Anti-rejection medicines suppress your immune system. This increases your risk for infection. Treatment of transplant rejection often involves increasing the dose of medicines you are taking. Your healthcare provider may add new medicines. Following a healthy lifestyle can help keep your heart healthy. Next steps. Tips to help you get the most from a visit to your healthcare provider: Know the reason for your visit and what you want to happen. Before your visit, write down questions you want answered. Bring someone with you to help you ask questions and remember what your provider tells you. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you. Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are. Ask if your condition can be treated in other ways. Know why a test or procedure is recommended and what the results could mean. Know what to expect if you do not take the medicine or have the test or procedure. If you have a follow-up appointment, write down the date, time, and purpose for that visit. Know how you can contact your provider if you have questions. Medical Reviewer: Steven Kang MD Medical Reviewer: Mandy Snyder APRN Medical Reviewer: Lu Cunningham © 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. Not what you're looking for? Start New Search Want More Information? Cedars-Sinai has a range of comprehensive treatment options. See Our Programs Looking for a Physician? Choose a doctor and schedule an appointment. Find a Doctor Need Help? 1-800-CEDARS-1 (1-800-233-2771) Available 24 Hours A Day Schedule a Callback Expert Care for Life™ Starts Here Adult Primary Care Pediatric Primary Care Urgent Care Need Help? 1-800-CEDARS-1 (1-800-233-2771) Schedule a Callback Looking for a Physician Choose a doctor and schedule an appointment. Find a Doctor Share Email Print
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TitleHeart Transplant Recovery, Care and Outcomes | Temple Health
Urlhttps://www.templehealth.org/services/heart-vascular/patient-care/programs/heart-transplant/heart-transplant-recovery-outcomes
DescriptionThe first few hours to weeks after your heart transplant are a critical time for you as your body adapts to its new healthy heart
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H1Heart & Vascular Institute
H2Secondary Navigation
Post-Surgery Care at the Hospital
Post-Surgery Care at Home
Medicine to Prevent Heart Rejection and Infection
Living a Heart-Healthy Lifestyle
Why Choose Temple Health for Heart Transplants
Ready for an Appointment?
H3Additional post-heart transplant medications
Preventing risk of infection
Outstanding Heart Transplant Outcomes
H2WithAnchorsSecondary Navigation
Post-Surgery Care at the Hospital
Post-Surgery Care at Home
Medicine to Prevent Heart Rejection and Infection
Living a Heart-Healthy Lifestyle
Why Choose Temple Health for Heart Transplants
Ready for an Appointment?
BodyHeart & Vascular Institute 800-TEMPLE-MED Schedule Appointment Doctors Locations Patient Care Conditions & Treatments Programs Search Clinical Trials Patient Support International Patients Research & Clinical Trials Research Focus Areas Search Clinical Trials For Physicians Physician Liaison Service Education & Events Refer a Patient Emergency & Transfer Services About Leadership Giving to Heart & Vascular Institute Call 800-temple-med SEARCH TEMPLE HEALTH   Find a Doctor   Schedule Appointment   800-TEMPLE-MED main menu Heart & Vascular Institute Back One Level Heart Transplant Program Heart Transplant Waiting List Recovery, Care & Outcomes Heart Transplant FAQs Doctors & Care Team Heart Transplant Surgery What to Expect Rejection Ventricular Assist Device (VAD) FAQs Advanced Heart Failure Program Mechanical Circulatory Support Program Heart & Vascular Institute resize text Life After Your Heart Transplant: Recovery, Care and Outcomes Life after heart transplantation can look very different, especially in the months following your surgery. Symptoms from heart diseases such as end-stage heart failure should improve dramatically. And many can perform the same level of physical activity and have the same quality of life as those who have not had a heart transplant. At Temple, we have achieved outstanding heart transplant survival rates. We tailor your care after surgery to meet your unique needs and to help ensure you’re as healthy as possible and thriving. Post-Surgery Care at the Hospital. The first few hours to weeks after your heart transplant are a critical time for you, as your body adapts to its new healthy heart. You will need close monitoring after surgery as you recover. Just after your surgery, you will be admitted to the ICU for an average of 5 days and then transferred to a recovery room for a 7- to 10-day stay. During this time, you can expect to: Be on a ventilator until you can breathe and cough on your own Perform coughing and breathing exercises under the guidance of a nurse every 2 hours Be on a heart monitor throughout your admission Receive educational support from members of the transplant team Post-Surgery Care at Home. Once you leave the hospital, you and your caregivers will take a more active role in the care of your new donor heart. This includes frequent check-ins and appointments with Temple’s heart transplant team to help ensure your recovery is going well and reduce your chance of organ rejection. During this time, you will: Conduct calls with your heart transplant coordinator to manage your medication, discuss your transition back home, and review information about activities that you should and should not do until instructed — such as driving, working and sexual activity Attend virtual and in-office appointments with your physicians Have tests and procedures, including heart biopsies to check for signs of rejection Perform cardiac rehabilitation activities, such as caring for your incision, moving around and breathing exercises. Here are 5 ways cardiac rehab can improve your heart health. After your heart transplant, watch for side effects and signs of complications or organ rejection, including: Redness, swelling, bleeding, drainage or pain at the incision site Trouble breathing Excessive fatigue Low blood pressure Contact your doctor immediately if you experience any of these symptoms. Staying in close contact with your medical team and attending all appointments and procedures can help reduce your risk of side effects and complications. Medicine to Prevent Heart Rejection and Infection. You must take anti-rejection medicine every day for the rest of your life to prevent the rejection of your new heart. Blood work must also be performed to monitor the side effects of anti-rejection medicine. You should refill your medications on time to avoid missing a dose. You should not be taking any over-the-counter medications or herbal supplements unless cleared by the transplant team. Additional post-heart transplant medications. Temple’s transplant team may prescribe additional medications to help manage other medical problems, such as: Pain Infection High blood pressure Diabetes High cholesterol or lipid levels Preventing risk of infection. Anti-rejection medicine may negatively affect the immune system and possibly lead to infections such as: Thrush Herpes Respiratory viruses You can help prevent the risk of infection during the first few months after surgery. You should: Avoid crowds, especially during high-risk periods such as flu season Avoid contact with animals, especially their feces Practice good hygiene — wash your hands often Practice good dental hygiene Avoid loved ones when they’re sick Keep in contact with your transplant team at Temple if you experience any symptoms or believe that you may have an infection. Living a Heart-Healthy Lifestyle. A new heart is a gift that must be cared for. You may need to make lifestyle changes to best care for your donor heart. Routine exercise, proper diet and avoiding smoking, alcohol and triggering chemicals are all essential to help you enjoy the benefits of your new heart for a long time. In particular, you should: Achieve and maintain a healthy weight Limit sugar and concentrated sweets Modify fat content by limiting how much fat you consume and replacing unhealthy fats with polyunsaturated fats Restrict sodium intake Temple nutritionists can work with you to develop a dietary plan that helps you take care of your donor heart and stay as healthy as possible. Just as important is maintaining good emotional health. Patients who have received a heart transplant may experience a range of emotions after surgery — including fear, depression and anxiety. Our transplant team can help connect those experiencing these emotions with a professional counselor or support group. Why Choose Temple Health for Heart Transplants. Our Heart Transplant team has a high degree of experience helping patients through the transplant recovery process. We stay with our patients for the long-term to make sure they get all the support they need. Outstanding Heart Transplant Outcomes. Based on the July 2021 Scientific Registry of Transplant Recipients report: Temple's survival rate 1 year after transplant is 85.0%. Despite taking on some of the most challenging cases, Temple has achieved outstanding survival rates. 70.9% of Temple patients received a donor heart within 1 year. That's more than the national average of 55.2%. Programs with higher transplant rates tend to perform transplants more frequently than programs with lower rates. Temple excels in donor heart assessment, resulting in a significantly higher transplant rate at 173.6% out of 100, and shorter time-to-transplant for waitlist candidates. Temple’s transplant eligibility criteria are broader than most. Patients who have been turned down for transplantation at other centers may be eligible at Temple. Due to our reputation for accepting and transplanting challenging, complex patients — including those over age 65, those with a higher BMI, or patients with other concomitant medical issues — Temple has been able to offer options to more patients with advanced heart failure. Ready for an Appointment? Find a doctor near you, request an appointment, or call 800-TEMPLE-MED (800-836-7536) today.
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Result 27
TitleHeart Transplant - Heart Centre
Urlhttp://heartcentre.ca/sites/default/files/Heart%20transplant%20A%20Brief%20Overview%20%28Jan-14%29.pdf
Descriptionor long period of time, it can be hard to ... Surgery. • you get the call. • you get your new heart ... How much time it takes you to recover depends on.
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TitleHeart Transplants in Infants & Children | Risks, Process & Statistics
Urlhttps://www.cincinnatichildrens.org/health/h/transplant
DescriptionLearn about the heart transplantation procedure, risks, preparation and survival rates provided by Cincinnati Children's
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TitleHeart Transplants in New Jersey | RWJBarnabas Health
Urlhttps://www.rwjbh.org/treatment-care/heart-and-vascular-care/tests-procedures/heart-transplant/
DescriptionHeart transplantation removes a person’s diseased or failing heart and replaces it with a healthy heart from a deceased donor. Visit our site to learn more about a heart transplant
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H1Heart Transplants in New Jersey
H2How to prepare for a heart transplant procedure
What to expect before a heart transplant procedure
How long is a heart transplant surgery?
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What to expect after a heart transplant procedure
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H2WithAnchorsHow to prepare for a heart transplant procedure
What to expect before a heart transplant procedure
How long is a heart transplant surgery?
What to expect during a heart transplant procedure
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BodyHeart Transplants in New Jersey Request an Appointment Heart transplantation (HT) is a type of open-heart surgery performed to remove a person’s diseased or failing heart and replace it with a healthy heart from a deceased donor. Most heart transplants are done on patients who have end-stage heart failure. Heart failure is a condition in which the heart cannot keep up with its workload to pump enough blood to meet the body’s needs. “End-stage” means the condition is so severe that most medical treatments have failed. Although a great solution for many, a heart transplant isn’t the right treatment for everyone. There are many factors that may disqualify someone, including: advanced age; a separate medical condition that could shorten your life; active infection(s), recent personal medical history of cancer; and the unwillingness to make lifestyle changes necessary to keep your donor heart healthy (e.g. not drinking or smoking). For those who do not qualify for a heart transplant, a ventricular assist device (VAD) provides an alternative. They are commonly used to provide a temporary solution for patients waiting a heart transplant (bridge to transplant), when heart failure is temporary due to an infection or another acute condition (bridge to recovery), when individuals are not qualified for a heart transplant (long-term therapy). How to prepare for a heart transplant procedure. Preparations for a heart transplant often begin long before the surgery. You may begin preparing for a heart transplant weeks, months or years before you receive a donor heart, depending upon the waiting time for transplant. Taking the first steps If your doctor recommends that you consider a heart transplant, you'll likely be referred to a heart transplant center for an evaluation. During an evaluation, your doctors will order several tests, including: Diagnostic tests and procedures Blood tests Cardiac Catheterization X-rays Ultrasound Echocardiogram (ECHO) Electrocardiogram (EKG/ECG) Stress test Urinalysis Waiting for a donor organ: If the transplant team determines you're a candidate, then the transplant center will register you on a waiting list. While on this list: Your medical team will closely monitor your condition. Your doctors may recommend a cardiac rehabilitation program. Your doctors may also suggest having a VAD implanted to support your heart while you wait for a donor organ. What to expect before a heart transplant procedure. A heart transplant usually needs to occur within four hours of organ removal for the donor organ to remain viable. As a result, hearts are offered first to a transplant center close by, then to centers within certain distances of the donor hospital. When you're notified that a potential organ is available, you and your transplant team have a limited amount of time to consider whether to accept the donation. You'll be expected to travel to the transplant hospital immediately. Once you arrive at the hospital, your doctors and transplant team will conduct a final evaluation to determine if the donor heart is suitable for you and if you're ready to have surgery. If it is decided that you are not, you may not be able to have the transplant. How long is a heart transplant surgery? Heart transplantation usually takes 4 to 6 hours, but the preparation and recovery may add several hours. What to expect during a heart transplant procedure. The procedure is performed in the cardiothoracic operating room (OR). Check with your doctor about the details of your procedure. In general: You will change into a hospital gown. Prior to starting the procedure, you will receive a local anesthetic. Once you are sedated, your doctor may insert a breathing tube through your throat into your lungs and connect you to a ventilator. This will breathe for you during surgery. Your doctor will administer general anesthesia (will make you feel sleepy). The procedure begins when your doctor exposes your heart by dividing the breastbone (sternum) in half. Your doctor then spreads both halves to gain access to your heart (open-heart surgery). For this type of surgery, your heart must be still. Prior to doing so, your doctor will place tubes into your heart so that blood can be pumped through your body by use of a heart-lung machine. This machine takes over for the heart by replacing the heart’s pumping action and the lungs by adding oxygen to the blood. Once the blood has been diverted into the bypass machine for pumping, your doctor will then stop the heart by injecting it with a cold solution. When the heart has been stopped, your doctor will remove the diseased heart and replaced it with the donor’s heart. Once your new heart is in place, he or she will connect the blood vessels carefully so there are no leaks. Once checked, the doctor will let the blood circulating through the bypass machine back into your heart. If your heart is not restarting after the procedure is complete, a mild electric shock may be used to restart it. Your doctor may also put temporary wires for pacing into your heart. These wires can be attached to a pacemaker, if needed, during the initial recovery period. Once the procedure is complete, the machine will be turned off. The tubes will be removed and the sternum will be sewn together with the use or sutures or surgical staples. Medical Illustration Copyright © 2019 Nucleus Medical Media, All rights reserved. What to expect after a heart transplant procedure . After the surgery, you will be taken to the cardiothoracic intensive care unit (CTICU) for further observation for several days. Heart transplantation typically requires a hospital stay of 7 to 14 days, or even longer. Other recommendations include: General guidelines The breathing tube is removed when you wake up from anesthesia. Diet is started the day after surgery with liquids, and quickly advanced to solids as tolerated Ambulation is started on the first or second day of surgery Urine catheters and drainage tubes (chest tubes) are removed after 24 to 48 hours If you have pacing wires, your doctor will remove those too Blood samples will be taken often to monitor your new heart, as well as other body functions Your healthcare team will closely watch your anti-rejection (immunosuppression) medicines to make sure you are getting the right dose and the best combination of medicines. Nurses, respiratory therapists, and physical therapists will work with you as you begin physical therapy and breathing exercises. Your doctor will give you instructions to follow during your recovery A cardiac rehabilitation program may also be suggested Our Quality Testimonials Appointments Patient Stories . By summer he was able to enjoy swimming with his family again and is grateful for this second chance at life. Steven Read More “I felt normal...I felt like before I got sick.” Derrick Read More “I’m looking to get back not just to 100 percent,” Bernard says, “but 200 percent, where I come back stronger than ever.” Bernard Read More View All Heart Transplant Stories Patient Stories . Watch Testimonial Watch Testimonial Watch Testimonial Health Articles. View All Posts Dec 17, 2021 Jersey City Medical Center Offers Minimally Invasive Artificial Intelligence Procedure to More Accurately Detect Coronary Artery Disease. Nov 17, 2021 Robert Wood Johnson University Hospital is First Cardiovascular Center of Excellence in New Jersey to Treat Patient with New Drug-coated Balloon Angioplasty Therapy. Nov 8, 2021 Jersey City Medical Center Expands Its Cardiovascular Program to offer Transcatheter Aortic Valve Replacement. Cooperman Barnabas Medical Center 94 Old Short Hills Road Livingston, NJ 07039 (973) 322-5000 View Newark Beth Israel Medical Center 201 Lyons Avenue at Osborne Terrace Newark, NJ 07112 (973) 926-7000 View Heart and Lung Specialty Center at Toms River 780 Route 37 Suite 120 Toms River, NJ 08755 (732) 341-2308 View Robert Wood Johnson University Hospital 1 Robert Wood Johnson Place New Brunswick, NJ 08901 (732) 828-3000 View The Robert Wood Johnson Transplant Center 10 Plum St, 7th Floor New Brunswick, NJ 08901 (732) 253-3699 View Center for Advanced Heart Failure and Transplant at Newark Beth Israel Medical Center 201 Lyons Avenue L4 Newark, NJ 07112 (973) 926-7205 View Heart Transplant Treatment & Care. offered at these locations in your neighborhood View All Locations
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TitleHeart Transplants: Purpose, Procerdure, Risks, Recovery
Urlhttps://www.webmd.com/heart-disease/heart-failure/heart-failure-heart-transplant
DescriptionLearn more from WebMD about heart transplant surgery, including who is eligible,what is involved before and after the procedure, and survival rates
Date
Organic Position29
H1Heart Failure and Heart Transplants
H2Who Is Considered a Candidate for a Heart Transplant?
What Is the Process for Getting a Heart Transplant?
How Are Organ Donors Found?
What Happens During a Heart Transplant?
What Are the Risks of a Heart Transplant?
What Is Organ Rejection?
Can a Person Lead a Normal Life After a Heart Transplant?
How Long Can a Person Live After a Heart Transplant?
Is a Heart Transplant Covered by Insurance?
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H2WithAnchorsWho Is Considered a Candidate for a Heart Transplant?
What Is the Process for Getting a Heart Transplant?
How Are Organ Donors Found?
What Happens During a Heart Transplant?
What Are the Risks of a Heart Transplant?
What Is Organ Rejection?
Can a Person Lead a Normal Life After a Heart Transplant?
How Long Can a Person Live After a Heart Transplant?
Is a Heart Transplant Covered by Insurance?
BodyHeart Failure and Heart Transplants Medically Reviewed by James Beckerman, MD, FACC on July 15, 2020 A heart transplant is the surgical replacement of a person's diseased heart with a healthy donor's heart. The donor is a person who has died and whose family has agreed to donate their loved one's organs.Since the performance of the first human heart transplant in 1967, heart transplantation has changed from an experimental operation to an established treatment for advanced heart disease. Like other organ transplantations, the number of heart transplantations in the U.S. is on the rise. In 2019, 3,552 were performed, up from 3,408 in 2018.Who Is Considered a Candidate for a Heart Transplant?People who have advanced (end stage) heart failure, but are otherwise healthy, may be considered for a heart transplant.The following basic questions should be considered by you, your doctor, and your family to determine if heart transplantation is right for you:Have all other therapies been tried or excluded?Are you likely to die in the near future without the transplant?Are you in generally good health other than the heart or heart and lung disease?Can you adhere to the lifestyle changes, including complex drug treatments and frequent exams, required after a transplant?If you answered "no" to any of the above questions, heart transplantation may not be for you. Also, if you have additional medical problems, such as other severe diseases, active infections, or severe obesity, you most likely will not be considered a candidate for transplant.What Is the Process for Getting a Heart Transplant?In order to get a heart transplant, you must first be placed on a transplant list. But, before you can be placed on the transplant list, you must go through a careful screening process. A team of heart doctors, nurses, social workers, and bioethicists review your medical history, diagnostic test results, social history, and psychological test results to see if you are able to survive the procedure and then comply with the continuous care needed to live a healthy life.Once you are approved, you must wait for a donor to become available. This process can be long and stressful. A supportive network of family and friends is needed to help you through this time. The health care team will monitor you closely to keep your heart failure in control until a donor heart is found. The hospital must know where to contact you at all times should a heart become available.How Are Organ Donors Found?Donors for heart transplants are individuals who may have recently died or become brain dead, which means that although their body is being kept alive by machines, the brain has no sign of life. Many times, these donors died as a result of a car accident, severe head injury, or a gunshot wound.Donors generally give their permission for organ donation before their death. The donor's family must also give consent for organ donation at the time of the donor's death.Donor organs are located through the United Network for Organ Sharing's (UNOS) computerized national waiting list. This waiting list assures equal access and fair distribution of organs when they become available. When a heart becomes available for transplantation, it is given to the best possible match, based on blood type, body size, UNOS status (based on the recipient's medical condition) and the length of time the recipient has been waiting. The race and gender of the donor have no bearing on the match. Unfortunately, not enough hearts are available for transplant. At any given time, almost 3,500 to 4,000 people are waiting for a heart or heart-lung transplant. A person may wait months for a transplant and more than 25% do not live long enough to receive a new heart.Many people who are waiting for transplantation have mixed feelings, because they are aware that someone must die before an organ becomes available. It may help to know that many donor families feel a sense of peace knowing that some good has come from their loved one's death.What Happens During a Heart Transplant?Once a donor heart becomes available, a surgeon from the transplant center goes to harvest the donor heart. The heart is cooled and stored in a special solution while being taken to the recipient. The surgeon will make sure the donor heart is in good condition before beginning the transplant surgery. The transplant surgery will take place as soon as possible after the donor heart becomes available.During a heart transplant, the patient is placed on a heart-lung machine. This machine allows the body to receive vital oxygen and nutrients from the blood even though the heart is being operated on. Surgeons then remove the patient's heart except for the back walls of the atria, the heart's upper chambers. The backs of the atria on the new heart are opened and the heart is sewn into place.Surgeons then connect the blood vessels, allowing blood to flow through the heart and lungs. As the heart warms up, it begins beating. Surgeons check all the connected blood vessels and heart chambers for leaks before removing the patient from the heart-lung machine.It is a complicated operation that lasts from four to 10 hours.Most patients are up and around within a few days after surgery, and if there are no signs of the body immediately rejecting the organ, patients are allowed to go home within seven to 16 days.What Are the Risks of a Heart Transplant?The most common causes of death following a heart transplant are infection and rejection. Patients on drugs to prevent rejection of the new heart are at risk for developing kidney damage, high blood pressure, osteoporosis (a severe thinning of the bones, which can cause fractures), and lymphoma (a type of cancer that affects cells of the immune system).Atherosclerosis of the heart's arteries or coronary artery disease develops in almost half the patients who receive transplants. And many of them have no symptoms, such as angina (chest pain), because they have no sensations in their new hearts. What Is Organ Rejection?Normally, the body's immune system protects the body from infection. This occurs when cells of the immune system move around the body, checking for anything that looks foreign or different from the body's own cells.Rejection occurs when the body's immune cells recognize the transplanted heart as different from the rest of the body and attempt to destroy it. If left alone, the immune system would damage the cells of a new heart and eventually destroy it.To prevent rejection, patients receive several drugs called immunosuppressants. These drugs suppress the immune system so that the new heart is not damaged. Because rejection can occur anytime after a transplant, immunosuppressive drugs are given to patients the day before their transplant and thereafter for the rest of their lives. To avoid rejection, heart transplant recipients must strictly adhere to their immunosuppressant drug regimen. Researchers are continually working on safer, more effective, and well-tolerated immunosuppressant drugs. However, too much immunosuppression can lead to serious infections. Without an active enough immune system, a patient can easily develop severe infections. For this reason, medications are also prescribed to fight infections.Heart transplant recipients are carefully monitored for signs of rejection. Doctors frequently take samples of small pieces of the transplanted heart to inspect under a microscope. Called a biopsy, this procedure involves advancing a thin tube called a catheter through a vein to the heart. At the end of the catheter is a bioptome, a tiny instrument used to snip off a piece of tissue. If the biopsy shows damaged cells, the dose and kind of immunosuppressive drug may be changed. Biopsies of the heart muscle are usually performed weekly for the first three to six weeks after surgery, then every three months for the first year, and then yearly thereafter. It is vital for you to be aware of the possible signs of rejection and infection so you can report them to your doctors and be treated immediately.Signs of organ rejection include:Fever over 100.4°F (38°C)"Flu-like" symptoms such as chills, aches, headaches, dizziness, nausea, and/or vomitingShortness of breathNew chest pain or tendernessFatigue or generally feeling "lousy"Elevation in blood pressureWith too much immunosuppression, the immune system can become sluggish, and a patient can easily develop severe infections. For this reason, drugs are also prescribed to fight infections. It is vital for you to be aware of the possible signs of rejection and infection so you can report them to your doctors and be treated immediately.Warning signs of infection include:Fever over 100.4°F (38°C)Sweats or chillsSkin rashPain, tenderness, redness, or swellingWound or cut that won't healRed, warm, or draining soreSore throat, scratchy throat, or pain when swallowingSinus drainage, nasal congestion, headaches, or tenderness along upper cheekbonesPersistent dry or moist cough that lasts more than two daysWhite patches in your mouth or on your tongueNausea, vomiting, or diarrheaFlu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy"Trouble urinating: pain or burning, constant urge or frequent urinationBloody, cloudy or foul-smelling urineIf you have any of these symptoms of organ rejection or infection, notify your doctor right away.Can a Person Lead a Normal Life After a Heart Transplant?With the exception of having to take lifelong medication to keep the body from rejecting the donated heart, many heart transplant recipients lead active and productive lives.However, there are some things to keep in mind:Medications. As mentioned, after a heart transplant, patients must take several drugs. The most important are those to keep the body from rejecting the transplant. These drugs, which must be taken for life, can cause significant side effects, including high blood pressure, fluid retention, excessive hair growth, osteoporosis, and possible kidney damage. To combat these problems, additional drugs are often prescribed.Exercise. Heart transplant recipients can exercise and are encouraged to exercise to improve the function of the heart and to avoid weight gain. However, due to changes in the heart related to the transplant, patients should speak to their doctor or cardiac rehabilitation specialist before beginning an exercise program. Because the nerves leading to the heart are cut during the operation, the transplanted heart beats faster (about 100 to 110 beats per minute) than the normal heart (about 70 beats per minute). The new heart also responds more slowly to exercise and doesn't increase its rate as quickly as before.Diet. After a heart transplant, the patient may need to follow a special diet, which may involve many of the same dietary changes made prior to surgery. A low-sodium diet will decrease the risk of high blood pressure and fluid retention. Your doctor will discuss your specific dietary needs, and a registered dietitian can help you understand specific dietary guidelines.How Long Can a Person Live After a Heart Transplant?How long you live after a heart transplant depends on many factors, including age, general health, and response to the transplant. Recent figures show that 75% of heart transplant patients live at least five years after surgery. Nearly 85% return to work or other activities they previously enjoyed. Many patients enjoy swimming, cycling, running, or other sports.Is a Heart Transplant Covered by Insurance?In most cases, the costs related to a heart transplant are covered by health insurance.It is important to do your own research and find out if your specific health insurance provider covers this treatment and if you will be responsible for any costs. Health Solutions. Penis Curved When Erect? Could I have CAD? Treat Bent Fingers Treat HR+, HER2- MBC Tired of Dandruff? Benefits of CBD Rethink MS Treatment AFib-Related Strokes Risk of a Future DVT/PE Is My Penis Normal? Relapsing MS Options Liver Transplants Save Lives Finance Plastic Surgery Bent Finger Causes Living With Psoriasis? Missing Teeth? More from WebMD. 5 Tips to Help With Relapsing MS How to Thrive With Narcolepsy Relief for Blocked Hair Follicles Psoriatic Arthritis and Your Sleep What Psoriasis Feels Like First Psoriatic Arthritis Flare Talking to Your Doctor About RA Crohn's: A 'Full-Body' Disease Avoiding Crohn’s Flares Health Benefits of Hemp Seed Oil Live Better With Psoriatic Disease Types of B-Cell Therapy for MS 5 Health Benefits of Hemp Why Prostate Cancer Spreads Living with Advanced Breast Cancer Where Breast Cancer Spreads
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Result 31
TitleHeart-lung transplant | NHS inform
Urlhttps://www.nhsinform.scot/tests-and-treatments/surgical-procedures/heart-lung-transplant
DescriptionLearn more about heart-lung transplants, used to treat severe conditions affecting both the heart and lungs
Date24 Sept 2021
Organic Position30
H1Heart-lung transplant
H2Coronavirus (COVID-19)
Introduction
Why it is necessary
Who can use it
Contraindications
How it is performed
Recovering from a heart lung transplant
Risks following a heart-lung transplant
Transplant success rate
How to get help
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Cardiothoracic
Common reasons for heart-lung transplants
Congenital heart disease
Primary pulmonary hypertension
Cystic fibrosis
Absolute contraindications
Relative contraindications
Initial assessment
Further assessment
The waiting list
The transplant process
After the transplant
Immunosuppressants
Infection
Fungal infections
CMV infection
Preventing long-term infection
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H2WithAnchorsCoronavirus (COVID-19)
Introduction
Why it is necessary
Who can use it
Contraindications
How it is performed
Recovering from a heart lung transplant
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BodyHeart-lung transplant See all parts of this guide Hide guide parts 1. Introduction 2. Why it is necessary 3. Who can use it 4. How it is performed 5. Recovering from a heart lung transplant 6. Risks following a heart-lung transplant 7. Transplant success rate 8. How to get help Introduction. A heart-lung transplant is a major surgical procedure. It is used to treat people who have severe, or life-threatening, conditions that are affecting both their heart and their lungs, such as severe congenital heart disease (birth defects that affect the normal working of the heart). The British Heart Foundation has more on congenital heart disease. During a heart-lung transplant, a donated heart and pair of lungs are taken from a recently deceased donor and are used to replace the patient’s diseased heart and lungs. A heart-lung transplant is a complex and demanding procedure that carries a high risk of complications, some of which can be fatal. Therefore, a heart-lung transplant is usually only performed when all other treatment options have been exhausted, and there is compelling evidence to suggest that the benefits of the transplant outweigh any risks. How common are heart-lung transplants? The first heart-lung transplant carried out in the UK was in 1983 and there are now an average of 9 transplants carried out each year in the UK. This number may seem low in numbers, but it is due to the fact that the availability of suitable donors is severely limited, and medical interventions continue to be the mainstay of most patients' management. The 2 main reasons for the low number of donors for transplant operations are discussed below. Firstly, most donated hearts are taken from people who are brain dead. Although there is no activity in their brain, and they are legally dead, a ventilator can be used to keep their heart beating and oxygen circulating through their blood. However, the prolonged use of a ventilator can damage the lungs and make them unsuitable for transplant. The second problem is that lung tissue rapidly deteriorates once it has been removed from the body. Therefore, a successful donation is only usually possible if the transplant is carried out within 4-6 hours of the lungs being removed from the donor. This means that a successful donation can only go ahead if the donor and recipient of the transplant are in relatively close geographical proximity. Due to the limited availability of organs, there remains an important clinical need for members of the public to join the NHS Organ Donor Register. Why it is necessary. Cardiothoracic. The heart and lungs work in close partnership with each other. Healthcare professionals use the term ‘cardiothoracic’ to describe this partnership. The partnership of the heart and lungs means they work together in the following way: the heart pumps oxygen-rich blood from the lungs to the rest of the body (the cells of the body) the body’s cells use the oxygen for energy the oxygen-poor blood is then pumped back to the lungs the lungs supply the blood with more oxygen, and the process starts again Due to the important partnership that exists between the heart and the lungs, any underlying problems with the heart can damage the lungs and vice versa. Therefore, in order to effectively treat certain health conditions, it is necessary to replace both organs. Common reasons for heart-lung transplants. There are a number of different reasons why a heart-lung transplant may be required. Some of the reasons are outlined below. Congenital heart disease. Congenital heart disease is a condition where children are born with birth defects that affect their heart. In some cases of congenital heart disease, damage to the heart means that the blood is pumped at a higher pressure than normal into the lungs. The excess pressure weakens the heart and damages the lungs. In the most serious cases, the damage to the heart and lungs may be untreatable and a heart-lung transplant will be required. Primary pulmonary hypertension. Primary pulmonary hypertension is a rare condition where, for reasons that are unknown, the blood pressure within the lungs is much higher than usual. Over time, the excess pressure can weaken the heart and then damage the lungs. Cystic fibrosis. Cystic fibrosis is a common, inherited condition that affects over 8,000 children and young adults in the UK. In cases of cystic fibrosis, a thick sticky mucus develops inside the lungs which can damage them. Cystic fibrosis can often be successfully treated using a lung transplant, but there may be some circumstances where if a donated set of heart and lungs are available, a heart-lung transplant will be performed. For example, if the blood supply that connects the heart to the lungs becomes damaged, it is more likely that transplanting both the heart and the lungs will be successful. There is also the additional benefit that the original heart, which is usually undamaged except for the nearby blood vessels, can be used as a transplant organ for somebody else. This is known as a ‘domino transplant’. Who can use it. As a result of the lack of available donor organs, transplant teams have to assess potential recipients very carefully. They need to establish whether there are problems, or factors, that may result in the donation proving unsuccessful. The outcome of the assessment may mean that the risks of a heart-lung transplant outweigh the benefits. Contraindications. Healthcare professionals use the term ‘contraindication’ to describe factors, or problems, that mean that a person is not suitable for a particular treatment. There are 2 types of contraindication: absolute contraindication - which means a person should not, under any circumstances, be offered a treatment relative contraindication - which means that while the treatment would generally not be recommend, there may be special circumstances where treatment could go ahead Absolute contraindications. Absolute contraindications for a heart-lung transplant include: being over 65 years of age and having another serious health condition having blood poisoning (septicaemia) having an incurable form of cancer currently misusing alcohol or drugs currently smoking, or having a mental health condition, such as schizophrenia, that means you are highly unlikely to comply with the treatment that will be required during the recovery period, such as taking immunosuppressant medication Relative contraindications. Relative contraindications for a heart-lung transplant include: having HIV having hepatitis B having hepatitis C being obese having severe diabetes that has caused damage to your organs, or having severe osteoporosis (brittle bones) - as many of the medications that are used in the recovery period can weaken bones, they are usually unsuitable for people with severe osteoporosis How it is performed. Initial assessment. If a heart-lung transplant is thought to be an appropriate treatment for you, it is likely that you will discuss this with your specialist and then be invited to your local hospital for an initial assessment. Further assessment. Once the contraindications have been considered, it is likely that you will be invited to your nearest transplant centre to have a more in-depth assessment. The purpose of having a more in-depth assessment is to build up a more detailed picture of your current state of health and to check whether there are any underlying problems that could affect your suitability for having a transplant. You will also be given the opportunity to meet the transplant team and to find out more about the procedure. Before visiting the transplant centre, you may find it useful to write a list of questions that you would like to ask the transplant team. As part of your assessment, you may have some of the tests that are described below. blood and urine tests - to check for viral or bacterial infections, as well as assessing the state of organs, such as your kidneys and liver chest X-rays blood pressure tests lung function test - where a machine called a pulse oximeter is used to measure the amount of oxygen that is in your blood computer topography (CT) and magnetic resomrinance imaging (MRI) scans - which can be used to check the state of certain organs, such as your lungs coronary angiography - a special type of X-ray that can be used to study the inside of your heart electrocardiography (ECG) - a test that can measure the electrical activity of your heart The whole assessment process usually takes between 2 to 4 days. If your child is being assessed, the transplant centre will be able to arrange accommodation for you if you need it. The final decision about whether you, or your child, is suitable for a heart-lung transplant is not made by one individual - it is a joint decision with a person-centred approach that the transplant team discusses to consider all of the tests and person as a whole. If the decision is straightforward, you will be informed quickly, perhaps before leaving the transplant centre. However, if the decision is more complex, the transplant team will want to carefully discuss all of the issues. Therefore, it may be several weeks before the decision is discussed with you. Once the decision has been made, you will have the opportunity to discuss the decision in person with a member of the transplant team. If it is decided that you, or your child, is not suitable for a heart-lung transplant, you will also be given the opportunity to discuss the treatment options that are suitable for you. The waiting list. If it is decided that you are suitable for a heart-lung transplant, your details will be added to the NHS Organ Donor Register, and you will be added to the waiting list. You will be given a pager so that staff at the transplant centre can contact you at any time during the night or day if a donated organ becomes available. You should also keep a suitcase packed with clothes and other suitable items, so that you are ready to leave for the transplant centre as soon as you are notified. It is your responsibility to inform the transplant centre if: there are any changes to your personal details - for example, if you have changed address, or if you are going on holiday you become more unwell or have changes to your normal symptoms you are admitted to hospital there are any changes to your medication It is impossible to say how long it will take for a suitable donor to be found. It may be several months, or even years, before a donated heart and lungs of the right size and blood group become available. Your transplant centre will be able to offer any support, guidance and information that you may need while you are waiting for a suitable donor to be found. The transplant process. Once a donated set of heart and lungs become available, your transplant team will contact you and arrange for transport to take you to the transplant centre as quickly as possible. You will be taken to the operating theatre and given a general anaesthetic. A machine called a heart-lung machine will be attached to your body using tubes that are inserted into your blood vessels. The machine will pump oxygen-rich blood around your body until the operation is complete. An incision (cut) will made in your chest, and your heart and lungs will be removed. The donated set of heart and lungs will then be put in place and reconnected to the surrounding blood vessels. The incision in your chest will be stitched up, and you will be transferred to an intensive care unit (ICU) where your recovery will be closely monitored. A heart-lung operation usually takes several hours to complete. Recovering from a heart lung transplant. After the transplant. Following your heart-lung transplant, it is likely that you will have to stay in the intensive care unit (ICU) for several days. There are several reasons for this: Your new organs will be very vulnerable to infection immediately after the transplant, so you will need to stay in a sterile (germ-free) environment. There is a risk that your body may reject the heart and/or the lungs, which would require emergency treatment. You will require additional assistance with breathing and feeding until you begin to recover. You will be given pain relief as required both at this stage (when you are less mobile) and as you recover and begin to move around the ward. You will then usually be transferred to a general ward within 3 to 4 days where your health will continue to be monitored as you recover from the effects of the surgery. Most people will be well enough to leave hospital within 3 weeks of having a heart-lung transplant. The recovery process Recovering fully from a transplant can be a long and sometimes frustrating process. You may be referred to a physiotherapist, or other specialist in rehabilitation, so that you can take part in exercises that are specifically designed to strengthen your new heart and lungs. This is known as cardiopulmonary rehabilitation. During your recovery period, you will need to attend regular check-ups so that the function of your new heart and lungs can be regularly monitored. You may need as many as 3 check-ups a week during the first few weeks after the transplant. These appointments will become less frequent if you make good progress. After having a heart-lung transplant, it may take up to 6 months before you are well enough to return to your normal daily activities. Once you make a full recovery, you will still require regular check-ups on a long-term basis. Depending on your condition, the timing of these can range from every 3 months to once a year. Immunosuppressants. After having a heart-lung transplant, one of the biggest risks is that your immune system will regard the new heart and lungs as foreign objects and begin to attack them. This is known as rejection.  In order to prevent your new heart and lungs from being rejected, you will need to take medicines, known as immunosuppressants, to suppress your immune system. Immunosuppressants work by interfering with the normal activities of specialised white blood cells called T cells. The immune system uses T cells to kill foreign cells, such as bacteria, viruses and, in the case of transplants, donated tissue, such as your new heart and lungs. Most people need to take a combination of 3 different immunosuppressants for the rest of their life. However, if you respond well to treatment, the doses of immunosuppressants may be lowered over the long term. Immunosuppressants are powerful medicines that can have a range of different side effects. Possible side effects you may experience include: increased vulnerability to infection weakened bones (osteoporosis) muscle weakness nausea vomiting stomach ulcers blurred vision insomnia weight gain mood swings shaking of the hands acne While these side effects may be troublesome, you should never stop or reduce the recommended dose of immunosuppressants, because if you do, it could lead to your heart and lungs being rejected. The transplant centre may be able to provide additional treatments to help you to cope better with any side effects that you experience after taking immunosuppressants. Risks following a heart-lung transplant. One of the biggest risks after having a heart-lung transplant is that, despite taking immunosuppressants, your body will reject the new heart and lungs. There are 2 types of rejection: acute rejection - where rejection occurs just after surgery chronic rejection - where rejection occurs many months or years after surgery Signs that your body may be rejecting your heart include: fatigue swelling of your arms and legs weight gain a high temperature (fever) of above 38C (100.4F) Signs that your body may be rejecting your lungs include: cough shortness of breath difficulties breathing a high temperature (fever) of above 38C (100.4F) If you have any of these symptoms, you should contact your GP and/or your transplant centre as soon as possible. Rejection can usually be treated by increasing the dose of your immunosuppressive medicines. Infection. The immunosuppressants medicines will weaken your immune system making you more vulnerable to infection. The 3 most common types of infection experienced by people who have undergone heart-lung transplants are: bacterial infection fungal infections cytomegalovirus (CMV) infection CMV is a common virus that is part of the herpes family of viruses. You may be given antibiotics to take for the first few weeks after your transplant as a precaution against infection Bacterial infection A bacterial infection of the lungs (pneumonia) is common in the first few weeks after a transplant. Symptoms of pneumonia include: breathing difficulties coughing up phlegm (thick mucus) that may be yellow, green, brown or blood-stained wheezing a rapid heartbeat (tachycardia) a high temperature (fever) of above 38C (100.4F) feeling generally unwell sweating and shivering loss of appetite pain in your chest If you think that you have pneumonia, you should contact your GP and your transplant team. If you have got pneumonia, the condition will need to be treated with antibiotics. Fungal infections. Although not as common as bacterial infections, fungal infections can also develop in the first few weeks after a transplant. Less serious fungal infections can develop in the skin, nails, mouth, feet and, in women, the vagina. The symptoms of these types of fungal infection will depend on what part of your body is affected, although shared symptoms include: scaling and redness of the skin itchiness in cases of vaginal infection, a discharge of a thick white fluid from the vagina More serious fungal infections can develop inside the body (invasive fungal infections), such as in the lungs (fungal pneumonia) or in the blood stream. Symptoms of an invasive fungal infection include: a high temperature (fever) of above 38C (100.4F) shortness of breath dizziness chest pain a change in behaviour, such as confusion or disorientation If you think that you may have an invasive fungal infection, you should contact your GP and/or transplant centre as soon as possible. Non-invasive fungal infections can be treated using antifungal creams and tablets. Invasive fungal infections may require admission to hospital and treatment with injections of anti-fungal medication (intravenous antifungals). As a precaution against fungal infections, you may be given a course of antifungal medication to take for several months after your transplant. CMV infection. CMV infections are common during the second month after a transplant. Symptoms of a CMV infection include: a high temperature (fever) of above 38C (100.4F) shortness of breath the appearance of large, painful ulcers in your mouth visual disturbances, such as blind spots, blurring and floaters (tiny black or shadowy dots or lines that appear to be floating in your field of vision) If you think that you have a CMV infection, you should contact your GP and/or transplant centre as soon as possible. CMV infections can be treated with anti-viral medicines. As a precaution against CMV, you may be given a course of anti-viral medication to take for several months after your transplant. Preventing long-term infection. After having a heart-lung transplant, it is likely that you will need to take immunosuppressants for the rest of your life, because you will be more vulnerable to infection. This means that you will have to take extra precautions that most people are not required to take. These include: avoiding crowds - if this is unavoidable, you should wear a face mask, particularly during the first year after your transplant avoiding close contact with anyone who is known to have an infection avoiding anything that could damage your lungs and make them more vulnerable to infection, such as smoke, chemical sprays or chemical fumes keeping your house very clean to prevent the spread of infection (you may need support with this initially) Transplant success rate. The results for heart-lung transplants have improved significantly since the operation was first carried out in 1983. This is mainly due to the introduction of immunosuppressants, which help prevent the immune system from rejecting donated organs. The most recently available data shows that: 66% of people will survive for 1 year after receiving a heart-lung transplant 63% of people will survive for 2 years after receiving a heart-lung transplant 47% of people will survive for 5 years after receiving a heart-lung transplant 36% of people will survive for 10 years after receiving a heart-lung transplant How to get help. Finding out that you need to have a transplant, waiting for suitable donor organs, the recovery process and the change of lifestyle can all be emotionally demanding for you and your family. If you feel depressed or would like to talk to someone about your feelings, see your GP. They can refer you to a counsellor and advise you about how to join a support group in your area.  Add Page to Info For Me Share Click here to share this page on Facebook (This will open a new window). Tweet Click here to share this page on Twitter (This will open a new window). Print Click here to print this page (This will open your print options in a new window). Source: Chest Heart & Stroke Scotland - Opens in new browser window . Last updated: 24 September 2021 How can we improve this page? Help us improve NHS inform . Feedback Alert Title. Feedback display message, this and the title will be overided by Javascript Community content from Health Unlocked - This will open in a new window. Chat to an NHS operator in our Live Chat - opens a new window
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Result 32
Titleheart-transplantation-service-adult.pdf - NHS England
Urlhttps://www.england.nhs.uk/wp-content/uploads/2017/04/heart-transplantation-service-adult.pdf
DescriptionFor hearts this would mean increasing transplants from DBD donors ... provides heart transplant and lung transplant assessment, surgery and life-long.
Date
Organic Position31
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H2WithAnchors
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TitleHeart Transplant: Donor Selection, Surgery, and Recovery
Urlhttps://www.verywellhealth.com/before-during-and-after-heart-transplant-4171892
DescriptionPeople with end-stage heart failure may be eligible for a heart transplant. Learn what happens before, during, and after this life-saving procedure
Date20 Jul 2021
Organic Position32
H1What to Expect From a Heart Transplant
H2Reasons for a Heart Transplant
Types of Heart Transplants
Donor Recipient Selection Process
Before Surgery
Surgical Process
After Surgery
Support and Coping
H3Who Is Not a Good Candidate?
Heart-Lung Transplant
Types of Donors
Finding a Match
Be Ready
Complications
Prognosis
Diet and Nutrition
Exercise
A Word From Verywell
H2WithAnchorsReasons for a Heart Transplant
Types of Heart Transplants
Donor Recipient Selection Process
Before Surgery
Surgical Process
After Surgery
Support and Coping
BodyWhat to Expect From a Heart Transplant By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine. Learn about our editorial process Updated on July 20, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Jennifer Schwartz, MD Medically reviewed by Jennifer Schwartz, MD Jennifer Schwartz, MD, is a board-certified surgeon and Assistant Professor of Surgery at the Yale School of Medicine. Learn about our Medical Review Board Table of Contents View All Table of Contents Indications Types Recipient Selection Before Surgery Surgical Process After Surgery Support and Coping A heart transplant is a very complex surgical procedure during which a patient’s own heart is surgically removed and replaced with a donor heart, although a less commonly used method keeps the patient's heart in place. Heart transplantation is done as a treatment for end-stage heart failure—heart disease that is severe enough that it will lead to death without the new organ. Heart transplantation isn’t considered a cure for heart disease, but rather a treatment that can significantly prolong the life of the heart recipient. On average, an adult patient who receives a donated heart lives an additional 10 years after surgery. Most of these patients would not survive a year, or possibly two years, without this life-saving procedure. Indeed / Getty Images Reasons for a Heart Transplant . There are many heart conditions that can become severe enough to warrant a heart transplant, such as cardiomyopathy, heart failure, and restrictive myopathy. Some are present at birth and others develop over time (e.g., coronary heart disease). Some conditions are the result of an injury to the heart, such as a heart attack that damages the heart muscle Regardless of how the disease process started, you may need a heart transplant if you experience: Systolic heart failure: Your heart is enlarged and too weak to pump blood with enough force.Diastolic heart failure: Your heart muscle is thick and stiff, and therefore unable to relax and fill with blood between each beat. This is more likely in people age 70 and older. Who Is Not a Good Candidate? . There are some general contraindications to receiving a heart transplant, though these vary by location, transplant center, and even surgeon. What one transplant center may say is a contraindication to being listed for a transplant may not be an issue for a different center. Some of these issues may only temporarily prevent transplantation. For example, a patient would not receive a transplant while they have a current high fever and an active infection, but would be eligible once they are well. People who are not candidates for a heart transplant include those with: Active infection Inability to manage the post-transplant regimen Current addictive behavior including illegal drugs, alcohol, and nicotine A history of cancer, a current diagnosis of cancer, or cancer that is likely to return Dementia Irreversible pulmonary hypertension Severe vascular disease Severe disease of another organ (for some, a dual transplant—such as a heart-kidney combination—is possible) Presence of an additional terminal disease  Heart Failure Types of Heart Transplants . There are two different surgical approaches to heart transplantation. Your surgeon will explain which one is better suited to your specific needs. Orthotopic approach: The more common of the two procedures, the orthotopic approach requires replacing the recipient heart with the donor heart. The recipient receives general anesthesia and is placed on a bypass machine to oxygenate the blood while the heart transplant is being performed. After the recipient’s heart is removed, the donor heart is prepared to fit and implantation begins.Heterotopic approach: With heterotopic transplantation, also called “piggyback” transplantation, the recipient’s heart remains in place and the donor heart is placed to the right side of the chest. The procedure is done rarely and is usually reserved for patients with certain forms of pulmonary disease. Heart-Lung Transplant . A heart-lung transplant is a surgery for those with life-threatening heart and breathing problems. Surgeons remove the damaged heart and lungs and replace them with a healthy heart and lungs from a deceased donor. This procedure is done very rarely because only a small percentage of people fit the criteria for donating both heart and lungs. Heart transplants are the third most common type of transplant in the United States, after kidney and liver transplants. In 2018, 3,408 heart transplants were performed. Donor Recipient Selection Process . Once you have been approved for a transplant, you will have to choose a transplant center. Seeing a transplant surgeon requires a referral from your own physician to the transplant center that performs heart transplants near your home. In many cases, there may only be one nearby, but in large cities, you may have multiple options. After meeting with the staff at a transplant center, you will be evaluated. This will include a review of your medical records, blood tests, possible imaging studies, and other tests designed to determine if you are well enough to tolerate transplant surgery but sick enough to need a new organ. When you consider transplant centers, you may want to: Learn about the number and type of transplants the center performs each year Ask about the transplant center's organ donor and recipient survival rates Compare transplant center statistics through the database maintained by the Scientific Registry of Transplant Recipients Consider other services provided by the transplant center, such as support groups, travel arrangements, local housing for your recovery period, and referrals to other resources. Tests will be done to examine your genetic makeup. It is important for you and the donor to be a good genetic match to minimize the chance of rejection. You will also undergo evaluations to determine if you have the mental capacity to tolerate the transplant process, as well as care for yourself and manage an extensive drug regimen after surgery. Many transplant centers will not perform transplants on individuals who will not be able to care for themselves independently after surgery. The transplant center will want to determine if you have any addiction issues, particularly if those issues led to the heart disease that is making a heart transplant necessary. For example, if you abused cocaine and it led to heart damage, it will be important that you are no longer abusing the drug. If you are, you will not be placed on the transplant list. Social workers at the transplant center can help you determine how you will pay for the surgery and if your insurance is adequate to cover the procedure and the additional lifelong expenses. The can also help you obtain insurance or sign up for state and federal programs that can assist with transplant expenses as well. Types of Donors . Donor hearts become available for transplantation when a person has died or is determined to be brain dead and they or their family members elect to donate their organs. A donor's sex and race do not determine whether or not a recipient can receive their organ. If the donor has an infectious disease, such as hepatitis, a recipient may be located that already has that disease so the organ can still be used. Individuals with any blood type can donate their heart, but recipient compatibility will be considered when finding a match. Many times, the donor and recipient are close in age, but this is not required. Finding a Match . Once it's determined that you are a good candidate for a heart transplant, you are placed on the transplant list by the transplant center. This is a database of potential donors and recipients. The system uses multiple types of criteria to create a list of every potential recipient of every organ donation. A complex algorithm helps determine the order in which patients appear on each list, or whether they appear at all. Examples of criteria used include: Age: The transplant system tries to maximize the life of a given transplant, so young people tend to be given younger organs in order to provide them with a transplant that could potentially last a lifetime. Severity of illness: Typically, those who are the sickest and those who have waited the longest are at the top of potential recipient lists. Location: After a donor heart is removed, preserved, and packed for transport by the medical staff, it must be transplanted into the recipient within four to five hours, so proximity is a factor. Blood type: Ensuring compatible blood types is key to reducing the risk of organ rejection. Body size: In order for a donor and a recipient to match, they must be approximately the same body size. A heart from a large man could never fit in petite female, and vice versa. Before Surgery . Once your transplant seems imminent, you'll undergo standard pre-operative testing to ensure you are well enough to withstand the surgery. These tests include: Blood tests to check your liver and kidney function, as well as the levels of the many components that make up your blood A chest X-ray An electrocardiogram (EKG) to see how well your heart is working Echocardiograpy, a test that provides a detailed image of your heart. An "echo" as it's called, provides information about the size and shape of your heart and how well its chambers and valves are working. Be Ready. Once a heart becomes available, you will have to get to the transplant center immediately, as the heart must be transplanted within six hours. It's a good idea to have a bag packed with items to make you feel comfortable during your stay (which can be around two weeks), such as pajamas, a robe, slippers, toiletries, and a pillow. You should also pre-arrange to have someone pick you up from the hospital and help you with daily responsibilities while you are in the hospital and during your recovery at home. Surgical Process . The heart transplant procedure begins with arriving at the hospital. Some people may be already hospitalized due to illness when an organ becomes available; others may receive a phone call that a match has been found. Once at the hospital, blood is drawn, an IV is placed, and for many, an indwelling catheter such as a PICC line is put in place for the fluids and medications that will be given during and after surgery. Surgery begins in the operating room, where general anesthesia is provided by an anesthesiologist. Once the patient is asleep, the procedure begins with a large incision in the middle of the chest, cutting through both the skin and bone of the chest to expose the heart. In many cases, two surgeons are operating together to make the transplant process go faster and more smoothly. The patient is placed on a heart-lung bypass machine so the blood continues to be oxygenated by the lungs and pump to the body. This part of the surgery is key because the heart is then stopped, then removed from the body. The donor heart is then sewn into place and restarted. Once the heart is beating, and the final work of placing chest tubes for drainage is complete, the chest is closed by wiring the sternum (breastbone) shut and closing the skin with staples, steristrips, or sutures. In general, this surgery takes three to four hours. It will take closer to six to eight hours, however, for patients who have a ventricular assist device (VAD). A VAD is a mechanical pump that keeps the heart pumping blood while a patient awaits a transplant. These devices can support the left ventricle (LVAD), the right ventricle (RVAD), or both (BIVAD). For those confined to a hospital bed, the machine's pump is located outside the body and is connected to the heart via tubes inserted in the abdomen. There are also implantable, portable pumps designed for healthier patients or for longer-term use. In a heart-lung transplant, the procedure is largely the same. An incision is made in the chest, and the surgeon will remove both the heart and lungs. The donated heart is placed first, followed by each of the lungs. The organs are reconnected to the surrounding blood vessels, and the lungs are attached to the windpipe. This procedure typically takes four to six hours. After a heart (or heart-lung) transplant, you will be taken to the ICU to recover and to slowly wake from sedation over the next day or two. You will remain in the hospital for a week or more. Complications . In addition to the general risks of surgery, the risks associated with anesthesia and the risks associated with open-heart surgery, there are some additional and significant risks that a patient should consider prior to having surgery. Risks include but are not limited to: Blood clots Stroke Anoxic brain injury: Brain damage due to a lack of oxygen Death: All surgeries have a risk of death, but the risk is higher than typical with heart transplantation, particularly if the heart does not start in the donor's body or does not function well. Acute rejection: The donor's body does not tolerate the transplanted heart. Heart transplant surgery is a very high-risk procedure because the heart is not only stopped but removed and replaced. After Surgery . The recovery from a heart transplant procedure lasts several months and may involve cardiac rehabilitation. Most patients are able to leave the hospital within a few weeks of the surgery, return to many of their normal activities within six weeks of surgery, and have reached the end of the recovery phase at the three to six-month mark. Lifelong immunosuppressants (calcineurin inhibitors) are necessary to prevent rejection of the donor heart. During follow-up appointments, which will happen regularly during the year after surgery, doctors will check to ensure medication adherence, ask about side effects, and check for any warning signs that the body is rejecting the new organ. Prognosis . For the average heart transplant patient with a good outcome from surgery, the expectation is an additional decade or more of life after the procedure. Approximately 80% to 95% percent of patients survive the first year. The average survival rate of an adult after a heart transplant surgery is 11 years, depending on depend on their age at the time of transplant, how well they follow their surgeon’s instructions, other health issues they may have, their daily routine (including diet and exercise), and how well their body tolerates the transplant process.  The average survival rate of adult heart transplant recipients is 11 years after the surgery, which means that 50% of patients live longer than that. This percentage has been steadily improving over the last several decades. Support and Coping . It's normal to feel anxious or overwhelmed while waiting for a heart transplant or to have fears about rejection, returning to work, or other issues after a transplant. Seeking the support of friends and family members can help you cope during this stressful time. Your transplant team can also assist you with other useful resources and coping strategies throughout the transplant process, such as: Joining a support group for transplant recipients: Talking with others who have shared your experience can ease fears and anxiety. Support groups may be in-person or online.Finding vocational rehabilitation services: If you're returning to work, your social worker may be able to connect you with rehabilitation services provided by your home state's department of vocational rehabilitation.Setting realistic goals and expectations: Recognize that life after transplant may not be exactly the same as life before transplant. Having realistic expectations about results and recovery time can help reduce stress, as can enlisting help with daily tasks.Educating yourself: Learn as much as you can about life post-procedure and ask questions about things you don't understand. How to Enjoy Better Health After an Organ Transplant Surgery Diet and Nutrition . Maintaining a healthy weight through diet and exercise can help prevent many common post-transplant complications, including infection, heart attacks, and bone thinning. Your transplant team should include a nutrition specialist (dietitian) who can discuss your dietary needs and answer any questions you have after your transplant. Your dietitian's recommendations may include : Eating at least five servings of fruits and vegetables each dayEating lean meats, poultry, and fishEating whole-grain breads, cereals, and other productsHaving enough fiber in your daily dietDrinking low-fat milk or eating other low-fat dairy products to help maintain healthy calcium levelsLimiting salt and sodium intake by using fresh herbs and spices to season foods and avoiding processed foodsLimiting unhealthy fats, such as saturated fats in butter and red meatsLimiting your caffeine and avoiding excessive alcohol intakeStaying hydrated by drinking adequate water and other fluids each dayAvoiding grapefruit and grapefruit juice, pomegranate, and Seville oranges due to their effect on a group of immunosuppressive medicationsFollowing food safety practices to reduce the risk of infection Exercise . After a heart transplant, regular exercise helps boost energy levels and increase strength. It also helps you maintain a healthy weight, reduce stress, and prevent common post-transplant complications such as high blood pressure and elevated cholesterol levels. Your transplant team will recommend a physical activity program based on your individual needs and goals. Walking, bicycling, swimming, low-impact strength training, and other physical activities you enjoy can all be a part of a healthy, active lifestyle after transplant. But be sure to check in with your transplant team before starting or changing your post-transplant exercise routine. How to Enjoy Better Health After an Organ Transplant Surgery A Word From Verywell . Heart transplant surgery is often a last resort of treatment for a heart that isn’t functioning well enough to sustain life. It is done when there are no other options left. Transplant surgery is risky, but for these patients, death is certain without a new heart. For the patient who finds a match and has a successful transplant surgery, life may be extended for decades. Was this page helpful? Thanks for your feedback! What are your concerns? Other Inaccurate Hard to Understand 19 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. ScienceDaily. Long-term survival possible for pediatric heart transplant patients. American Heart Association. Heart transplant. John Hopkins Medicine. Heart transplant patient selection criteria. Flécher E, Fouquet O, Ruggieri VG, Chabanne C, Lelong B, Leguerrier A. Heterotopic heart transplantation: where do we stand?. Eur J Cardiothorac Surg. 2013;44(2):201-6. doi:10.1093/ejcts/ezt136 Le pavec J, Hascoët S, Fadel E. Heart-lung transplantation: current indications, prognosis and specific considerations. J Thorac Dis. 2018;10(10):5946-5952. doi:10.21037/jtd.2018.09.115 Organ Procurement and Transplantation Network. Penn Medicine. Heart evaluation. Schwartz BG, Rezkalla S, Kloner RA. Cardiovascular effects of cocaine. Circulation. 2010;122(24):2558-69. doi:10.1161/CIRCULATIONAHA.110.940569 Abara WE, Collier MG, Moorman A, et al. Characteristics of deceased solid organ donors and screening results for hepatitis B, C, and human immunodeficiency viruses - United States, 2010-2017. MMWR Morb Mortal Wkly Rep. 2019;68(3):61-66. doi:10.15585/mmwr.mm6803a2 United Network for Organ Sharing. How we match organs. The Alliance. Leadership in Organ Donation and Transplantation. The Key to Preserving Organs for Transplant? Texas Heart Institute. A heart surgery overview. University of California, San Francisco. Cardiac Surgery. Ventricular Assist Devices. John Hopkins Medicine. Heart transplant. UptoDate. Patient education: heart transplantation (beyond the basics). American Organization Transplant Association. Patient support groups. Stanford Health Care. Nutrition guidelines after a heart transplant. Fukatsu S, Fukudo M, Masuda S, et al. Delayed effect of grapefruit juice on pharmacokinetics and pharmacodynamics of tacrolimus in a living-donor liver transplant recipient. Drug Metab Pharmacokinet. 2006;21(2):122-5. doi:10.2133/dmpk.21.122 Stanford Health Care. Exercise and heart transplant. Additional Reading Heart Transplant. National Heart, Lung and Blood Institute. Heart Transplant Beyond The Basics. Medline Plus. Prognosis After Cardiac Transplantation In Adults. Medline Plus. American Society of Transplantation. Getting a New Heart. Huddleston, C, et al. Heart-lung transplantation. J Thorac Dis. 2014 Aug; 6(8): 1150–1158. doi:10.3978/j.issn.2072-1439.2014.05.11 United Network of Organ Sharing (UNOS). Organ Facts and Surgeries: Heart. Related Articles What You Should Know About Liver Transplant Surgery What You Should Know About Kidney Transplant Surgery Lung Transplants for Severe Cystic Fibrosis Stem Cell Transplantation from a Donor Before, During, and After Lung Transplant Surgery Treatment with Hematopoietic Stem Cell Transplantation What to Expect From a Pancreas Transplant Skin Grafts Treat Burns, Wounds, and Are Used for Reconstruction Multiple Myeloma Treatment with Stem Cell Transplant Organ Transplants Overview 8 Transplant Support Groups of 2021 What Is the Universal Recipient Blood Type? How Donating and Receiving Bone Marrow Is Done What to Expect From a Head Transplant Hand Transplant: Donor Selection, Surgery, and Recovery Understanding Chronic Graft-Versus-Host Disease
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TitleThe first U.S. adult heart transplant | Stanford Medicine
Urlhttps://stanmed.stanford.edu/2018winter/fifty-years-since-first-us-adult-heart-transplant-stanford.html
Description
Date
Organic Position33
H1Magical moment
H2The enormity of the first U.S. adult heart transplant
H3Race to transplant
Shumway’s first
Bringing the donor to Stanford
‘A three-ring circus’
A fight to keep the patient alive
Refining the work
Additional Reading
H2WithAnchorsThe enormity of the first U.S. adult heart transplant
BodyMagical moment The enormity of the first U.S. adult heart transplant . By Tracie White For 30 seconds on the afternoon of Jan. 6, 1968, in an operating room at Stanford Hospital, two human hearts lay very still in two separate basins near the unconscious body of a 54-year-old patient, and time froze. “We both stood there and stared into this huge, empty cavity for a good half a minute,” says Edward Stinson, MD, chief resident at the time. “It was a magical moment.”  Norman Shumway, seated right center, On Jan. 6, 1968, performed the first U.S. adult heart transplant. Edward Stinson, seated across from him, and Nurse Bernadine Hartman assisted in the surgery. (Photo: Stanford Medical History Center) Related reading What happened next: Stanford’s heart transplant breakthrough precipitated years of protocol advances The young surgeon was assisting his mentor Norman Shumway, MD, PhD, chief surgeon, who had just removed Mike Kasperak’s diseased heart in an effort to save the retired steelworker’s life. It was the first attempted heart transplant of an adult in the United States.“Do you think this is really legal?” Stinson asked Shumway.“I guess we’ll see,” Shumway said. One of the two hearts, diseased beyond repair, would never beat again. But the other, if transplanted into Kasperak’s chest within the next hour or two, could start up again and save his life. It was an outrageous act that was being followed with bated breath by the world as a frenzied press corps, camped out in the hallways of the hospital’s basement, issued moment-by-moment reports. “I just remember thinking the future was going to be different if they can transplant a heart,” Tom Brokaw, the anchor and managing editor of NBC Nightly News for 22 years, says in a recent interview. On that day, he was one of the reporters at the hospital, waiting for the news to break. That surgery, 50 years ago, captured a moment in history when transplantation of a human heart was so hard to fathom, so bizarre, it was considered shocking, almost indecent. The heart, more than any other organ, holds a unique place in the public imagination, seen as the seat of the soul, the symbol of love and compassion. So, what happens if it’s cut out and replaced with a stranger’s? Does a man become a woman if transplanted with a woman’s heart? Was it even legal? These types of questions hung over the surgery, as Shumway and Stinson paused for a moment to consider the enormity of their actions. Today in the United States, death is defined by law as the cessation of electrical activity in the brain — although this definition is not without controversy. In 1968, the legal moment of death was murkier. Was it when the brain stopped working or when the heart stopped beating? For those pioneering surgeons and cardiologists, using the still-beating heart of a brain-dead donor was just common sense if it gave a dying patient a second chance at life. Sick hearts must be replaced with healthy hearts to save lives. On that cold, bright winter day in 1968, the spell broke and the surgeons got back to work. There was no turning back. Race to transplant. In the race to be the first to transplant the human heart — and a race it was — Shumway, a tall, lanky country boy from Michigan, was considered the leader of the pack. His decades-long research working with Richard Lower, MD, in dogs in the laboratory, ultimately led to what remains the standard surgical technique for heart transplantation. The researchers’ first big success occurred in 1959, when Shumway and Lower — a surgical resident who later joined the faculty of the Stanford School of Medicine — successfully performed the first dog heart transplantation. Shumway, along with a gang of rotating residents, continued studies in the lab for eight more years and in the process developed a method of preserving the donor heart by placing it in a solution of ice-cold saltwater to reduce its metabolism. They learned about the transplant rejection response, which would become the key stumbling block to successful heart transplants. Then, on Nov. 20, 1967, Shumway and his team announced that Stanford was finally ready to conduct the first human heart transplant, and the wait for a suitable patient and a donor began. A potential patient had been identified in October, but died before a donor could be found. Two weeks after Shumway’s announcement, on Dec. 3, 1967, South African surgeon Christiaan Barnard, MD, surprised not only Shumway, but also the entire world, by giving Louis Washkansky, a grocer dying of heart disease, a new heart. Using Shumway’s simple surgical technique, Barnard forever cemented himself into the annals of history as the first to transplant an adult human heart. Washkansky lived 18 days. layers layers Heart recipient Mike Kasperak, left, and his wife, Ferne. Surgeon Norman Shumway and cardiologist Ed Harrison speak to the media, below, after the historic surgery. (Photos: AP Newswire and Stanford Medical History Center) Shumway’s first. It was a shock to the Stanford program. Everyone had expected Shumway to be the first. In fact, Shumway’s first human heart transplant would be the world’s fourth. On Dec. 6, 1967, in New York, the first pediatric heart transplant was performed. The infant’s heart stopped beating after seven hours. Barnard performed a second transplant on Jan. 2, 1968. Not until Jan. 5, 1968, were both a donor and a transplant recipient found at Stanford. At 2 p.m. Jan. 5, Kasperak had a massive heart attack at his home in East Palo Alto. He’d been living with heart disease for several years, and the prognosis wasn’t good. “He had been referred to me,” says Don Harrison, MD, a Stanford cardiologist. “He had end-stage heart disease and was not going to live very long. I remember talking to his wife about this transplant surgery. I explained to her that this was a new procedure that had only been done once in the world before. I had to explain to her that her husband was terminally ill, and there was nothing we could do.” According to news reports, Kasperak asked his wife, Ferne, if he should go ahead with the operation.“Go ahead,” she said. “I want you alive with me.” Just four hours after Kasperak’s heart attack and 7 miles west of his home, another tragedy occurred. Virginia-Mae White, a 43-year-old housewife and mother of two from Mountain View, suffered a brain hemorrhage that left her in a coma at nearby El Camino Hospital. Physicians had confirmed that she was brain-dead by the time they placed her on a respirator, which pumped air in and out of her lungs and kept her heart beating. Part of the pathos surrounding the drama of each of the 2,000 heart transplants routinely done each year in the United States comes from the reality that for one person to live, another must die. Today, more than 4,000 people in the United States are waiting for a donor heart at any given time. Each case evokes the same emotional quandary that Shumway felt when he picked up the phone just before noon Jan. 6, 1968, to call Bill White, Virginia’s husband, to ask him for his wife’s heart. It was an outrageous act that was being followed with bated breath by the world. The couple lived in a modest home and had two children, an 18-year-old daughter and a 12-year-old son. They had recently celebrated their 25th wedding anniversary. Shumway was typically light-hearted and quick-witted. In his lab, the professor of cardiothoracic surgery was upbeat, confident, somewhat irreverent and brilliant. His team members loved him. For him, as for anyone, this wasn’t going to be an easy conversation. In his book Every Second Counts: The Race to Transplant the First Human Heart, author Donald McRae describes the conversation between Shumway and Bill White that day: “Once Shumway had explained the mechanics of transplantation and discussed the concept of brain death, White revealed that his wife had been fascinated by the South African transplant. She and Bill had recently talked to friends about Edward Darvall — who had allowed his daughter’s heart to be used for the Washkansky transplant. ‘How marvelous,’ Virginia White said, ‘to give someone else a chance to live.’ “White needed only 30 minutes to discuss the transplant with his children. His answer to Shumway was decisive. They wanted him to proceed.” “Knowing that she is helping another is easing our grief,” Bill White said later in news reports. “I’ve got two of the proudest children you ever knew.” It was time to round up the surgical team. Bringing the donor to Stanford. That afternoon, Stinson was sent to pick up Virginia White at El Camino Hospital in an ambulance and deliver her, with her heart still beating, to Stanford Hospital at 3:30 p.m. Shumway received a neurologist’s confirmation of brain death to proceed, and the surgery began. Two surgical teams were set up in two adjoining rooms on the second floor of the east wing of the hospital. Stinson removed White’s heart in Room 12, then walked it over in a basin filled with cold saltwater to Room 13, where Shumway was waiting. Kasperak was connected to a heart-lung machine that kept his blood circulating while Shumway cut out his diseased heart. White’s heart, just a third the size of Kasperak’s, which was swollen by disease, was then lifted out of its basin and placed inside the empty chest cavity. Shumway sutured White’s heart into Kasperak’s chest, connecting the major heart vessels — the vena cava, the aorta, the pulmonary artery — and the left atrium. In all, the surgery took about 3½ hours. White’s heart had been motionless for two hours. Now, there was nothing to do but wait and see if it would beat again. It generally takes about 20 or 30 minutes for a transplanted heart to begin to beat after surgery. The surgeon triggers the electrical system of the heart with a single shock from a defibrillator, then waits for it to “pink up” as blood flows back into it. The recipient remains attached to the heart-lung machine until the heart starts to beat effectively again and can take over to keep the blood circulating. “The excitement was palpable,” Harrison says. Ten, 20 minutes passed. At 25 minutes, the new heart faintly pulsed and then grew stronger. “We were all elated.” layers Edward Stinson, MD, assisted cardiatric surgeon Norman Shumway in the first U.S. adult heart transplant. (Timothy Archibald photography) ‘A three-ring circus’. Downstairs, all hell broke loose. Fifty or so journalists had arrived even before surgery began, according to an article in Stanford Report by Spyros Andreopoulos, director of the medical center’s news office at the time. He had converted two classrooms into an impromptu press room. “The tip actually came from a reporter from the San Jose Mercury News who was at a wedding reception with members of the transplant team,” Andreopoulos wrote. “When they received an emergency call from the hospital, he deduced that the transplant operation was imminent.” The news spread fast. Television reports aired that night. “My friends and I were on the phone that night saying, ‘Oh my gracious, did you hear they did the transplant?’” says Joan Miller, RN, who was at home after finishing her shift on the third floor of the hospital, just above the surgical rooms. “When I arrived at work it was chaos. It was like a three-ring circus. People were everywhere. It was just great fun and exciting. On break, we’d race down to the basement to see it all — the cameras, the equipment, the news anchors.” By the time the operation was complete and Kasperak was moved on a gurney down the hall to the intensive care unit, reporters were literally scaling the hospital walls trying to snap photos of him through the window of his room. “I remember thinking they were going to break their necks!” says Stinson, who saw them climbing when he stepped outside. Kasperak’s nurses, though, were quick to close the curtains, preventing any photos, and the defeated reporters climbed back down. The next morning, Shumway, with Harrison by his side, stood with arms folded over a wrinkled, white lab coat and faced the crowd of several hundred reporters at a news conference held in one of the medical school’s amphitheaters. “We have reached first base, so to speak, but our work is just beginning,” Shumway said, cameras clicking. “The heart transplant patient, Mike Kasperak, awakened in satisfactory condition.” Harrison, the patient’s cardiologist, presented diagrams of cardiac functioning measurements collected through the night showing that the heart was functioning well. Shumway, known to be shy of the media, would later turn down offers to appear on Face the Nation, Meet the Press and the Today show, but that morning he appeared calm and in high spirits. “Shumway looked just a little bit like a guy who had just got off the gridiron,” Brokaw says. “Exhausted, but pleased with himself. He looked the part — handsome, white jacket, just a built-in charisma. Here was this monumental moment, and he handled it with such modesty.” A fight to keep the patient alive. During the next few weeks, Stinson, who later joined the School of Medicine faculty, led the fight to keep Kasperak alive. The first five nights post-surgery, Stinson remained sleepless by his patient’s side. Meanwhile, the Stanford press office issued daily bulletins on Kasperak’s condition. “The patient, Mike Kasperak, 54 years old, was reported to be awake and alert,” the New York Times reported three days after surgery. “He was allowed a first visit with his wife yesterday evening and slept during the night.” Two days later, it followed up with: “Mr. Kasperak managed to scribble an ‘I love you’ note and hand it to his wife.” For the first few days post-surgery, Kasperak’s condition remained hopeful, but then he slipped into a semi-comatose state. Extensive bleeding of the stomach led to worries that his liver and kidneys had been too severely damaged by years of heart disease to keep him alive. “In retrospect, he was too ill at the time of surgery,” Stinson says. “His lungs, liver, kidneys, GI tract weren’t functioning well. His body didn’t tolerate the stress of the operation well.” Fifteen days after the surgery, Kasperak died of severe hemorrhaging. Stinson, making certain he was given enough morphine that he was never in pain, was there by his side. In the aftermath of the Stanford transplant, the world hit near-hysteria in its fascination with heart transplants. Nearly 100 medical institutions jumped in to attempt the operation. The surgery itself proved fairly simple, but the inability to prevent recipients’ bodies from rejecting foreign hearts quickly led to alarming death rates. Sensationalized accounts of these operations appeared in newspapers like the National Enquirer. One paper ran with this headline: “Docs give her a man’s heart — now she puffs stogies and rants and raves at TV wrestlers.” At the same time, lawsuits against heart surgeons became something of a fad worldwide, with defense attorneys claiming their clients were not guilty of murder despite having, for example, shot a victim in the head. It was the surgeons, who removed the victims’ hearts, who were guilty of the murder, they argued. The Santa Clara County coroner threatened to bring murder charges against Shumway after his first transplant, but the district attorney refused. Shumway did testify in the 1974 murder trial in Oakland of Andrew Lyons, who had shot one of Shumway’s transplant donors in the head. “I’m saying anyone who is brain-dead is dead,” Shumway testified, according to a story in the New York Times. Lyons was found guilty. Not until 1976 would the issue of cause of death be resolved in California, with the establishment of a state law on brain death that made it clear doctors could legally remove a beating heart from the body of a brain-dead patient. In 1970, on the third anniversary of Barnard’s first transplant, exhausted by this near madness and frightened by the soaring death rates, the medical establishment, led by the American Heart Association, called for a moratorium on heart transplants. All major institutions complied, except for one: Stanford. A 1971 Life magazine cover story, “A new report on an era of medical failure: The tragic record of heart transplants,” reported the numbers: of the 166 heart transplants performed, only 23 recipients were still alive, giving the procedure an overall mortality rate of 85 percent. “Shumway had been the man who American medicine thought would usher in the era of transplanted hearts,” the magazine reported. “Instead he became the principal surgeon to survive it. Mercifully, the race was no longer a race. The spectators had gone home; all the runners save one had dropped out. He could afford to take all the time he needed to reach the finish line.” Refining the work. “We just ignored it all,” says John Schroeder, MD, a professor of cardiovascular medicine who in 1968 was a member of the Shumway team as a cardiology resident. He helped write the grant proposals that kept Stanford’s research program alive following Kasperak’s transplant. Returning to the laboratory, the Stanford physician-scientists continued to methodically publish scientific papers and conduct heart transplants, slowly establishing new protocols for the selection of patients and for measuring and treating rejection that would lead to the success of heart transplantation. Today, Stanford Medicine’s reputation is firmly established as the research center responsible for leading to the thousands of successful transplants carried out annually around the world. But that first surgery remains a magical moment, for Stinson at least, and an essential one, along the journey toward making heart transplantation a standard operation. “We learned a lesson,” Stinson says. “Patient selection would be key to the success of this operation. Mr. Kasperak was just too sick to survive. At the time of his death, the heart was probably the only functioning organ he had.” Shumway, who died of cancer in 2006, for many years kept a slogan hanging on his wall that said: “Where there is death, there is hope.” The year following Mike Kasperak’s death, Ferne Kasperak was asked by a reporter at the Palo Alto Times about the decision that led to her husband undergoing the first adult heart transplant in the United States. “He had 15 days extra that I don’t think he would have had,” she reportedly said. “I have no regrets, and I don’t think Mike did either.” Share This Twitter Facebook Email Print previous PreviousThe power of CRISPR. Next nextWhat happened next. Tracie White is a science writer in the Office of Communications. Email her at [email protected] email Email the author Additional Reading. Virtual calming. Easing anxiety in young patients using immersive technology No place to call home. Housing insecurity puts children’s care, treatment at risk A healing environment. Family, nature key to healing at Lucile Packard Children’s Hospital Stanford Eye opening. Curing cataracts in the Himalayas and beyond Two minds. The cognitive differences between men and women
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Result 35
TitleHeart transplant Information | Mount Sinai - New York
Urlhttps://www.mountsinai.org/health-library/surgery/heart-transplant
Description
Date
Organic Position34
H1Heart transplant
H2Description
Why the Procedure Is Performed
Risks
Before the Procedure
After the Procedure
Outlook (Prognosis)
References
Version Info
H3
H2WithAnchorsDescription
Why the Procedure Is Performed
Risks
Before the Procedure
After the Procedure
Outlook (Prognosis)
References
Version Info
BodyHeart transplant Cardiac transplant; Transplant - heart; Transplantation - heart Share A heart transplant is surgery to remove a damaged or diseased heart and replace it with a healthy donor heart. The interior of the heart is composed of valves, chambers, and associated vessels. The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide. The heart is made up of the two atria which receive blood and two ventricles which are the actual pumps of the heart. The left ventricle pumps blood into the aorta sending oxygenated blood to the rest of the body. The heart is located in the chest cavity, or thorax. It pumps blood from the lungs to the rest of the body. Description. Finding a donor heart can be difficult. The heart must be donated by someone who is brain-dead but is still on life support. The donor heart must be in normal condition without disease and must be matched as closely as possible to your blood and /or tissue type to reduce the chance that your body will reject it.You are put into a deep sleep with general anesthesia, and a cut is made through the breastbone.Your blood flows through a heart-lung bypass machine while the surgeon works on your heart. This machine does the work of your heart and lungs while they are stopped, and supplies your body with blood and oxygen.Your diseased heart is removed and the donor heart is stitched in place. The heart-lung machine is then disconnected. Blood flows through the transplanted heart, which takes over supplying your body with blood and oxygen.Tubes are inserted to drain air, fluid, and blood out of the chest for several days, and to allow the lungs to fully re-expand. Why the Procedure Is Performed. A heart transplant may be done to treat:Severe heart damage after a heart attack Severe heart failure, when medicines, other treatments, and surgery no longer helpSevere heart defects that were present at birth and can't be fixed with surgeryLife-threatening abnormal heartbeats or rhythms that do not respond to other treatments Heart transplant surgery may not be used in people who:Are malnourishedAre older than age 65 to 70Have had a severe stroke or dementiaHave had cancer less than 2 years agoHave HIV infectionHave infections, such as hepatitis, that are activeHave insulin-dependent diabetes and other organs, such as the kidneys, that aren't working correctly Have kidney, lung, nerve, or liver diseaseHave no family support and do not follow their treatmentHave other diseases that affect the blood vessels of the neck and legHave pulmonary hypertension (thickening of blood vessels in the lung)Smoke or abuse alcohol or drugs, or have other lifestyle habits that may damage the new heart Are not reliable enough to take their medicines, or if the person is not able to keep up with the many hospital and medical office visits and tests Risks. Risks from any anesthesia are:Reactions to medicinesProblems breathing Risks from any surgery are:BleedingInfection Risks of transplant include:Blood clots (deep venous thrombosis)Damage to the kidneys, liver, or other organs from anti-rejection medicinesDevelopment of cancer from the drugs used to prevent rejectionHeart attack or strokeHeart rhythm problemsHigh cholesterol levels, diabetes, and bone thinning from the use of rejection medicinesIncreased risk for infections due to anti-rejection medicinesLung and kidney failureRejection of the heartSevere coronary artery diseaseWound infections The new heart may not work at all Before the Procedure. Once you are referred to a transplant center, you will be evaluated by the transplant team. They will want to make sure that you are a good candidate for a transplant. You will visit many times over several weeks or even months. You will need to have blood drawn and x-rays taken. The following may also be done:Blood or skin tests to check for infectionsTests of your kidney and liverTests to evaluate your heart, such as ECG, echocardiogram, and cardiac catheterizationTests to look for cancerTissue and blood typing, to help make sure your body will not reject the donated heartUltrasound of your neck and legs You will want to look at one or more transplant centers to see which would be best for you:Ask them how many transplants they perform every year and what their survival rates are. Compare these numbers with the numbers from other centers. These are all available on the internet at unos.org.Ask what support groups they have available and how much help they offer with travel and housing.Ask about the costs of medicines you will need to take afterwards and if there is any financial help in getting the medicines. If the transplant team believes you are a good candidate, you will be put on a regional waiting list for a heart:Your place on the list is based on several factors. Key factors include the type and severity of your heart disease, and how sick you are at the time you are listed.The amount of time you spend on a waiting list is usually NOT a factor for how soon you get a heart, except in the case of children. Most, but not all, people who are waiting for a heart transplant are very ill and need to be in the hospital. Many will need some sort of device to help their heart pump enough blood to the body. Most often, this is a ventricular assist device (VAD). After the Procedure. You should expect to stay in the hospital for 7 to 21 days after a heart transplant. The first 24 to 48 hours will likely be in the intensive care unit (ICU). During the first few days after a transplant, you will need close follow-up to make sure that you do not get an infection and your heart is working well.The recovery period is about 3 months and often, your transplant team will ask you to stay fairly close to the hospital during that time period. You will need to have regular check-ups with blood tests, x-rays, and echocardiograms for many years.Fighting rejection is an ongoing process. The body's immune system considers the transplanted organ a foreign body and fights it. For this reason, organ transplant patients must take drugs that suppress the body's immune response. To prevent rejection, it is very important to take these medicines and carefully follow your self-care instructions.Biopsies of the heart muscle are often done every month during the first 6 to 12 months after transplant, and then less often after that. This helps determine if your body is rejecting the new heart, even before you have symptoms.You must take drugs that prevent transplant rejection for the rest of your life. You will need to understand how to take these medicines, and know their side effects.You can go back to your normal activities 3 months after the transplant as soon as you feel well enough, and after talking with your health care provider. Consult your provider if you plan to engage in vigorous physical activity.If you develop coronary disease after a transplant, you may have cardiac catheterization every year. Outlook (Prognosis). Heart transplant prolongs the life of people who would otherwise die. About 80% of heart transplant patients are alive 2 years after the operation. At 5 years, 70% of patients will still be alive after a heart transplant.The main problem, as with other transplants, is rejection. If rejection can be controlled, survival increases to over 10 years. References . Chiu P, Robbins RC, Ha R. Heart transplantation. In: Sellke FW, del Nido PJ, Swanson SJ, eds. Sabiston and Spencer Surgery of the Chest. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 98.Jessup M, Atluri P, Acker MA. Surgical management of heart failure. In: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 28.Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Pediatric heart and heart-lung transplantation. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 470.McMurray JJV, Pfeffer MA. Heart failure: management and prognosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 53.Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Card Fail. 2017;23(8):628-651. PMID: 28461259 pubmed.ncbi.nlm.nih.gov/28461259/. Version Info. Last reviewed on: 4/24/2021 Reviewed by: Mary C. Mancini, MD, PhD, Director, Cardiothoracic Surgery, Christus Highland Medical Center, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Find a Doctor Request an Appointment close× close×
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TitleExperience a Heart Transplant in 360° - YouTube
Urlhttps://www.youtube.com/watch?v=Kriob0nAuyU
DescriptionFilmed recently at William P. Clements Jr. University Hospital, the video details the process of a heart transplant and all its intricacies, with narration f..
Date13 Mar 2018
Organic Position35
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BodyrightContact usCreatorsAdvertiseDevelopersTermsPrivacyPolicy & SafetyHow YouTube worksTest new features© 2022 Google LLC
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TitleHeart Transplant | American Heart Association
Urlhttps://www.heart.org/en/health-topics/congenital-heart-defects/care-and-treatment-for-congenital-heart-defects/heart-transplant
DescriptionThe American Heart Association explains that a heart transplant gives a patient with congenital heart disease the opportunity to have a normal heart with normal blood circulation
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H1Heart Transplant
H2Topics Related to Surgery
H3What is a heart transplant?
Why is it needed?
How does it affect the heart?
What can I expect if my child is a heart transplant recipient?
What will I need in the future?
Medical Follow-up
Activity Restrictions
Endocarditis Prevention
Pregnancy
Will I need more surgery?
H2WithAnchorsTopics Related to Surgery
BodyHeart Transplant A heart transplant gives a patient with congenital heart disease the opportunity to have a normal heart with normal blood circulation. If the transplant goes well, heart function and blood flow will be better than ever. Topics Related to Surgery. What is a heart transplant? A heart transplant replaces the patient's heart with a donor heart. Doctors remove the patient's heart by transecting the aorta, the main pulmonary artery and the superior and inferior vena cavae, and dividing the left atrium, leaving the back wall of the left atrium with the pulmonary vein openings in place. The surgeon connects the donor heart by sewing together the recipient and donor vena cavae, aorta, pulmonary artery and left atrium. In patients with congenital heart disease, the surgeon may simultaneous transplant the lungs and the heart. Why is it needed? You may require a heart transplant for several reasons. The most common reason is that one or both ventricles have aren't functioning properly and severe heart failure is present. Ventricular failure can happen in many forms of congenital heart disease, but is more common in congenital defects with a single ventricle or if long-standing valve obstruction or leakage has led to irreversible heart failure. Patients who as children had the Fontan procedure, which helps complex congenital heart defects, may need a heart transplant because the blood flow through the venous system is slow and the veins are congested, which can lead to swelling, fluid accumulation, and protein loss. How does it affect the heart? The donor heart is matched to the recipient by blood type and body size. As the heart transplant recipient, you must take medications to prevent his or her immune system from rejecting the new heart. These drugs are called immunosuppressive medication. Your medical team will balance the amount of immunosuppressive medication you need to prevent rejection of your new heart with the risk of side effects, which include infection or cancer. What can I expect if my child is a heart transplant recipient? When a child receives a heart transplant, the transplanted heart grows to adult size as the patient grows. Your child will need to take immunosuppressive medications and other medicine for the rest of his or her life to control the sides effects of the transplant. During young adulthood, your child's medical care will be transitioned from a pediatric to an adult heart transplant cardiologist. What will I need in the future? After your heart transplant, your medical team will monitor you closely for heart rejection, which can happen in the heart muscle cells or in the heart's arteries. They will also watch for side effects of the immunosuppressive medications, which include diabetes, infection, kidney disease, cancer or high blood pressure. If any of these problems arise, your doctor will change the medication type or dose. You and you're your doctor may also decide to change your immunosuppressive medications as new drugs become available. Medical Follow-up. You will require regular checkups after your transplant by a transplant cardiologist. At these visits, your cardiologist will do blood tests to check the levels of your immunosuppressive drugs and look for side effects. He or she may also order electrocardiogram, echocardiogram and Holter monitoring to help monitor your heart rhythm and function, or an endomyocardial biopsy, which is a diagnostic procedure that surveys the sufficiency of your immunosuppressive therapy. Your doctor will evaluate your coronary arteries yearly or every other year to monitor for signs of narrowed coronary arteries in your transplanted heart. You should also have routine medical checkups to maintain overall health. Activity Restrictions. Heart transplant recipients have no specific activity restrictions. Discuss activity ideas with your transplant cardiologist. Endocarditis Prevention. Endocarditis is an infection of the inner layer of the heart. While some people who have congenital heart disease must take antibiotics prior to some medical and dental procedures to prevent endocarditis, most heart transplant recipients don't need them unless they also have significant heart valve disease. Pregnancy. Women who've had a transplant could have complications during pregnancy. Depending on the type, immunosuppressive medications may negatively affect the fetus. You may also have a greater risk of rejection once the baby is born. If you are considering pregnancy, discuss the pros and cons with your transplant cardiologist and obstetrician. See the Pregnancy section for more information. Will I need more surgery? A transplant heart can help you lead a more active, fulfilling life, but there may be times when additional surgery is required. For instance, if the rhythm of your transplant heart becomes slow, you may need to have a pacemaker. Rarely, the tricuspid valve can become damaged by the endomyocardial biopsy procedure; if that happens it will need to be repaired or replaced. Patients with congenital heart disease who have had a coarctation repair or problems with narrow or small pulmonary arteries may need surgery or interventional catheterization after the transplant to increase the size of these areas. Sometimes, a transplanted heart may fail because of rejection, damage to the heart cells or coronary arteries of the heart, which leads to heart failure. If this happens, doctors can sometimes transplant another heart. Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff. Play without Auto-Play Play Video Text Your Heart Surgery: Realization and Repair Play without Auto-Play Play Video Text Your Heart Surgery: Rehab and Recovery
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TitleTransplant services at Royal Papworth Hospital
Urlhttps://royalpapworth.nhs.uk/our-services/surgery/transplant-services
DescriptionRoyal Papworth Hospital is the biggest heart and lung transplant unit in the UK, carrying out 80 cardiothoracic transplants in 2019/20
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H1Transplant services
H2Overview
Cardiothoracic transplantation
Innovation: UK, European and world firsts
DCD heart transplants
UK heart and lung transplant activity report 2020/21
Mechanical devices
Patient referrals
Useful resources
Specialist Transplant services
History of Royal Papworth Hospital transplantation
Coronavirus: Questions and advice for our transplant patients
Royal Papworth Hospital transplant news
Advanced heart failure referrals - information for healthcare professionals
Search for Services
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H3Life with an LVAD
Writing to your donor family
H2WithAnchorsOverview
Cardiothoracic transplantation
Innovation: UK, European and world firsts
DCD heart transplants
UK heart and lung transplant activity report 2020/21
Mechanical devices
Patient referrals
Useful resources
Specialist Transplant services
History of Royal Papworth Hospital transplantation
Coronavirus: Questions and advice for our transplant patients
Royal Papworth Hospital transplant news
Advanced heart failure referrals - information for healthcare professionals
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Search results
BodyTransplant services Since performing the UK's first successful heart transplant in 1979, Royal Papworth Hospital has continued to be a world leader in heart and lung transplantation. It is the biggest adult cardiothoracic transplant centre in the UK, and leads the world in the pionerring field of DCD heart transplantation. Coronavirus: Please see the current advice for our transplant patients Overview. Royal Papworth Hospital's heart and lung transplant programme is the biggest and most experienced unit in the country, treating patients from across the United Kingdom. Teams here perform approximately 90 adult heart, lung and heart-lung transplants each year, including about 50% of the UK's cardiothoracic DCD activity.  The team cares for around 1,000 transplant recipients and also retrieves cardiothoracic organs for other UK centres.  In 2020/21, despite the pressures of the COVID-19 pandemic, 37 heart transplants and 19 lung transplants were performed at Royal Papworth Hospital, which is roughly two-thirds of the activity in a normal year.  The transplant team also implant Ventricular Assist Devices which act as a bridge for some patients on the heart transplant waiting list.  Cardiothoracic transplantation. Royal Papworth Hospital is the country's main adult heart and lung transplant centre and has carried out a number of UK, European and world first transplants since the UK's first successful heart transplant operation by Sir Terence English in 1979. It is also a world-leader in DCD heart transplantation.  Since then, almost 3,000 heart, lung and heart-lung transplants have been carried out by the hospital, with world-leading survival rates, the shortest waiting lists and an increasing number of patients living 30+ years post-transplant.  Teams at Royal Papworth have conducted the most heart transplants every year in the UK since 2008/09 and is the most active adult cardiothoracic transplant programme. In 2020/21, the hospital performed 56 transplants which was more than any other UK centre, with survival rates consistently above the national average. The hospital has also pioneered the use of invasive monitoring and hormone resuscitation for managing multi-organ donors which has become the international gold standard in donor management. Innovation: UK, European and world firsts. In 1979, Royal Papworth Hospital performed the UK's first successful heart transplant. This was followed five years later by the first successful heart-lung tranplant in the UK and the world's first heart-lung and liver transplant in 1986.  In 2015 a team at Royal Papworth Hospital became the first in Europe to successfully perform a transplant using a non-beating heart from a circulatory determined dead (DCD) donor. Up until then our transplant team were only able to transplant hearts from donors following the diagnosis of brain-stem death (DBD).  The transplant team at Royal Papworth Hospital took this one step further when, in June 2019, the world's first DCD heart-lung operation was performed on a 24-year-old patient.  View a full timeline of the history of transplantation at Royal Papworth Hospital.  DCD heart transplants. Royal Papworth Hospital is a world-leader in DCD heart transplantation, having performed the first in Europe in 2015 and more than any other centre worldwide. Donation after circulatory death (DCD) refers to the retrieval of organs for the purpose of transplantation from patients whose death is diagnosed and confirmed using cardio-respiratory criteria. Essentially, their heart has stopped beating and is no longer circulating blood around the body following the planned withdrawal of life-sustaining treatments.  Previously, all transplants were after brain-stem death (DBD); a person's heart is still beating but they no longer have any brain functions and will not be able to breathe without mechanical support. In October 2018, Royal Papworth Hospital's DCD heart transplant operation was used on the 50th patient. It continues to be the biggest such programme in the world with 90 transplants now performed and in 2019/20 accounted for 50% of the hospital's heart transplant activity. Now in its sixth year, short and mid-term survival via the DCD method at Royal Papworth Hospital is comparable to DBD heart transplants with similar length of stay in intensive care and total stay in hospital post-transplant. Read more in The Journal of Heart and Lung Transplantation - '5-Year Single Centre Early Experience of Heart Transplantation From Donation After Circulatory Determined Death (DCD) Donors'.   Fran Middleton received a DCD heart transplant at Royal Papworth Hospital in 2018 UK heart and lung transplant activity report 2020/21. NHS Blood and Transplant's national organ and tissue donation and transplantation activity report 2020/21 was published in July 2021. The report lists a number of highlights for Royal Papworth Hospital: We performed the most heart transplants (37) of any UK centre. We performed the most cardiothoracic transplants (56) of any UK centre, making us the UK's biggest cardiothoracic transplant unit. Of those, 17 were DCD transplants (11 hearts and six lungs). There were a total of 36 cardiothoracic DCD transplants in the UK, meaning Royal Papworth Hospital was responsible for nearly 50% of DCD activity.  However, NHS Blood and Transplant's annual report on cardiothoracic organ transplantation shows that the number of patients on both the heart transplant waiting list (340) and the lung transplant waiting list (346) is at an all-time high nationally, which means that demand is rising. At three years after being listed for a routine heart transplant in the UK, only 17% of patients have been called in from home for a transplant. This is 47% for lung transplant patients, which shows there continues to be an unmet need.  If you would like to be an organ donor, please join the organ donation register and communicate your decision with your family. You could save up to nine lives.  Mechanical devices. Royal Papworth Hospital has a long history of innovation in heart and lung transplantation and has been using mechanical circulatory support devices to treat patients with end-stage heart failure since the 1980s. Sometimes, very sick heart failure patients require bridging therapy before transplantation. This can be through the insertion of a mechanical blood pump to assist the left ventricle of the heart, known as a ventricular assist device (VAD). Patients fitted with these devices can be independent within the community while waiting for a suitable donor heart. Patient referrals. Patients are referred to the service by their local GP. The transplant physicians decide if the patient would be suitable for an outpatient and/or inpatient assessment. It is usual for a family member to accompany the patient on these visits. A range of planned tests are carried out and the process culminates in a multidisciplinary team meeting which discusses the options for each individual patient and makes recommendations for their future care. These options are then discussed with the patient. Useful resources. Life with an LVAD. Luis shares his experience of having a Left Ventricular Assist Device (LVAD) followed by a donation after circulatory donation (DCD) heart.    Luis received a DCD heart transplant at Royal Papworth Hospital in 2016   Writing to your donor family. Sarah, Chrissy, Katie and Bianca from our transplant link team talk you through the dos and don'ts when it comes to writing to your donor family.  Specialist Transplant services . VISIT History of Royal Papworth Hospital transplantation . Since performing the first successful heart transplant in the UK in 1979, Royal Papworth Hospital has continued to lead the way in cardiothoracic transplantation. VISIT Coronavirus: Questions and advice for our transplant patients . Useful advice and FAQs for our heart transplant and lung transplant patients at Royal Papworth Hospital. VISIT Royal Papworth Hospital transplant news . Stories from the transplant team at Royal Papworth Hospital VISIT Advanced heart failure referrals - information for healthcare professionals . Information for healthcare professionals on how to refer a patient to the advanced heart failure service at Royal Papworth Hospital NHS Foundation Trust. VISIT Search for Services. Search results.
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TitleHeart Transplant
Urlhttps://www.cham.org/HealthwiseArticle.aspx?id=hw30661
DescriptionA heart transplant is a procedure in which a surgeon removes a diseased heart and replaces it with a donor heart. During a heart transplant, a mechanical pump circulates blood through the body while the surgeon removes the diseased heart and replaces it with a healthy heart from a recently deceased donor. The surgeon..
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H2WithAnchorsSurgery Overview
What To Expect
Why It Is Done
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BodyHeart Transplant Surgery Overview. A heart transplant is a procedure in which a surgeon removes a diseased heart and replaces it with a donor heart. During a heart transplant, a mechanical pump circulates blood through the body while the surgeon removes the diseased heart and replaces it with a healthy heart from a recently deceased donor. The surgeon connects the donor heart to the major blood vessels and hooks the heart up to wires that temporarily control the heartbeat. The procedure takes several hours. To prevent the body from rejecting the donor heart, your surgeon will give you powerful drugs (immunosuppressants) right after surgery. You must continue to take them. What To Expect. After a heart transplant, the recovery process is similar to the process after other heart surgeries. You will spend about 1 to 2 weeks in the hospital after surgery. You may have to stay longer. How long you'll stay depends on your health and if you have complications from surgery. While in the hospital, you will start a cardiac rehabilitation program. And your doctors will check on your heart to make sure your body isn't rejecting it. Cardiac rehabilitation. A cardiac rehab program can help you recover from your surgery and be active again. Your transplanted heart will respond to activity a little differently. Your heart rate will not increase like it used to. And you will have a higher resting heart rate. This is because some of the nerves that control your heart were cut during your surgery. After a heart transplant, you must follow a strict lifestyle involving daily medicines and regular medical care. This includes regular sampling (biopsies) of the transplanted heart tissue to check for rejection. Learn more. Cardiac Rehabilitation Why It Is Done. A heart transplant is an option when the heart no longer works well enough and a person is at risk of dying. A heart transplant may be considered when a person has severe heart disease and is likely to benefit most from a donor heart. A person might be a candidate for a transplant when any of these conditions are true: The person has end-stage heart failure, ischemic heart disease, cardiomyopathy, or congenital heart disease. The person has a low chance of living as long as 1 year without a heart transplant. The person has no other serious medical conditions that would reduce life expectancy. The doctor strongly expects that a heart transplant will increase survival and improve the person's quality of life. At some centers, transplant candidates must demonstrate that they have quit smoking and/or overusing alcohol for a period of time (such as 4 to 6 months) before they are considered for placement on a transplant waiting list. How Well It Works. In carefully selected people, a heart transplant can be very successful. About 87 out of 100 people who have a heart transplant survive for at least 1 year. About 60 out of 100 survive 10 years.footnote 1 Most people can have a good quality of life after their transplant. They can be active, have a social life, and return to work. Risks. Risks from heart transplant include: Rejection of the donor heart. To check for rejection, surgeons will regularly test a sample (biopsy) of the heart tissue. They'll also do echocardiography, electrocardiography (ECG, EKG), or blood tests. If your body rejects the heart, you will receive other drugs (such as immunosuppressants or steroids) to suppress your immune system so that it does not reject the donor heart. These drugs may have serious side effects, including an increased risk of infections and cancer. Infection. Clogging of the arteries (atherosclerosis) that may develop in the donor heart. (This is usually a complication and can affect long-term survival.) Death. Related Information. Organ Transplant References. Citations. Lund H, et al. (2017). The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Heart Transplantation Report—2017. Focus theme: Allograft ischemic time. Journal of Heart and Lung Transplantation 36(10): 1037–1046. https://doi.org/10.1016/j.healun.2017.07.019. Accessed October 7, 2019. Credits. Current as of: March 17, 2021 Author: Healthwise Staff Medical Review: E. Gregory Thompson MD - Internal Medicine Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology Kathleen Romito MD - Family Medicine Top of the page Current as of: March 17, 2021Author: Healthwise StaffMedical Review:E. Gregory Thompson MD - Internal Medicine & Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology & Kathleen Romito MD - Family MedicineLund H, et al. (2017). The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Heart Transplantation Report-2017. Focus theme: Allograft ischemic time. Journal of Heart and Lung Transplantation 36(10): 1037-1046. https://doi.org/10.1016/j.healun.2017.07.019. Accessed October 7, 2019. Topic Contents. Surgery OverviewWhat To ExpectWhy It Is DoneHow Well It WorksRisksRelated InformationReferences Heart transplant This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content.To learn more about Healthwise, visit Healthwise.org. © 1995-2021 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
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TitleHeart Transplant | Winchester Hospital
Urlhttps://www.winchesterhospital.org/health-library/article?id=14818
DescriptionA heart transplant removes a severely diseased and failing heart and replaces it with a healthy heart from a deceased donor
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TitleHeart Transplant - Heart Transplantation in India - NH
Urlhttps://www.narayanahealth.org/heart-transplant
DescriptionAre you looking for the best heart transplantation in India? Book an appointment with the top heart transplant surgeon at Narayana Health
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H1NH cares Heart Transplant
H21.
What is a heart transplant?
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Eligibility for a heart transplant
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Understanding the heart transplant procedure
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Finding a donor for heart transplant
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How to prepare for a heart transplant?
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Risk and complications of heart transplant
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How do I recover from a heart transplant?
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Precautions to take after surgery
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Life after a heart transplant
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Diet and nutrition
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Heart Transplant FAQs: All your concerns addressed
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12. Stories of Hope
H3Enquire now
Q. What difference would a heart transplant surgery make to your life?
Q. How much time would I need to get discharged from the hospital after the heterotopic heart transplant?
Q. Which will stand the best heart hospital in India for me?
Q. Can I continue to exercise after a heart transplant?
Q. What are the chances of survival after receiving a heart transplant?
Q. I have heart failure but I am managing it with medicine. How do I know when to consult my doctor, in case of an emergency?
Q. What if a heart transplant is not possible? Is there an alternative?
Q. I have just found out I need a heart transplant. I feel overwhelmed. What should I do?
Q. Is there a chance of the new heart failing?
Q. Why choose Narayana Health for heart transplant procedure?
Q. How long can you live with a new heart?
Q. What is the survival rate for heart transplant patients?
Q. Do you die during a heart transplant?
Q. What is the cut off age for heart transplant?
Q. How long do heart transplants take?
Q. How painful is a heart transplant?
Q. Can a living person donate a heart?
Hear from our Doctors
Hear from our Patients
H2WithAnchors1.
What is a heart transplant?
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Eligibility for a heart transplant
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Understanding the heart transplant procedure
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Finding a donor for heart transplant
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How to prepare for a heart transplant?
6.
Risk and complications of heart transplant
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How do I recover from a heart transplant?
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Precautions to take after surgery
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Life after a heart transplant
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Diet and nutrition
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Heart Transplant FAQs: All your concerns addressed
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12. Stories of Hope
BodyNH cares Heart Transplant: Understanding the procedure 1. . 1. What is a heart transplant? . A heart transplant is a medical procedure that involves replacing a failing heart with a healthy heart from a donor. The process is seen as a last resort for treating heart conditions and is generally recommended by doctors when other treatments haven’t been fruitful. These treatments are surgeries, and they use medications to treat heart problems. Heart failure is a condition where the heart is not working as efficiently as it usually should. Your entire body needs blood to perform all the necessary functions. When the blood flow becomes insufficient, due to the heart being unable to pump blood adequately, then disruption occurs; this makes your heart weak. Heart failure can affect any side of your heart, or it can affect both sides of your heart at the same time. 2. . 2. Eligibility for a heart transplant . You need to meet the eligibility criteria before you can undergo heart transplant surgery. Not every individual who needs a heart transplant can get a heart transplant procedure done because in some cases, it can be dangerous. Several factors determine your eligibility, and your doctor will ensure you're eligible before you are recommended to get a heart transplant procedure. The following are some factors that affect your eligibility for a heart transplant. When you have an active infection then your doctor will not recommend heart transplant because it can cause more complications. If you are not ready to take precautionary measures to ensure you keep your new heart healthy, your doctor won’t recommend the heart transplant procedure. If your doctor thinks that recovering from a heart transplant surgery will be difficult for you then he may not recommend the procedure. If someone in your family has cancer, or if there is a history of cancer, then you might not be a good candidate for a heart transplant procedure. When you are suffering from another health issue that can potentially cut your life short, even after receiving a healthy heart, then your doctor won’t recommend a heart transplant. The eligibility criteria for getting a heart transplant, will be determined by your doctor based on your current health, age, and lifestyle (among other factors). 3. . 3. Understanding the heart transplant procedure . The heart transplant procedure is complex. It takes several hours for heart transplant surgery to be completed. If this is the second time that you're having heart surgery, then the heart transplant surgery can take longer than expected; the procedure is open-heart surgery. Firstly, you will receive general anaesthesia in the form of medication so that you sleep. Your body must receive oxygen-rich blood, which is why you will be connected to a heart-lung bypass machine. Secondly, the surgeon will make an incision, and this allows them to operate on your heart. The incision will be made such that the chest bone is separated and the rib cage is opened. The surgeon then removes the diseased heart. The healthy donor heart is then sewn in place, and the blood vessels are then attached to the new heart. This process enables blood to start flowing, and the heart then starts to beat normally. If the donor's heart has trouble beating, then an electric shock might be given. Once the heart transplant procedure is completed, you will receive pain relief medications. A ventilator will be used so that you don't have trouble breathing after heart surgery. Fluids need to be drained after the surgery, and this is done with the help of tubes that are attached to your heart and lungs. You will receive medicines and fluids through IV tubes once the surgery has been completed. You will stay in the ICU for a few days after the heart transplant surgery. You will then be moved to a general hospital room where you can stay for a few weeks. Your stay in the ICU and hospital room depends on your situation and the surgery. Once you are discharged from the hospital, then you will be monitored frequently to ensure your health is as it should be. The monitoring is more frequent in the first few months, after your heart transplant surgery, and afterwards, the frequency decreases. The tests include heart biopsies and electrocardiograms, among others. Heart biopsies are used to determine whether the new healthy donor heart is being rejected by your body or not. There is a higher chance in the beginning for your new heart to be rejected by your body, which is why heart biopsies occur more at that time. Mostly, there are no symptoms that give you an indication of your body rejecting the heart. Some of the symptoms that can indicate donor heart rejection include unexplained weight gain, inability to breathe properly, fatigue, and not urinating as much as you normally do. These symptoms can indicate an infection, too, which is why you must contact your doctor whenever you experience something out of the ordinary. 4. . 4. Finding a donor for heart transplant . Firstly, you will be put on a waiting list after you are found to be eligible for a heart transplant. At the moment, there are thousands of people waiting for heart transplants because there are not enough hearts available. When you are waiting for a healthy donor heart to be available, your condition will be monitored by doctors. Your treatment can be changed depending on your condition when you are waiting for a heart to be available for transplantation surgery. Some people develop severe medical conditions, where they may not be eligible for heart transplant surgery anymore. In this case, your name will be removed from the list until you recover from the health problem. Depending on your recovery, you may be put back on the waiting list for a donor's heart. When you are waiting, your doctors can recommend cardiac rehabilitation to you, which provides you with information about how to stay healthy before and after a heart transplant surgery. When you are waiting for a donor's heart, sometimes your condition can deteriorate. This can be because the treatment that you are undergoing is unable to support your vital organs. This can cause health complications to arise. In such a case, you might need a device such as the ventricular assist device to be implanted. This helps to keep you stable until you receive a donor heart which can be transplanted in place of your diseased heart. Once a donor's heart becomes available, several factors determine whether it is a good match or not. These factors include the duration you have for a donor's heart, the urgency of your request depending on the condition, and your blood type, among others. Only when the donor's heart makes a good match, your heart transplant procedure can be started. 5. . 5. How to prepare for a heart transplant? . You can prepare for your heart transplant, depending on how long you need to wait for a donor's heart. You can start preparing for your surgery well in advance. This is best done by writing down any questions you may have and asking your doctor about them. For instance, you might want to know about the heart transplant cost, the duration of the procedure, and if there are any special arrangements that you need to make, in advance. By asking questions, you will know how to prepare yourself, in the best way, for a heart transplant. This will help decrease stress because having a heart transplant can be quite stressful. Several tests will be done to ensure you are eligible for receiving a heart transplant. An evaluation will be done to ensure you are emotionally and physically ready to receive the donor’s heart. Your doctor will be best able to guide you about how you can best prepare for a heart transplant depending on your unique case. 6. . 6. Risk and complications of heart transplant . A heart transplant procedure is a significant operation. Various risks and complications can arise due to heart transplant surgery. The following are some of the risks associated with heart transplant surgery. There are various medications that you need to take after a heart transplant. These strong medicines can cause some side effects. For instance, immunosuppressants that you take after a heart transplant can cause health problems such as kidney damage. You can even get osteoporosis, diabetes, and high blood pressure as a result of taking these medications. The body can reject the donor heart, which is one of the most significant risks of a heart transplant. About 10% of people who receive a heart transplant can show signs of heart rejection. This usually occurs in the first year after a donor's heart has been transplanted. The immune system is responsible for detecting any outside material. When a new heart is transplanted, your immune system can reject it as it starts to attack it, thinking that it does not belong in your body. Generally, medications are given in the case of rejection. You don't need to experience any symptoms that indicate rejection. Doctors will monitor you and perform biopsies regularly, especially in the first year of heart transplantation. The biopsies are used to check the heart tissue, which is an indicator of whether the heart has been rejected or not. Immunosuppressants lead to hampering your body's ability to defend itself against infection. Sometimes, there may be a need for the patient to be hospitalized due to a serious infection that is caused due to a heart transplant. When the immunosuppressant medicines are decreased after a while, then the risk decreases along with it too. Coronary arteries can get affected after a heart transplant. Cardiac allograft vasculopathy, commonly known as CAV, can develop after a heart transplant procedure has been performed. In this condition, the walls of the coronary arteries become hard and thick. This leads to a problem in blood circulation which can eventually lead to other heart problems such as heart failure, heart attack, and abnormal heart rhythms. It can lead to death, as well. Cancer is another risk of heart transplant surgery. It is recommended that regular checkups are done to ensure there is no cancer growth. Immunosuppressants are responsible for increasing the risk of developing cancer such as skin cancer, and non-Hodgkin's lymphoma after a heart transplant. Some of the heart transplant complications include the formation of blood clots, heart stroke, bleeding, heart attack, and infection. 7. . 7. How do I recover from a heart transplant? . Your doctor will provide you with thorough information about recovery after a heart transplant. You will need to ensure that you listen carefully to what your doctor says and follow the instructions so that you can recover well. People who receive heart transplants are usually able to lead better lives after the surgery and can go back to their usual activities. Recovery can take six months, but it can vary from person to person. As long as you are taking the medicines prescribed by your doctor and taking good care of yourself, as per your doctor's recommendations, there is nothing for you to worry about. If you're a woman who has received a heart transplant and you are planning to have a baby, then you should speak to your doctor about it. Usually, women don't have a problem conceiving after a heart transplant, but the medications can cause complications. 8. . 8. Precautions to take after surgery . Once the heart transplant surgery is completed, there are several precautions that you need to keep in mind. These adjustments might seem overwhelming, but they ensure that you can recover fast and can lead a normal life after a heart transplant. Your doctor will prescribe immunosuppressants which are used to ensure your immune system does not attack the new healthy donor heart after it has been transplanted. Immunosuppressants ensure the risk of heart rejection is decreased. These are usually prescribed lifelong. Even with the help of immunosuppressants, your immune system might still not fully accept the new heart. The problem with immunosuppressants is there are many side effects, especially in the beginning. Immunosuppressants can make you prone to infections because your immune system is suppressed and is not working optimally. For this, your doctor will prescribe additional medication. Sometimes, immunosuppressants can worsen some health issues, such as diabetes and high blood pressure. It can increase the risk of developing other health problems, like high cholesterol, as well. The key to recovery, after a heart transplant surgery, is to ensure you listen to what your doctor advises. You need to make lifestyle changes so that you don’t develop any infections, in the future. You may need to include exercise and healthy eating habits in your routine. 9. . 9. Life after a heart transplant . You will be constantly monitored after a heart transplant. In the first few months, many tests will be conducted to ensure the new heart has been accepted by your body, and to ensure additional problems won't crop up. You will need to ensure you are staying healthy at all times so that you can enjoy a good quality of life, after a heart transplant. Ensure you meet your doctor regularly and inform him about any problems you are experiencing. 10. . 10. Diet and nutrition . Diet and nutrition are important aspects that you need to pay close attention to after you have a heart transplant surgery. You want to ensure you are taking care of your health and making healthy choices daily so that your heart remains healthy. Here are some diet and nutrition tips for a healthy heart. You should drink plenty of water and stay hydrated at all times. Ensure that you include lots of vegetables and fruits in your daily diet. Instead of only focusing on one type, you should have different types of fruits and vegetables daily. You should consume lean meats such as poultry and fish, regularly. If you drink alcohol then you should decrease how much you drink. However, it is best if you can avoid alcohol altogether. Ensure you decrease salt consumption. It is best if you opt for healthy alternatives such as whole-grain foods. These include whole-grain cereals, bread, and grains. You should avoid grapefruit, including grapefruit juice. You should ensure you are consuming sufficient calcium. You should choose fat-free dairy products or low-fat dairy alternatives. You should take precautionary measures to ensure you don’t get any infection. Your doctor will discuss healthy eating habits with you considering your current lifestyle and you both can create an eating plan accordingly. If you are obese, or overweight, then you should consider losing weight and maintaining a healthy weight with the help of exercise and diet. This will help ensure you can live healthily for a long time. 11. . 11. Heart Transplant FAQs: All your concerns addressed . Q.   What difference would a heart transplant surgery make to your life? A heart transplant will make you free from the agonies of the determinants and symptoms of heart failure. After the transplant, you may become healthy to perform all the physical activities without any hassle. Therefore, you have to follow all the precautions and medicine courses that your physician prescribes to keep your transplanted heart healthy. Q.   How much time would I need to get discharged from the hospital after the heterotopic heart transplant? The heart transplant procedure is neither too complicated nor too easy to deal with. It takes around 10 to 15 days for you to get discharged from the hospital if you have no severe complications. Sometimes, a heart recipient takes two weeks to cover up the weakness of a heart transplant. Q.   Which will stand the best heart hospital in India for me? You need to discover which is the best heart hospital in India. Narayana Health is here for a hassle-free heart transplant procedure. Doctors at Narayana health work diligently to render less-complexed heart treatment surgery. The doctors will guide you everything from diet to precautions. They don't leave any stone unturned in your betterment. You can trust Narayana health, where the treatment causes the most effective heart transplant surgery. Q.   Can I continue to exercise after a heart transplant? Exercise is great for enhancing your overall health, and it is recommended by doctors after a heart transplant, as well. Regular exercise helps you reduce stress and control other conditions, so you can stay healthy; it helps you recover faster too so that you have strength. Not all types of exercises may be recommended though depending on your particular condition. You must consult with your doctor about the types of exercise that you can perform after a heart transplant. Q.   What are the chances of survival after receiving a heart transplant? Survival rates, of people who have received a heart transplant, are high. With the right guidance and constant follow-up care, the chances of you surviving for five years, or more, after a heart transplant are high. Q.   I have heart failure but I am managing it with medicine. How do I know when to consult my doctor, in case of an emergency? You must know when you should immediately call your doctor. When you notice that you are experiencing new symptoms then you should get in touch with your doctor as soon as possible. The following are a list of symptoms that indicate heart failure and you should call your doctor immediately. You suddenly gain five pounds or more in a single well, or two pounds or more in a single day. You find it difficult to breathe even when you are resting. You experience chest pain. You have an irregular heartbeat. You don’t urinate like you normally do. You notice your abdomen, feet, ankles or legs are swollen. Your heart rate is rising to new levels. You feel bloated all the time. You feel very confused all of a sudden. You feel more tired than usual. You lose your appetite. You are out of breath more often. You have a tough time doing daily activity. You notice a change in your sleep pattern; you may feel sleepier or have a difficult time sleeping. Whenever you experience something that doesn’t seem right, then it is best if you contact your doctor immediately. For this reason, you should always keep emergency contact numbers safely with you at all times, so you can easily access them whenever required. Q.   What if a heart transplant is not possible? Is there an alternative? Some people are not good candidates for receiving a heart transplant. In such cases, doctors recommend ventricular assist device or VAD. These help pump blood and are implanted in your chest. They help to pump blood from your ventricles to your body. VADs can be used for short-term in some people or long-term in others. For instance, people awaiting heart transplant can have a VAD implanted until a donor heart is available. People who can’t have heart transplant can have a VAD implanted for the long term, as well.However, VAD isn’t for everyone. If your doctor notices that it is not helpful then an artificial heart is another option that your doctor can recommend. Q.   I have just found out I need a heart transplant. I feel overwhelmed. What should I do? It is normal for you to feel overwhelmed with the news of requiring a heart transplant because things might not be the same after transplant. Instead of worrying about the heart transplant, it is recommended that you read as much as you can about heart transplant, so that you can have realistic expectations from the procedure. You can join a support group so you can gather information about people who have gone through the heart transplantation surgery. Q.   Is there a chance of the new heart failing? Yes, there is. Not all heart transplants are successful and for some people, the new healthy heart might fail even after successful transplantation. Your body may reject the new heart completely even with the help of immunosuppressants or you might develop diseases such as coronary artery disease which can lead to heart failure. Your doctor will tell you about the best course of action, in each case. Q.   Why choose Narayana Health for heart transplant procedure? . If you are looking for one of the best heart transplant hospitals in India then Narayana Health is one of them. It is one of India’s leading heart transplant hospital which has top heart surgeons in India. It has an active transplant program available for patients and provides artificial hearts and ventricular assist devices for patients who are not eligible for a heart transplant as well. Narayana Health thoroughly evaluates you so you are always given the best treatment possible according to your case. Doctors at Narayana Health work with you so you understand the entire procedure and why you are being given the particular treatment for your heart condition. You will be guided by the doctors and they will leave no stone unturned to ensure that you are aware of what to expect before the procedure, during the procedure, and after the procedure. This helps you understand the entire treatment without feeling stressed at any point. Q.   How long can you live with a new heart? . After a heart transplant, your life expectancy depends on many factors like general health, your age, commitment towards a lifestyle change and response to the transplant. 75% of heart transplant patients live up to 10 years after surgery and 85% of then return to their normal work life. Many patients also enjoy light physical activities like running, cycling, swimming, etc. Q.   What is the survival rate for heart transplant patients? . With improvement in treatments suppressing the immune system and preventing all kinds of infection, the survival rate among heart transplant patients has increased. Approximately 85-90% of heart transplant patients live up to one year after their surgery. The annual death rate after one year is 4%. The one-year survival rate in people with congenital heart disease is 79%. Q.   Do you die during a heart transplant? All kinds of surgeries have a risk of death, but in a heart transplant, the risk is higher than typical, especially when the donor's body does not accept the transplanted heart and does not tolerate it and functions well. Overall, a heart transplant surgery is a very high-risk procedure because the heart is not only stopped but is removed, replaced and sets up in another body to function. Q.   What is the cut off age for heart transplant? . The maximum age limit for heart transplant varies with each institution, but 65 is the cutoff age to have this kind of transplant. Q.   How long do heart transplants take? . Heart transplant surgery procedure takes approximately four hours. During the procedure, the patient is aided by a heart-lung machine for blood circulation throughout the body. Q.   How painful is a heart transplant? . Most patients do not report a lot of pain after heart transplant surgery. The patient will be constantly monitored, given pain medication, and outfitted with drainage tubes to remove excess fluid from the chest cavity. Whereas the incision might cause pain or discomfort while coughing or sudden jerky movements. Q.   Can a living person donate a heart? . Organ donors are usually deceased, but some organs can be donated by living donors. Deceased organ donors can donate both kidneys, liver, both the lungs, heart, pancreas, and intestines. Whereas living organ donors can donate only one kidney, one lung, a portion of the liver, pancreas, or intestine. 12. . 12. Stories of Hope . Hear from our Doctors . Hear from our Patients . Related Diseases & Treatments:  Congenital Heart Disease Coronary Artery Disease Heart Attacks Heart Disease Heart Failure Heart Murmur Heart Pacemakers Heart Stents Heart Surgery Heart Valve disease Irregular Heartbeat Related Specialities:  Cardiac Surgery - Adult Cardiac Surgery - Paediatric Cardiology - Adult Cardiology - Paediatric Heart Transplant Request an appointment Need Assistance? Call Our 24/7 Helpline Number. 186 0208 0208 Do You have a Question? Enquire Now! Expert CancerOpinion VideoConsultation BookAppointment
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Result 43
TitleHeart Transplant | Heart Care | Intermountain Healthcare
Urlhttps://intermountainhealthcare.org/services/heart-care/treatment-and-detection-methods/heart-transplant/
DescriptionHeart transplant, also called cardiac transplantation, is a successful treatment for advanced heart failure after other treatments are no longer helpful
Date
Organic Position42
H1
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H2WithAnchors
Body="https://www.googletagmanager.com/ns.html?id=GTM-PX5NCF" height="0" width="0" style="display:none;visibility:hidden">
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TitleMUSC Heart Transplant Programs | MUSC Health | Charleston SC
Urlhttps://muschealth.org/medical-services/transplant/heart-transplant
DescriptionAs South Carolina’s only heart transplant center, we offer shorter transplant wait times, quicker hospital recoveries and excellent transplant success rates
Date
Organic Position43
H1MUSC Heart Transplant Program
H2Why Choose MUSC Health for Heart Transplant?
Heart Transplant: What to Expect
Support Services
Our Care Team
H3Contact Us
Team Approach to Care
Speed & Excellence
Complete Heart Failure Care
Multiple Organ Transplants
Cardiac Rehabilitation
Evaluation & Waiting List
Surgery & Recovery
H2WithAnchorsWhy Choose MUSC Health for Heart Transplant?
Heart Transplant: What to Expect
Support Services
Our Care Team
BodyMUSC Heart Transplant Program Heart transplant surgeons at MUSC Health performed the state’s first heart transplant in 1987. Since then, we’ve saved the lives of more than 530 people with advanced heart failure. As the only heart transplant program in South Carolina, we provide you with more options to help you enjoy a longer, more productive life.  Why Choose MUSC Health for Heart Transplant? Our doctors are some of the world’s foremost heart experts. We have an exceptionally skilled team of cardiologists and transplant surgeons, who are board-certified in advanced heart failure, cardiovascular disease, and transplant cardiology. Our heart transplant specialists are always by your side, carefully guiding you through every step of the transplant process. Team Approach to Care. Your transplant team consists of specialists from many disciplines, including transplant surgeons, transplant cardiologists (heart doctors), nurses, behavioral health specialists, dietitians, and social workers. This team works with you and your referring physician to provide you with personalized care and ensure your transplant is a success. Speed & Excellence. Our transplant team has dedicated their careers to providing outstanding care. For you, this commitment means: Shorter transplant wait time: Our status as the state’s only heart transplant center means less of a transplant wait for you. Since 2016, the average wait time for a heart transplant has been approximately 80 days. This wait time is among the lowest in the country. Lower heart rejection rates: All donor hearts from South Carolina come to us first for potential matching with a recipient. Because our cardiologists and surgeons are selective when matching recipients with donor hearts, there is less risk of organ rejection. Quicker recovery: Our exceptional care lowers your risk of postoperative complications. As a result, we have one of the shortest hospital recovery periods in the country. Less time in the hospital also means less infection risk for you. Excellent outcomes Complete Heart Failure Care. Depending on your heart condition, you might need a ventricular assist device (VAD) or other mechanical circulatory support device to help your heart pump blood. Our Advanced Heart Failure Program offers the most treatment options in the state, including the newest generation of VADs. Your options include: Bridge-to-transplant VADs temporarily support your heart until a donor heart becomes available. Destination therapy VADs provide a long-term option if you don’t want a transplant or are physically unable to undergo surgery. Multiple Organ Transplants. If needed, our highly skilled transplant team can perform a combination heart-kidney transplant. This procedure is typically reserved for younger patients with few health complications. Cardiac Rehabilitation. Exercise specialists at our cardiac rehabilitation program offer a supervised health and wellness program for people who have had heart transplants. After your surgery, these specialists work with you to strengthen your body and your new heart. Heart Transplant: What to Expect. Evaluation & Waiting List. You’ll undergo an extensive medical evaluation and screening process to determine if you’re a suitable candidate for a heart transplant. This process involves multiple medical tests to evaluate your overall health, including an EKG, chest X-ray, heart catheterization, ultrasound, cardiopulmonary stress test, and blood work. You’ll also complete a screening with a social worker to identify issues that could negatively affect your transplant process and recovery. We make sure that you have a good support system to aid in your recovery. As soon as you’re approved for a heart transplant, we’ll place you on the United Network for Organ Sharing (UNOS) waiting list. UNOS uses several factors, including medical urgency and blood type, to match recipients and donors. Transplant wait times at MUSC Health tend to be shorter than the national average because we’re the only ones in the state offering this procedure. Surgery & Recovery. When a donor heart becomes available, you’ll undergo transplant surgery at MUSC Health. The surgery can take four to six hours depending on the complexity. After surgery you’ll spend at least 24 hours in our intensive care unit. Most of your recovery takes place in our dedicated organ transplant unit. You can expect to be in the hospital for approximately 12 days. This hospital stay is among the shortest in the country. Support Services. Receiving a new heart is a life-changing experience that requires a strong commitment from you and your caregiver. After discharge, you and your caregiver need to stay in the Charleston area for six to eight weeks for ongoing post-transplant care. Our patient support services team provides high-level help before, during, and after your transplant. Our patient care coordinators assist with: Housing and transportation during your stay in Charleston. Insurance coverage, prior authorizations, and billing issues. Coordinating appointments and medical tests. Our Care Team.
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Result 45
TitleHeart - Transplant Living
Urlhttps://transplantliving.org/organ-facts/heart/
Description
Date
Organic Position44
H1Heart
H2How does your heart work?
How does your heart work?
Common heart diseases
About a heart transplant operation
H3Preparing for the hospital
The procedure
During recovery
H2WithAnchorsHow does your heart work?
How does your heart work?
Common heart diseases
About a heart transplant operation
BodyHeart How does your heart work? The heart is a strong and muscular organ that is about the size of a fist in adults. It pumps blood throughout the body and is located behind the breastbone between the lungs. Deoxygenated blood flows from the heart to the lungs where it gives up carbon dioxide and is freshly oxygenated. From there, the blood returns to the heart and is pumped to the rest of the body. Heart Q & A Location of the heart How does your heart work? Your heart pumps blood throughout your body, bringing the oxygen and nutrients it needs. The heart also carries away waste. The heart works like a pump, or two pumps in one. The right side of your heart receives blood from the body and pumps it to the lungs. Common heart diseases. Common diseases that may lead to transplantation include: Cardiomyopathy Heart failure Restrictive myopathy Coronary heart disease About a heart transplant operation. In the four decades since the first human heart transplant occurred in 1967, the procedure has changed from an experimental operation to an established treatment for advanced heart disease. They are now the third most common organ transplant operation in the U.S. Preparing for the hospital. Preparing for the hospital In preparing for your heart transplant surgery, use the following checklist to prepare for your procedure: Select your primary support person. Choose someone you feel close to who has the time, health, and flexibility to be your caregiver. You need to know you are not a burden to this person. For caregivers, follow this link for more information on caring for patients. Prepare a phone/email tree. This will make it easier for your caregiver to update friends and family while cutting down on phone or email volume. Organize your personal affairs. Consider filling out an advanced directive, writing a will, and sharing access to bank accounts, e-mail, or blogs with a trusted loved one. You may also need to fill out Family Medical Leave Act, insurance, or loan deferment paperwork. Consider dependent care. Find someone you trust and set up a plan to take care of your children and/or pets. Ask your doctor when you can expect to see your children and pets after your transplant. Arrange transportation. You will want to plan how to get to the transplant center quickly when you get the call that an organ is available. Be sure to make these arrangements well in advance. If you are relocating, make sure you make housing arrangements in advance. Pack your bags. You’ll need to be ready to leave as soon as you get the call that an organ is available. Include insurance information, a list of medications, an extra 24-hour supply of medication, and other necessities. The procedure. There are two very different surgical approaches to heart transplantation: the orthotopic and the heterotopic approach. Because the length of this surgery is different for every patient, families should talk with the surgeon about what to expect. Orthotopic approach. The more common of the two procedures, the orthotopic approach, requires replacing the recipient heart with the donor heart. After the donor heart is removed, preserved and packed for transport, it must be transplanted into the recipient within four to five hours. The recipient receives general anesthesia and is placed on a bypass machine to oxygenate the blood while the heart transplant is being performed. After the recipient’s heart is removed, the donor heart is prepared to fit and implantation begins. Heterotopic approach. Heterotopic transplantation, also called “piggyback” transplantation, is accomplished by leaving the recipient’s heart in place and connecting the donor heart to the right side of the chest. The procedure is rare compared to orthotopic transplantation and is advantageous because the new heart can act as an assist device if complications occur. Your physician can explain why this approach may better suit your needs. During recovery. Postoperative care begins with a team of health professionals within the hospital. Careful, comprehensive post-surgical monitoring constantly evaluates whether the body is accepting the new organ. In addition, the amount of time you spend in the recovery room, waking up and getting to the point that you’re ready to go home, will vary from patient to patient. Because individual experience after recovery is so unique, it is important to discuss with your physician what to expect after surgery. Reference and Publication Information United Network for Organ Sharing (UNOS) is committed to providing accurate and reliable information for transplant patients. The content on this page was originally created on August 1, 2003 by UNOS and last modified on September 1, 2017. The following sources were used as references: National Library of Medicine, retrieved June 1, 2003. Day, Claire, BS, RN, CCTC and Rose Rivers PhD, RN. Ed. Franki Chabalewski. “Nursing Care of the Renal Transplant Recipient.” UNOS Donation and Transplantation Nursing Curriculum. 1996 This Web site is intended solely for the purpose of electronically providing the public with general health-related information and convenient access to the data resources. UNOS is not affiliated with any one product nor does UNOS assume responsibility for any error, omissions or other discrepancies. UNOS proudly recognizes sponsors whose generosity helps make our lifesaving mission possible. Learn about sponsorships and our editorial standards. Share This https://www.facebook.com/UnitedNetworkForOrganSharing https://twitter.com/unosnews https://www.linkedin.com/company/unos
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Result 46
TitleNew heart transplant method being tested for the first time in the U.S
Urlhttps://www.statnews.com/2020/01/16/heart-transplant-donation-after-cardiac-death/
DescriptionThe procedure involves “reanimating” hearts after they have been removed from donors who died of some form of cardiac failure
Date16 Jan 2020
Organic Position45
H1‘Donation after cardiac death’: New heart transplant method being tested for the first time in the U.S
H2About the Author Reprints
Tags
Recommended Stories
H3Shraddha Chakradhar
A tiny Florida company got more of a scarce Covid therapy than some big hospitals, raising equity questions
Pushback to Covid-19 vaccines remains stubbornly high among white evangelicals
Chatbots, surveys, and texts: Telehealth companies cut costs by reimagining the front desk
Texas is trying to create the next research triangle for biotech. Will it work?
The biotech scorecard for the first quarter: 19 stock-moving events to watch
H2WithAnchorsAbout the Author Reprints
Tags
Recommended Stories
Body‘Donation after cardiac death’: New heart transplant method being tested for the first time in the U.S. By Shraddha Chakradhar Jan. 16, 2020 Reprints Medical instruments for heart surgery Patrick Semansky/AP More than 250,000 people in the U.S. are currently at the end stages of heart failure, up to 15% of whom are in desperate need of a transplant. A new method of “reanimating” donor hearts from those who have died from cardiac failure is currently being tested in the U.S., and may soon ease that burden. As part of the new procedure, known as “donation after cardiac death,” or DCD, transplants, organs are retrieved from those who have died because their heart stopped — either naturally or because physicians discontinued life support. That work is made possible by a machine that allows the heart to not only be perfused with warm blood after it has been removed from the donor, keeping the heart functional and “alive” enough to be transported and transplanted several hours after retrieval, but also allows surgeons to assess the heart’s functionality in a way that wasn’t previously possible. Last month, a team at Duke University was the first in the U.S. to perform the procedure in an adult as part of a multicenter clinical trial. And just last week, Massachusetts General Hospital in Boston and the University of Wisconsin in Madison, which are also a part of the trial, reported their first such transplant. advertisement There are strict rules on how and when organs can be retrieved for transplantation — in the U.S., heart transplant donors can’t have died of circulatory death in some form. “There’s a tremendous disconnect between people who need a transplant, and the number who actually get it,” said Dr. Jacob Schroder, a thoracic and cardiovascular surgeon who is a part of Duke’s DCD heart transplant team. “[DCD heart transplants] will expand the donor pool by 30%, or 3,400.” advertisement “If proven successful and safe through this study, transplanting DCD hearts on a wider basis would be another great tool in our arsenal to utilize more organs and increase the number of lives saved through transplantation,” said Dr. David Klassen, chief medical officer of the United Network for Organ Sharing, the nonprofit that manages organ transplantation in the U.S. Ten such heart transplants have already been performed among the three centers in the past month since the trial was initiated. Three other research centers — Vanderbilt, Stanford University, and Emory University — will soon be joining the trial, which is scheduled to run until 2021. In all, 15 sites across the U.S. will be involved. “If done correctly, a DCD donor heart may outperform a brain dead donor heart [because] the effects of prolonged brain death on the heart is quite jarring,” said Dr. Mandeep Mehra, an advanced cardiovascular specialist at Brigham and Women’s Hospital in Boston, who is not involved in the trial. “This is a necessary addition to our armamentarium for organ donor recovery.” For years, DCD transplants in U.S. adults have been done with other organs, including the lungs, kidney, and liver. And the very first heart transplant in 1967 could very well have been a DCD transplant, Mehra pointed out, because there was no legal definition of brain death at the time. And at least one team in Colorado has performed a small number of DCD heart transplants in pediatric patients in the U.S., according to Mehra. But in recent years, and for adults, the heart has been a major exception for DCD transplants because its inability to pump oxygenated blood after death has meant a higher risk for damage, in which heart tissue begins to die or otherwise deteriorate. Traditional cold storage has also not allowed physicians to assess the heart’s function for any signs of damage, since a heart that is injured is less likely to help a prospective transplant recipient. As the need for heart transplants has risen, physicians have looked for ways to overcome the barriers to using DCD hearts. Other countries, including the U.K. and Australia, have been performing DCD heart transplants for several years now. The procedure was first performed by a group in Sydney’s St. Vincent’s Hospital in July 2014. The Royal Papworth Hospital in the U.K. followed soon after in February 2015. There have been over 100 DCD heart transplants combined at the two locations. Five of the six hospitals that do heart transplants in the U.K. have used the DCD method, according to Dr. Pedro Catarino, who is part of the DCD heart transplant team at Royal Papworth Hospital. He added that in the next six months, the U.K. will have a national retrieval system for DCD hearts. In contrast, physicians in Australia can perform the procedure, but it’s not covered by the government, said Dr. Kumud Dhital, who performed the first DCD transplant and who is now director of cardiothoracic surgery and transplantation at the Alfred Hospital in Melbourne. Transplants there have thus far have been paid for by philanthropic donations. The Australia and U.K. groups, like Schroder’s at Duke, have relied on the TransMedics Organ Care System to reanimate the heart and assess its function after it has been removed from a donor. “With the Organ Care System, time is no longer a limitation,” said Dr. Waleed Hassanein, CEO of TransMedics. “The OCS is always supplied with oxygenated blood and we’ve transplanted organs 21 hours after [they have been placed in the machine],” a feat that he said is not possible with traditional cold storage used to preserve organs. The system has been used for nearly 170 DCD heart transplants worldwide, Hassanein said. The time it takes to remove the organ from the body, before it’s placed in the TransMedics machine, can be a limiting factor, as is this is the time that can lead to the most injury to the heart. “The longest we have heard of is 40-45 minutes, but we usually expect that time to be around 30 minutes,” Hassanein said. “Even with that limit of 30-45 minutes, you can triple or quadruple the number of heart transplants,” he added. A heart retrieved from a donor who died a cardiac death is “reanimated” for transplantation using the TransMedics Organ Care System. Dr. Jacob Schroder Importantly, the organ care system also allows transplant surgeons to measure the function of the heart before they transplant it to a recipient, allowing them to assess the organ’s viability. The system “replenishes the energy stores and you can see the heart beating,” Catarino said. “It’s not doing work, but you can measure the heart’s metabolic consumption, if it’s stressed or had coronary artery disease.” The next step in the U.S. is for the TransMedics system to gain Food and Drug Administration approval for heart preservation — the agency has only signed off so far on its use in lung transplants. Though the company, which is sponsoring the multicenter trial, has worked with the FDA to develop the trial protocol: For every three patients who receive a heart transplant through the current standard for the procedure, one person will receive a DCD heart. The hope, according to Schroder, is to have completed around 50 DCD heart transplants by the end of the trial in 2021, at which point TransMedics will also look to file an application for FDA approval. The procedure does have risks, including that some patients need to be connected to an external machine that pumps oxygenated blood to the body until the heart recovers its full function. But Hassanein said the company hasn’t heard of risks other than what’s expected with regular transplants, like organ rejection and death. The results from elsewhere in the world are already promising. The recipient of the first-ever DCD heart in 2014 is “still doing extremely well,” Dhital said. A study published by the Australia group in April 2019 found that the survival rate among DCD heart transplant recipients was the same — or even higher in some cases — than those who received hearts removed from donors who suffered brain deaths. A 2017 study from the U.K. group compared survival rates of 26 DCD heart recipients to an equal number of patients who received heart transplants via conventional methods. After 90 days, 92% of those who received DCD hearts were still alive, compared to 96% of those who received hearts after donors had died of neurological failure. After one year, those figures were 86% and 88%, respectively. The teams in the U.S. are hopeful that the trial underway will yield similar results and spur FDA approval. “Organ transplantation is the most cost-effective treatment for end-stage disease,” Hassanein said. “The DCD heart trial is a big deal and it’s very exciting for the field. It could make heart transplantation more of a reality for all those patients who are on the waiting list.” Correction: An earlier version of this story misspelled Dr. David Klassen’s name. About the Author Reprints . Shraddha Chakradhar . Reporter, Morning Rounds Writer, Intern Coordinator Shraddha writes the Morning Rounds newsletter and covers health and medicine. @scchak Tags. 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Result 47
TitleLucky No. 8 (and 972) • Discovery
Urlhttp://discoverymag.umn.edu/stories/lucky-no-8-and-972
DescriptionMeet Minnesota’s own Cheri Lemmer, the longest-surviving heart transplant recipient in the world
Date
Organic Position46
H1
H2Meet the Minnesota woman who is grateful to be the world's longest-surviving heart transplant recipient
‘I felt this energy’
Another success
H3Next
Stress-fueled dreams
Fall 2020
‘The audacity to do something’
Lucky No. 8 (and 972)
Stress-fueled dreams
Q&A
Forefront
Gallery
Synopsis
Gratefully Yours
Recent Issues
H2WithAnchorsMeet the Minnesota woman who is grateful to be the world's longest-surviving heart transplant recipient
‘I felt this energy’
Another success
BodyFall 2020 Issues/Contents Feature Lucky No. 8 (and 972) Meet the Minnesota woman who is grateful to be the world's longest-surviving heart transplant recipient . By Susan Maas BRADY WILLETTE Share Twitter Facebook Email After Cheri Latzke Lemmer’s heart transplant in 1981, at age 24, she figured she’d be lucky to make it to 30.“It was scary back then—the survival rate wasn’t very good,” Lemmer recalls. “You had a good chance of making it one year, but your odds of making it five years weren’t very high.”Lemmer was heart transplant patient No. 8 at what was then called University of Minnesota Hospitals. The team had performed its first heart transplant three years earlier.In May 2020, this pioneering heart transplant program celebrated a major milestone: its 1,000th transplant. The team also celebrates the fact that its average patient survival is 13.6 years posttransplant, three years beyond the national average—with many heart recipients living decades beyond that.Lemmer, 64, had a second successful heart transplant a year ago at M Health Fairview University of Minnesota Medical Center.The Le Sueur, Minnesota, woman is grateful to be the longest-surviving heart transplant recipient in the world.‘I felt this energy’. In 1981, Lemmer was a young mother of preschoolers when she was diagnosed with an enlarged heart. She was sent to the University of Minnesota, which had a legacy of outstanding cardiac care: surgeons here had performed the world’s first successful open-heart surgery in 1952 and the world’s first artificial heart valve implant in 1958.“I went through a very brief screening, nothing like they do now,” Lemmer says. “I remember getting the call the day before my son’s second birthday. I don’t recall being nervous or scared until the night before the transplant, driving up to the U—that’s when I started wondering if I would see my kids again.” Cheri Lemmer’s young children liked to “ride” her IV poles in the hospital after her 1981 heart transplant. She received her new heart the day her son turned 2.“The thing I remember most is waking up: I have 11 siblings, and I think most of them were in the room when I came to,” Lemmer recalls. “I felt this energy I hadn’t felt in so long. I couldn’t talk because of the breathing tube, but I wanted to get right out of bed!”Lemmer was released from the hospital in 17 days, a record back then. “I was so young, and I was in pretty good shape,” she says. “And I guess I’ve always had a lot of determination.”Much about the transplant program has evolved in 40 years—with expanded screening protocols; more effective immune-suppressing drug regimens that decrease the risk of organ rejection; more comprehensive follow-up care; and coordinated, multidisciplinary services that include nutrition and mental health care. But the core of the program remains the same: world-class expertise delivered with compassion.Lemmer’s story is among many that make M Health Fairview surgical director of heart transplantation Ranjit John, M.D., and his colleagues proud.“It illustrates how we’ve grown from a pioneering program in the late ’70s and early ’80s to one whose state-of-the-art techniques now set the standard of care,” says John, a professor of cardiothoracic surgery in the U of M Medical School. “Offering patients hope and the chance at long-term survival gives our team immense satisfaction. We’re thankful to be a part of their story and path to recovery.”Another success. Lemmer had her second heart transplant—No. 972 for the U team—last fall. This time, she got the call while grocery shopping. “I was thinking, ‘OK, I’ll go through checkout and then I’ll drive up there. No, wait, why am I going to go through checkout?’” she recalls, laughing. “So I left my grocery cart sitting there, picked up my husband, and we drove straight up.” “I have such faith and such trust in my doctors and my transplant coordinator. I’d never go anywhere else.” — Cheri Latzke Lemmer Today the program offers more specialized support for different aspects of the transplant process, Lemmer says, including mental health care. “It’s so very thorough. And the pain management has come a long way.”Lemmer did three months of cardiac rehabilitation after her surgery. “I was pretty physically fit before the surgery,” she says. “Every day at work, I’d go up to the fitness center on my lunch hour. I just keep pushing myself. I don’t sit still very well.”Except for a few weeks after her second transplant, Lemmer never stopped working. While COVID-19 has cramped her active lifestyle, she still gardens and decorates cakes. And she’s soon planning to resume one of her all-time favorite hobbies: chainsaw sculpture carving.Lemmer is careful about avoiding physical contact with everyone but her husband, Rick Lemmer. She’s especially susceptible to germs because of the immune system–suppressing medications that help to prevent rejection of her new heart, and COVID-19 has been particularly hard on people with heart disease. So for now, visits with her two children and five grandchildren take place on video or from across her backyard.“Part of me wants to say, ‘the heck with it,’ but I worked too hard for this new heart,” she says.And she respects her M Health Fairview Transplant Care team too much not to heed their advice.“I have such faith and such trust in my doctors and my transplant coordinator,” Lemmer says. “I’d never go anywhere else.”Learn how your gift can support heart transplant patients or research by contacting Michelle Boe of the University of Minnesota Foundation at 651-999-9287 or [email protected]  Patients helping patientsCancer survivor, heart transplant recipient, kidney transplant recipient—Glen Kelley has lived a four- decade health odyssey that’s more dramatic than fiction. “I’m full of recycled parts,” he quips.Today Kelley is president of the Second Chance for Life Foundation, which provides financial, educational, and emotional support to heart transplant and left-ventricular assist device (LVAD) patients at M Health Fairview University of Minnesota Medical Center. (LVADs can do the work of failing hearts before a transplant or sometimes can be used to avoid the need for a transplant.) Kelley says his own experiences give him the “rocket fuel” to run an organization like Second Chance.Founded in 1986, the group is led by volunteers, most of them former transplant patients—“patients helping patients,” Kelley says. “If you need a transplant, you’re out of work for a while. And if you’re traveling here from out of town or out of state, you need housing.”His doctors believe that Kelley’s heart condition, restrictive cardiomyopathy, is a result of cancer treatments he received for lymphoma in his late teens. He first experienced heart problems in his 30s and eventually had two bypasses—plus valve repairs and replacements, and a pericardiectomy—in 2013 and 2015, respectively. In 2016, he had a heart transplant.His gratitude for the expert care he received at the U makes his involvement with Second Chance a labor of love. “When you’ve got a failing heart, there’s nothing better than finding somebody you can talk to who’s on the other side of it,” Kelley says. “That woman is riding her bicycle? That guy is out there playing golf? I didn’t know if I was going to live past tomorrow!” Next. Feature Stress-fueled dreams. Find out what’s behind our wild pandemic nightmares, and how quality sleep can make a difference. Fall 2020. Features. Feature ‘The audacity to do something’. University researchers, clinicians, and scientists of all stripes lend their expertise to take on COVID-19 challenges. Feature Lucky No. 8 (and 972). Meet Minnesota’s own Cheri Lemmer, the longest-surviving heart transplant recipient in the world. Feature Stress-fueled dreams. Find out what’s behind our wild pandemic nightmares, and how quality sleep can make a difference. Departments. Q&A. How racism affects your health Forefront. Building better brains Resilience in a crisis Easing cancer’s burden For persistent wounds, a living bandage What shapes tomorrow’s physicians Making headlines Gallery. Ingenuity in action Synopsis. From lab to community immunity Gratefully Yours. Collaboration is key Recent Issues. Fall 2021 Spring 2021 Fall 2020 Spring 2020 All Issues
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Result 48
TitleAbout Heart Transplant
Urlhttps://www.nationwidechildrens.org/specialties/heart-failure-transplant/about-heart-transplant
DescriptionA heart transplant offers an improved quality of life but it also comes with many new responsibilities
Date
Organic Position47
H1About Heart Transplant
H2How are Potential Heart Transplant Patients Evaluated?
How are Organs Distributed?
What are the Different Listing Status?
How Long Does a Heart Transplant Take?
You Might Also Be Interested In
H3
H2WithAnchorsHow are Potential Heart Transplant Patients Evaluated?
How are Organs Distributed?
What are the Different Listing Status?
How Long Does a Heart Transplant Take?
You Might Also Be Interested In
BodyAbout Heart Transplant The decision to proceed with heart transplant is considered when no other medical or surgical options are available. A heart transplant offers an improved quality of life but it also comes with many new responsibilities. How are Potential Heart Transplant Patients Evaluated? Anyone considered for transplant will have an extensive evaluation by the heart transplant team. Evaluation and testing can take 2-3 days. This includes: Cardiac Catheterization: used to evaluate the function and anatomy of the heart. Also looks at the blood pressures in the chambers of the heart and the blood pressure of the lung arteries. Echocardiogram (ECHO): an ultrasound of the heart that measures the size, anatomy and function of the heart. Electrocardiogram (EKG): shows the heart rhythm and heart rate. Chest X-ray: an X-ray image of heart and lungs Blood Tests: blood will be drawn to check the function of the kidneys, thyroid, pancreas, liver, immune system and blood type Dental Evaluation: check for any dental cavities Nutrition Evaluation: provides support in making healthy diet choices Social Work Evaluation: identifies needs and social support system How are Organs Distributed? Heart Transplant is not available for everyone. There are specific criteria for eligibility that are published and supported by the Ohio Solid Organ Transplant Consortium (OSOTC). Our program is a member of OSOTC and information (without identifiers) is sent to the OSOTC for review prior to listing a patient.  Once the evaluation is complete, the next step is listing. Listing is done through the national transplant list managed by the United Network for Organ Sharing (UNOS). UNOS works with our local procurement agency, Lifeline of Ohio, to recover organs. Organs are distributed to the most critically ill patients. Once a person is listed for heart transplant, they are given a listing status based on the severity of heart failure. This status is determined by UNOS. UNOS ensures fair distribution of organs. What are the Different Listing Status? Status 1A often involves the critically ill. These patients are usually in the intensive care unit. They may require special medical equipment to support breathing and/or require certain high dose intravenous (IV) medication(s) to help the heart work better. Status 1B patients require the same medications to help their heart work better but at lower doses. They do not need care in the intensive care unit but will be hospitalized on the step-down heart floor. Infants and children who can not gain weight appropriate for their age due to their heart problem can be listed as 1B. Status 2 patients do not meet status 1A or 1B criteria. They are well enough to wait at home. They will be called at home or given a pager to carry and will be notified by the Transplant Coordinator when a new heart is available. How Long Does a Heart Transplant Take? A suitable organ donor is a person who is a match to the patient’s blood type and is of similar body size. The average waiting time for a new heart can be weeks to months. When the appropriate donor heart is found, we will begin the process of preparing for the surgery of heart transplant. This surgery is very similar to any other type of open heart surgery. The average length of surgery is approximately 6-8 hours. You may wait with your family and friends in the surgical waiting room in the main hospital on the second floor. Here you will receive updates from the surgical team and the surgeon will meet you here once the surgery is complete.  After the transplant operation, the hospital recovery time is variable but may be several weeks. After the heart transplant surgery the patient is cared for in the Cardiothoracic Intensive Care Unit (CTICU) for close monitoring. Once able, the patient will be moved to the cardiac step-down unit (H4A) with the next transition to be discharged to home. You Might Also Be Interested In. Article Kawasaki Disease. Article Lipid Screening. Article Return to Play COVID Guidelines - Symptomatic.
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Result 49
TitleHeart Transplant Process
Urlhttps://www.froedtert.com/transplant/heart-transplant/process
DescriptionHeart transplant patients can expect surgical expertise and life-long support at Froedtert & the Medical College of Wisconsin in Milwaukee, Wis
Date
Organic Position48
H1The Heart Transplant Process: What Patients Can Expect
H2Heart Transplant Clinic: Comprehensive, Personalized Care
Preparing for Heart Transplant
Heart Transplant Surgery
Recovery From Heart Transplant Surgery
Life-Long Transplant Care Resources
FAQ and Resources
Transplant and the COVID-19 Vaccine
Care Team Rallies Around Young Heart Transplant Patient and His Family
Cowboy Chuck: A Story of Hearts, Horses and Hope
Heart Failure, July 2019
Amid Organ Donor Shortage, Innovations Offer More Options to Patients
Innovative Option When a Heart Transplant Is Not Possible
Parallel Lives: Cousins Receive Heart Transplants
H3
H2WithAnchorsHeart Transplant Clinic: Comprehensive, Personalized Care
Preparing for Heart Transplant
Heart Transplant Surgery
Recovery From Heart Transplant Surgery
Life-Long Transplant Care Resources
FAQ and Resources
Transplant and the COVID-19 Vaccine
Care Team Rallies Around Young Heart Transplant Patient and His Family
Cowboy Chuck: A Story of Hearts, Horses and Hope
Heart Failure, July 2019
Amid Organ Donor Shortage, Innovations Offer More Options to Patients
Innovative Option When a Heart Transplant Is Not Possible
Parallel Lives: Cousins Receive Heart Transplants
BodyThe Heart Transplant Process: What Patients Can Expect Heart & Vascular Not every patient with advanced heart failure will need a heart transplant. We carefully evaluate each patient to ensure that the option is pursued only when all others have been exhausted. Heart Transplant Clinic: Comprehensive, Personalized Care. The Heart Transplant Clinic is the dedicated, central home for our patient’s pre-transplant evaluation and post-transplant care. To meet the many needs transplant patients may face, the clinic’s multidisciplinary team of experts includes transplant coordinators, dietitians, pharmacists, social workers, psychologists, case managers and financial counselors. We understand that the overall quality of care before, during and after a patient’s transplant surgery is crucial to a successful transplant process. Preparing for Heart Transplant. Before transplant, patients are thoroughly screened to ensure that they are healthy enough for transplant. The evaluation covers mental and physical health, and includes blood tests, a medical history review and diagnostic tests of the lungs and other body systems. Once accepted for transplant, patients are placed on the United Network for Organ Sharing (UNOS) wait list. Transplant coordinators facilitate education for patients and families to help them take the best care of themselves once out of the hospital. Heart Transplant Surgery. Heart transplant surgery is complex and the approach varies based on each patient’s unique needs. The entire process is orchestrated by transplant coordinators who guide patients and their families through each step. Generally, surgery lasts about four to five hours. Heart transplant at Froedtert Hospital involves the skills of heart surgeons, transplant cardiologists, anesthesiologists, nurses, technicians and other professionals, all specialists in the procedure. They prepare patients for surgery and administer general anesthesia to help them remain unconscious during the surgery.  Once patients are asleep, surgeons make an incision down the center of the chest and separate the two halves of the breastbone to allow access to the heart. The patient’s blood supply is rerouted temporarily from the heart to a cardiopulmonary bypass machine (heart-lung machine). At this point, the patient’s diseased heart is removed, the healthy donor heart implanted and the patient’s blood supply connected to the new heart. Physicians then shock the heart to start it beating and pumping blood.   Following a thorough check of the heart’s function and the blood connections, the breastbones are rejoined and the chest incision closed. Patients then proceed to the recovery room.   Recovery From Heart Transplant Surgery. Following surgery, heart transplant patients receive care in the cardiovascular intensive care unit for two or three days until they are moved to a surgical nursing unit when their condition is more stable. Nurses who staff the units are specially trained to care for heart transplant patients. Post-transplant patients are seen daily by cardiologists for the medical component of their care, and by heart transplant surgeons for post-surgical care. Patients can expect to be in the hospital for about two weeks. Life-Long Transplant Care Resources. Heart transplant patients need follow-up care for the rest of their lives. Patients may also need pacemakers or other heart and vascular care in the years following their heart transplants. Our Heart and Vascular team provides the full continuum of heart care options. Additionally we offer a Transplant Support Group that is open to any heart, lung or abdominal (liver, kidney and pancreas) transplant patient and their caregivers. Post-transplant coordinators in our Heart Transplant Clinic work with patients to coordinate every aspect of their follow-up transplant care. Having dedicated, experienced staff and knowledgeable resources all in one location gives patients a familiar place where their unique needs are well-understood and met. For more information about the heart transplant process, see our FAQ. Appointments 414-805-3666 Request Appointment View Specialists Treatment Locations Contact Us FAQ and Resources  . What conditions lead to the need for a heart transplant? Most people who become candidates for a heart transplant have severe heart failure from one of several causes. Ischemic cardiomyopathy. These patients may have had multiple heart attacks or they may have had coronary bypass surgery and no longer have any vessels to use for a bypass procedure. They also may not be able to undergo further stent procedures. Idiopathic cardiomyopathy. These patients, who tend to be younger, have heart failure with an unknown cause. Congenital heart disease. This emerging group of patients are people who have congenital heart disease that was either repaired when they were children or was never repaired. Now their hearts are starting to fail, and transplant may become an option. Do I have any other treatment options besides transplantation? There are a variety of treatment options available, including ventricular assist devices (VADs), but there is no one solution for every patient. Before considering transplantation, other treatments generally have been exhausted. While some organ transplants may be considered life-enhancing, a heart transplant is normally undertaken as a lifesaving procedure. Who are good candidates for heart transplant? Determining who is a good candidate depends on many factors. It can depend on the severity of the patient’s heart failure, overall health and whether they suffer from coronary disease, valve disease or some other condition. Am I too old for a heart transplant? While patients over age 70 are generally less likely to receive a transplant, that is not an absolute standard. Age is one of many factors considered. Will other medical problems eliminate me from consideration? Diseases that could limit the patient’s longevity or ability to recover might disqualify them from becoming a transplant candidate. For example, patients who have had cancer in the past five years are unlikely to receive a transplant. How do I get on the transplant list? What about wait times? If patients and physicians feel they have exhausted all treatment options and need to consider heart transplant, patients will undergo an extensive evaluation. The transplant physicians and team will review patient medical histories, conduct diagnostic tests and assess social and mental readiness for transplant. We want to make sure that patients are healthy enough for the surgery and able to comply with the care regime required after transplant to keep healthy.  Once approved for transplant, the care team will make arrangements for the patient’s name to be placed on the transplant waiting list and will discuss wait times with them. Wait times may vary greatly depending upon blood type. I live a few hours away. Can I have pre-transplant testing done closer to home? Transplant coordinators make it a priority to schedule pre-transplant screenings all in one day or as is most easy and convenient for patients. It is preferred that tests related to the evaluation are done at our facility so results are timely and coordinated. If scheduling becomes a problem, however, transplant coordinator can suggest other options. What will my life be like after heart transplant? Many people are able to resume normal activities and work without limitations after heart transplant. Patients will need to consider themselves heart transplant patients for the rest of their lives, however, as they take medications, have regular check-ups and stay as healthy as possible. Some patients find that other conditions develop after transplant, such as diabetes, kidney disease or high blood pressure. Keep in mind that conditions are manageable compared to the heart condition that led to transplant. No matter what, the transplant care team will be there with the care, tools and support patients need to live the highest quality of life. Will I ever need another heart transplant after my first heart transplant? Heart transplant patients generally live 13 – 15 years after their first heart transplant before a second transplant may be needed. Thanks to today’s medical advancements, it is not unusual for patients to live long enough to need more than one transplant. Where can I get more information? United Network of Organ Sharing (UNOS) – Information about the organ allocation process and access to various national, regional, state and center-specific data reports. Transplant Living – A patient education site sponsored by UNOS to inform about life before and after transplant. Scientific Registry of Transplant Recipients – Generates reports to compare survival rates of heart transplant facilities across the country Visit Children’s Wisconsin, Versiti Blood Center of Wisconsin and the Medical College of Wisconsin to learn more about our Transplant Center partners. Transplant and the COVID-19 Vaccine. Transplant patients may be at a higher risk of severe COVID-19, and we have seen worse outcomes if they do get it. Due to the increased risk, we recommend transplant patients get the vaccine. Learn More More to Explore From the Blog Last Updated July 8, 2021 Care Team Rallies Around Young Heart Transplant Patient and His Family . From the Blog November 19, 2019 Cowboy Chuck: A Story of Hearts, Horses and Hope . Video Heart Failure, July 2019 . From the Blog April 5, 2019 Amid Organ Donor Shortage, Innovations Offer More Options to Patients . From the Blog December 28, 2018 Innovative Option When a Heart Transplant Is Not Possible . From the Blog Last Updated July 8, 2021 Parallel Lives: Cousins Receive Heart Transplants . Share This:
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Result 50
TitleHeart Transplant Process | Advocate Health Care
Urlhttps://www.advocatehealth.com/health-services/organ-transplant-surgery-program/heart-transplant/transplant-process
DescriptionOur multi-disciplinary team at Advocate Heart Institute works closely with you throughout the entire heart transplant process, to ensure you have answers to all of your questions and understand your options
Date
Organic Position49
H1Heart transplant program process
H2Referral process
Evaluation & transplant processes
Chicagoland location
Refer a patient or learn more
H3Heart transplant
H2WithAnchorsReferral process
Evaluation & transplant processes
Chicagoland location
Refer a patient or learn more
BodyHeart transplant program process Our multi-disciplinary team at Advocate Heart Institute works closely with you throughout the entire heart transplant process, to ensure you have answers to all of your questions and understand your options. Referral process. We strive to make the transplant referral process easy for both the patient and the physician. The following are key indicators for referral, for advanced heart failure therapies and heart transplantation: Frequent hospitalizations for heart failure Inability to tolerate much activity Non-response to medical therapy Inabiility to tolerate heart failure medications Increasing diuretic dosage Non-response to cardiac resynchronization therapy (CRT) As an advanced heart failure patient, your transplant coordinator helps you and your referring physician from the start of the referral process through completion of follow-up care. Our physicians and transplant coordinators are available 24 hours a day, seven days a week to answer questions from you and your doctor. When referred to our heart transplant program, you are evaluated to determine if a heart transplant is an appropriate treatment. Our team’s goals are to make sure every patient is given the option for heart transplantation, and to determine if transplantation will provide the best outcome and quality of life. Here are some frequently asked questions to help you prepare for your first evaluation and subsequent outpatient visits to the Transplant Center. Should I bring someone to the appointment? Yes, it's important for you to bring someone to the evaluation visits to act as your main support person. This person should be someone who will help you before and potentially after your transplant. The support person can: Help ask questions Provide additional health information Offer emotional support Help recall information discussed at the visit What should I bring with me? For each outpatient visit, please remember to bring: State ID or driver’s license Insurance card Current medication list Any medical records or written information regarding past medical history Name of referring physician, and their address and phone number List of questions Referral for the office visit (HMO members) How long will the visit take? The initial visit can take up to two hours. Most of this time is spent: Reviewing your health history Providing education about the risks, benefits and expectations of heart transplantation Addressing all questions Our team strongly encourages you and the people accompanying you to eat a full meal prior to your appointment. Evaluation & transplant processes. Here's how the transplant process works, from initial evaluation through surgery and follow-up: Step 1: Initial evaluation. First, you will meet a transplant cardiologist, a surgeon and an advanced practice nurse. The team will review your medical history and current health status thoroughly. If they determine that you would benefit from transplantation your case will move forward toward a full transplant evaluation. Step 2: Full transplant evaluation. The full transplant evaluation consists of: Consultation with our transplant and multi-disciplinary team Extensive cardiac testing Imaging Laboratory tests Cancer screening  You may be seen by specialists from the multi-disciplinary team to address any other organ-specific issues discovered during the initial or full transplant evaluations. Depending on your current health status, testing is performed either on an inpatient or outpatient basis. The advanced practice nurses will arrange the testing ordered by the physicians. Step 3: Presentation to the Heart Transplant Board. As part of our weekly transplant team meeting, patients undergoing evaluation are presented to the multi-disciplinary team to determine candidacy and treatment recommendations based on the following: Results of diagnostic tests Medical criteria Fitness to undergo surgery Chance of recovery Various lifestyle factors Step 4: Placement on the donor organ waitlist. After being deemed eligible for transplant, you will meet with the transplant coordinators to learn about the transplant process and consent for listing. You are then placed on the national organ transplant waitlist through the United Network of Organ Sharing (UNOS). While on the waitlist, monthly blood work and check-ups are performed to monitor your condition. Step 5: Transplant surgery. Once a donor is identified and deemed suitable for organ donation, UNOS will run a match list to identify those patients eligible to receive organs from this donor. A cadaveric heart is matched to a patient based on: Blood type Height Weight Distance Time on the UNOS waitlist Medical urgency When a match is found, the transplant team will call you and surgery will occur immediately. Once admitted, you will undergo some minor lab work and a physical exam, and then will be moved to the operating room. The transplant requires two surgical teams. One team will be in place to retrieve the donor heart while the other surgical team first prepares for and then performs your surgery. Even though the actual suturing of the heart can be completed within an hour, the entire transplant surgery can last six hours or more due to multiple factors such as: Distance from the donor hospital Scar tissue or adhesions from previous cardiothoracic surgeries Bleeding Step 6: Post-transplant recovery. Heart recipients will recover in our state-of-the-art Adult Surgical Heart Unit (ASHU), an intensive care unit designed specifically for open heart surgery patients. Depending on your status going into the transplant procedure, a post-operative stay is approximately 14 days. Specially trained nurses administer immunosuppressant drugs to help prevent your immune system from rejecting the transplanted heart. Before leaving the hospital, the advanced practice nurse, dietician and clinical pharmacist will teach you about: Caring for your incisions Recognizing symptoms of rejection and infection Understanding medications Activity guidelines Step 7: Discharge and follow-up. Upon discharge, you will follow up with members of the transplant team to monitor your progress as you resume normal activities. The follow-up visits are frequent immediately following surgery, but will decrease over time. The transplant team will work closely with your referring physician and primary care physician to ensure your care is coordinated and thorough. Chicagoland location. Advocate Heart Institute at Christ Medical Center 4440 W. 95th Street Oak Lawn, IL 60453 Refer a patient or learn more. Contact our transplant coordinator to refer a patient or to learn more about our program Call 877-684-4327
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TitleHeart Transplant Surgery | Methodist Healthcare
Urlhttps://sahealth.com/specialties/heart-transplant/
DescriptionOur expert surgeons offer medical care and perform heart transplants for patients with heart failure in San Antonio, Texas
Date
Organic Position50
H1Heart transplant
H2Heart transplant program in San Antonio
Heart transplant candidacy
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Heart transplant recipients' tribute
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H3Find care at these locations
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Find care at these locations
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H2WithAnchorsHeart transplant program in San Antonio
Heart transplant candidacy
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BodyHeart transplant A heart transplant is a surgical procedure performed on patients with heart failure, where the failing heart is replaced with a healthier heart from an organ donor. Methodist Healthcare / Specialties / Transplant services / Heart transplant Find care at these locations. Methodist Hospital Helpful Links. Find A Doctor Get Directions Call Heart Transplant Clinic Patient Referral Form Transplant Services Show more links Heart transplant program in San Antonio. The Methodist Heart Institute’s Heart Failure Center provides medical and surgical interventions for hearts that are failing. With the largest heart transplant program in Central and South Texas, our team has performed more than 500 transplants and implanted over 200 assist devices since the start of the program in 1986. For more information about our heart transplant services, please call (210) 575-8485. A heart transplant can help patients with heart failure, a condition that means the heart no longer pumps enough to meet the demands of the body. The goal of the heart transplant program is to exhaust all medical therapies before resorting to a heart transplant, which is reserved as a final life-saving option. Transplant services are only considered for patients with severe heart failure who meet heart transplant criteria and have healthy organs otherwise. Heart transplant candidacy. If your doctor feels you may be a candidate for heart transplant evaluation, you will have to undergo multiple diagnostic tests and medical evaluations. You will also participate in various consultations with members of our heart transplant interdisciplinary team, including our surgeons, dietitian, social worker, psychiatrist, financial advisor and other consulting physicians as necessary. Private insurance, as well as Medicare and Medicaid, provides coverage for heart transplants. Our financial coordinators verify transplant benefits from your provider, assist with information and planning, help you understand what your insurance will and will not cover and estimate transplant and medication costs. If you are a physician and think your patient is a candidate for heart transplant surgery, please fill out our online patient referral form. Read about a Methodist Healthcare patient's heart transplant journey Heart transplant list. The heart transplant team meets regularly to discuss a candidate’s needs and the likelihood of a successful transplantation. If you are an ideal candidate for the procedure, your name is placed on the United Network for Organ Sharing (UNOS) waiting list for a donor heart. Your place on the list is determined by the severity of your illness and how long you have been waiting. You may move up or down the list as your condition declines or improves. Heart transplant surgery. As the donor heart is being transported to the hospital, the patient will be prepared for surgery. The transplant operation lasts four to six hours. During the procedure, the patient is placed on a heart-lung bypass machine, keeping the blood circulating and oxygenated. The diseased heart is removed, and the donor heart is reconnected to major blood vessels and surrounding tissues. After surgery, the patient is taken to the Surgical Intensive Care Unit and then transferred to a regular room in the hospital’s transplant unit. Most transplant patients spend approximately 10 days in the hospital following an operation. While hospitalized, the transplant program team provides post-transplant education and support services. The patient is informed about diet, exercise, cardiac rehabilitation and medications. Heart transplant recovery. After discharge, activity will be limited for six to eight weeks. The patient must keep a daily record of blood pressure, pulse, temperature, dosages and times medication is taken. Patients are watched closely for signs of rejection of the transplanted heart. Rejection may occur because your body perceives the heart as foreign, and your immune system attacks the heart. Because post-transplant medications are designed to suppress the immune system to reduce the risk of rejection, they also increase the risk of infection. Immediately following discharge, it is imperative that patients avoid large crowds or come in contact with unhealthy individuals. Your transplant team will do their best to reduce your chance of having complications and to treat any problems or difficulties right away. Following instructions carefully, and keeping your transplant team informed of any problems you have or are concerned about, will help you return to a normal, active life. Heart transplant recipients' tribute. View the incredible story of a group of Methodist Heart Institute Transplant Recipients who decided to honor their donors and donor families by running the San Antonio Rock n' Roll Half Marathon. Find care at these locations. Methodist Hospital Helpful Links. Find a Doctor Get Directions Call Heart Transplant Clinic Patient Referral Form Transplant Services Heart transplant locations. Retrieving location data... Enter address or location Use my location Or Use My Location View by Location Type Sort By A-Z Listing Z-A Listing List Map ×Close Facility Star Rating Description. Each patient’s experience at our practice is important to us. As we strive to provide the highest level of care, we value feedback on all aspects of the patient experience. This Medical GPS patient experience survey measures patient satisfaction from the time the appointment was made to the time the patient spent with the provider. Recommend: The Recommendation rating reflects patients’ overall likelihood of recommending their provider to friends or family members. Exam Thorough: The Exam Thorough rating reflects how satisfied patients were at the thoroughness and completeness of their examination and treatment. Provider Answers: The Provider Answers rating shows the level of patient satisfaction on how the provider was able to answer questions and fully explain treatment. Provider Concern: Provider concern measures the extent to which patients agree they were treated with courtesy, respect and concern throughout the entire examination. Wait Reasonable: This rating measures patient satisfaction on the total time spent waiting for the provider. Close × Your Destination. Use Google Maps Use Apple Maps COVID-19 Screening Tool
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TitleHeart Transplant: What to Expect | Barnes-Jewish Hospital
Urlhttps://www.barnesjewish.org/Medical-Services/Transplant/Heart-Transplant/Heart-Transplant-Process/Heart-Transplant-What-To-Expect
Description
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TitleThe Heart Transplant Procedure at Allen Hospital in Waterloo, Iowa
Urlhttps://www.unitypoint.org/waterloo/heart-transplant.aspx
DescriptionUnityPoint Health - Allen Hospital in Waterloo, Iowa, outlines the heart transplant surgical procedure, explaining how and where the procedure is done, and what to expect
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TitleWaiting for a Heart Transplant | How to Prepare for Heart Transplant | Duke Health
Urlhttps://www.dukehealth.org/treatments/transplant-program/heart-transplant/waiting-heart-transplant
DescriptionA heart transplant is a life-changing surgery, but waiting for a donor heart may be a stressful. We provide you with the assistance you need as you prepare for your transplant
Date
Organic Position53
H1Waiting for a Heart Transplant
H2Step Two: How to Prepare for a Heart Transplant
The Donor Heart Match Process
Staying Healthy
Be Prepared for the Call
Heart Support While You Wait
Why Choose Duke
H3Ventricular Assist Devices (VADs)
Intra-Aortic Balloon Pumps (IABPs)
Extracorporeal Membrane Oxygenation (ECMO)
Shorter Wait Times
Expanded Heart Donor Pool
A Dedicated Transplant Coordinator
H2WithAnchorsStep Two: How to Prepare for a Heart Transplant
The Donor Heart Match Process
Staying Healthy
Be Prepared for the Call
Heart Support While You Wait
Why Choose Duke
BodyWaiting for a Heart Transplant Step Two: How to Prepare for a Heart Transplant. For More Information A heart transplant is a life-changing surgery, but waiting for a donor heart may be a stressful -- and sometimes lengthy -- process. Patients awaiting a transplant must meet waitlist requirements, attend regular medical appointments, and be available at any time to report to the hospital for a transplant. Keeping track of these details can be difficult, but patients and families don’t have to do this on their own. As one of the largest heart transplant programs in the country, we provide you and your loved ones with the resources and assistance you need as you prepare for your heart transplant. Call for a Heart Transplant Evaluation 855-855-6484 The Donor Heart Match Process. After you are approved for a heart transplant, your name is placed on the United Network of Organ Sharing (UNOS) national waitlist and is ranked according to medical urgency statuses. (Status 1 is the most urgent, and Status 6 is the least urgent.) UNOS matches potential donors with people waiting for a transplant. When a donor heart becomes available, it is first offered to the person with the most urgent medical status who best matches the donor’s characteristics, like blood type and body size, and is geographically closest to the donor. If the heart is not a good match for that person, the donor heart is offered to the next person on the list, moving to less urgent and more distant patients until it is accepted. RELATED BLOG ARTICLE New Options Make It Possible for More People to Receive Heart Transplants Staying Healthy. As a candidate for a heart transplant, it is important to stay healthy in preparation for surgery. Establishing good habits now can also help you make the most of life with your new heart. Avoid nicotine in all forms, including cigarettes, patches, and gum. Do not use alcohol or other drugs. Maintain physical fitness and stamina by exercising regularly, as your health condition allows. Maintain a healthy weight and follow dietary recommendations, such as limiting salt. Keep regular appointments with your transplant team. story text Quote Link location text Be Prepared for the Call. You and your caregiver should always be prepared to receive a call that a donor heart has been matched to you. Once you are notified, you should arrive at the hospital within four hours. Depending on how far you live from Duke, you may need to relocate closer to the hospital while you wait for a donor heart. Your transplant coordinator will discuss this with you and can help you make short- or long-term lodging arrangements if needed. Request a Referral from Your Doctor If you are interested in making an appointment for an evaluation, please ask your cardiologist to submit a referral. Heart Support While You Wait. We provide the support your heart needs while you wait for a donor. We offer the full range of medications and devices to help slow your heart disease, manage symptoms, and optimize your heart function until you’re ready for transplant. These devices may include: Ventricular Assist Devices (VADs) . Surgically implanted devices that help the heart pump blood to the rest of the body. In most cases, patients can go home with these devices in place. VADs can serve as a bridge to transplant or as a long-term solution for those who are not eligible for a heart transplant. Intra-Aortic Balloon Pumps (IABPs) . Devices placed during a minimally invasive catheterization procedure. They help the heart pump more blood and reduce its workload. An IABP requires patients to stay in the ICU until they are ready for a VAD or heart transplant. Extracorporeal Membrane Oxygenation (ECMO). A machine that pumps and oxygenates blood outside of your body, supporting the work of both the heart and lungs. Like an IABP, it is a short-term bridge to a VAD or transplant and requires the person to stay in an ICU. RELATED BLOG ARTICLE Duke Surgeons First in U.S. to Place New-Generation Artificial Heart Best Heart Hospital in North Carolina When it comes to your heart care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cardiology and heart surgery program is nationally ranked, and the highest ranked program in North Carolina, according to U.S. News & World Report for 2021–2022. Why Choose Duke. Shorter Wait Times . Wait times for a donor heart can range from days (for people on ECMO) to years (for those doing well at home with a VAD). Duke has some of the shortest wait times in the region. We use innovative techniques that allow us to use donor hearts that other centers may not be able to transplant, and that means there are more hearts to go around. Expanded Heart Donor Pool. One reason why Duke can offer more hearts to more people is our participation in a clinical trial studying Donation after Circulatory Death (DCD). In fact, Duke surgeons performed the first DCD heart transplant in the U.S. in December 2019. We are one of only five centers in the U.S. approved to use this process. The DCD program could expand the donor pool by 30%, reducing wait times. A Dedicated Transplant Coordinator . Preparing for heart transplant can be overwhelming. As a patient at Duke, you have around-the-clock access to your transplant coordinator who can help you manage appointments, help you arrange lodging, organize medication, and more. The transplant coordinator also provides training and education before and after your transplant. Step 3: Transplant Surgery Reviewed: 09/25/2020 Back to Top
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Result 55
TitleHeart transplant waiting list grows - NHS Organ Donation
Urlhttps://www.organdonation.nhs.uk/get-involved/news/heart-transplant-waiting-list-grows/
DescriptionThe waiting list for heart transplants has increased by more than 130% in the last ten years
Date24 Sept 2019
Organic Position54
H1Heart transplant waiting list grows
H2The average wait for a heart
Changes to organ donation law
Press release notes
H3Join the Organ Donor Register
What can you donate?
H2WithAnchorsThe average wait for a heart
Changes to organ donation law
Press release notes
BodyHeart transplant waiting list grows The waiting list for heart transplants has increased by more than 130% in the last ten years. 24 September 2019 There are hundreds of hospital patients waiting for a heart transplant across the UK. They are relying on an organ donor to save their life. Ahead of World Heart Day on Sunday (29 September), NHS Blood and Transplant is highlighting that there are more than 300 people hoping for the call that a heart has been found for them. The waiting list for hearts has increased more than 130% in the last decade*. As awareness and knowledge around heart transplants has grown, more people are being referred for heart transplants. The ability to use ventricular assist devices (VADs) also means patients are able to wait longer. More donated hearts are needed to help the 313** patients currently waiting for a transplant. One person who knows what the wait for a heart transplant is like is Lyndsey Fitzpatrick. The 34-year-old, from the Wirral, will have been waiting for three years on Saturday (28 September). She has a series of heart conditions, which meant she needed open heart surgery aged three and a pacemaker, aged 10. She has gone on to have three more pacemakers. In 2015 her health started to deteriorate and in September 2016 Lyndsey went on the waiting list for a heart transplant. She said: “I have had health problems my whole life. Throughout my life I have struggled with my mobility, breathlessness and exhaustion on a daily basis. I have to use a wheelchair or mobility scooter when I’m out and about. “I try keep a happy, cheerful and optimistic state of mind throughout it all and enjoy my life even if I do have to take life at a slower pace and rest when needed. “People say to me ‘You look well’ but I definitely don’t feel well, whatever well is. I guess I have just become good at concealing my illness on the outside but I struggle with it on a daily basis. “From a young age my family and I have known that I would need a heart transplant but now nearly three years after going on the transplant list I’m still waiting for that all important phone call. A call to say a match has been found for me, a call to say that I can start the next chapter of my life. “I know it is hard for people to talk about organ donation but for people like me and many others that are waiting for a heart that conversation could save our lives. We are just kindly asking for families to talk about organ donation and decide if it is something they could agree to.” The average wait for a heart . The average wait for an adult who needs a heart transplant is nearly three years, that is an average of 1,085 days, for patients who have never been on the urgent waiting list and 30 days**** for those adults who have been on the urgent list. These patients are relying on a person or family to say ‘yes’ to organ donation in order to save their life. Anthony Clarkson, Director of Organ Donation and Transplantation at NHS Blood and Transplant, said: “We can save more lives if more organs are donated, and we urgently need more hearts to help the hundreds of people waiting for a transplant. “We want to help as many people as possible so we would urge everyone to think about organ donation and share your decision with your family. It’s a conversation that saves lives. “Sadly 21 patients died last year before they could receive the heart transplant they desperately needed and 201 people have lost their lives in the last five years in need of a heart transplant***.” Minister for Care, Caroline Dinenage said: “Heart transplantation is truly a miracle of modern medicine, and has saved countless lives. “But as we celebrate 40 years since the UK’s first heart transplant, the number of people in need of a new heart keeps growing and tragically many will die waiting. “My priority as the Minister overseeing organ donation is to ensure that no one misses out on a second chance of life. Ahead of World Heart Day, I urge everyone to talk to their families about donation and register their decision. Together, we can help save countless lives.” Changes to organ donation law. Next year, the law around organ donation is changing in England and Scotland. From spring 2020 in England and autumn 2020 in Scotland, all adults (those aged over 18 in England and over 16 in Scotland) will be considered as having agreed to donate their own organs when they die unless they record a decision not to donate, or are in one of the excluded groups. This system was introduced in Wales in December 2015. Families will still always be involved in organ donation so it is vital that they know what your choice is. In the lead up to the change in law, NHS Blood and Transplant is urging families across England to talk and share their decision. If the time comes, families find the organ donation conversation much easier if they already know what their relative wanted. John Maingay, Director of Policy and Influencing at the British Heart Foundation, said: “Hundreds of people across the country are on the waiting list for a heart transplant at any one time, and sadly not everyone will currently receive the transplant that they desperately need. The introduction of Max and Keira’s Law in England and Scotland means we will switch to a soft opt out system, which will provide much needed hope for those on the heart transplant waiting list. “This is a significant legal change that makes it all the more important for everyone to let their closest relatives know what they would want to happen with their organs in the event of their death.  It is also vital that you make sure your decision is registered, so there is no confusion about what you want. Letting people know your wishes for after you die could ultimately save the lives of others.” Find out more and register your decision by visiting NHS Organ Donor Register at www.organdonation.nhs.uk and share your decision with your family. Press release notes. * NHS Blood and Transplant – Transplant Activity Report 2018/19 – pg 62 - The number of patients active on the heart transplant list at year end 2018/19 has increased by 134% since 2010, when there were 126 patients waiting on 31 March 2010 compared to 295 on 31 March 2019 ** the active heart transplant waiting list as at 19 September 2019, NHS Blood and Transplant figures *** NHS Blood and Transplant figures - the number of patients that died on the heart transplant waiting list (or were removed due to deterioration and died): 2018/19 – 21 2017/18 – 31 2016/17 – 39 2015/16 – 51 2014/15 – 59 **** NHS Blood and Transplant – Transplant Activity Report 2018/19 – pg 67 The overall median waiting time to heart transplantation, for adults, was 1,085 days for patients who had never been on the urgent waiting list (‘never urgent’). For patients who had been on the urgent list (‘ever urgent’), the overall median time on the urgent list before transplant was 30 days. This is for patients registered between 1 April 2011 and 31 March 2016. Notes to editors NHS Blood and Transplant is a joint England and Wales Special Health Authority. We provide the blood donation service for England and the organ donation service for the UK. We also provide donated tissues, stem cells and cord blood. We are an essential part of the NHS, saving and improving lives through public donation. It is quick and easy to join the NHS Organ Donor Register. Call 0300 123 23 23 or visit www.organdonation.nhs.uk  Families are always involved in organ donation discussions. You can make things easier for your family by telling them you want to donate. Every day across the UK around three people who could have benefited from a transplant die because there aren’t enough organ donors. Anyone can join the NHS Organ Donor Register, age and medical conditions are not necessarily a barrier to donation. One donor can save or transform up to nine lives through organ donation and save and transforms even more by donating tissue. The Government has announced plans for a presumed consent system of organ donation to take effect from spring 2020. Under the system, you would be a donor unless you register a decision not to donate. Families will still be able to object to donation so it’s important that you make their decision easier at a difficult time by also telling them that you want to donate. Contact us For additional information please contact Cherry Brown by calling 0151 268 7016 or emailing [email protected]  Call the press office on 01923 367 600 or email [email protected] For urgent out of hours enquiries please call: 0117 969 2444 Join the Organ Donor Register. Record your decision to donate your organs What can you donate?
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Result 56
TitleHeart Transplant | University Hospitals
Urlhttps://www.uhhospitals.org/health-information/health-and-wellness-library/article/tests-and-procedures/heart-transplant
Description
Date
Organic Position55
H1Heart Transplant
H2What is a heart transplant?
Why might I need a heart transplant?
What are the risks of a heart transplant?
How do I get ready for a heart transplant?
What happens during a heart transplant?
What happens after a heart transplant?
Next steps
H3In the hospital
At home
H2WithAnchorsWhat is a heart transplant?
Why might I need a heart transplant?
What are the risks of a heart transplant?
How do I get ready for a heart transplant?
What happens during a heart transplant?
What happens after a heart transplant?
Next steps
BodyHeart Transplant What is a heart transplant? . A heart transplant is surgery to remove the diseased heart from a person and replace it with a healthy one from an organ donor. To remove the heart from the donor, two or more healthcare providers must declare the donor brain-dead. Before you can be put on a waiting list for a heart transplant, a healthcare provider makes the decision that this is the best treatment choice for your heart failure. A healthcare team also makes sure you are otherwise healthy enough to go through the transplant process. Why might I need a heart transplant? . You may need a heart transplant if your heart is failing and other treatments are not effective. End-stage heart failure is the final stage of heart failure. The heart muscle is failing severely in its attempt to pump blood through the body. Other treatments are no longer working. Despite its name, a diagnosis of heart failure does not mean the heart is about to stop beating. The term failure means the heart muscle is failing to pump blood normally because it's damaged, very weak, or both. Some causes of heart failure include: Heart attack (myocardial infarction or MI) Viral infection of the heart muscle High blood pressure Heart valve disease Heart defects present at birth (congenital) Irregular heartbeats (arrhythmias) High blood pressure in the lungs (pulmonary hypertension) Alcoholism or substance abuse Chronic lung diseases, such as emphysema or chronic obstructive pulmonary disease (COPD) Enlarged, thick, and stiff heart muscle (cardiomyopathy) Low red blood cell count (anemia) Your healthcare provider may have other reasons to recommend a heart transplant. What are the risks of a heart transplant? . As with any surgery, complications may occur. Potential risks of a heart transplant may include: Infection Bleeding during or after the surgery Blood clots that can cause heart attack, stroke, or lung problems Breathing problems Kidney failure Coronary allograft vasculopathy (CAV). This is a problem with the blood vessels that carry blood to the heart muscle itself. They become thick and hard. This can cause serious heart muscle damage. Rejection or failure of the donor heart Death Your body's immune system may reject the new heart. Rejection is your body's normal reaction to a foreign object or tissue. When you get a new heart, your immune system reacts to what it sees as a foreign threat and attacks the new organ. To allow the transplanted organ to survive in a new body, you will need to take anti-rejection medicines. The medicines will trick the immune system into accepting the transplanted organ and keep the immune system from attacking it. You will need to take the medicines to prevent or treat rejection for the rest of your life. These medicines have side effects too. The side effects will depend on the specific medicines you take. It's important that you continue to take these medicines as prescribed by your healthcare provider. You also need to keep up with regular follow-up appointments to monitor the heart transplant and reduce your chances for rejection. Other risks may include: Current or repeated infections that don't get better with treatment Poor blood circulation throughout the body, including the brain Metastatic cancer. This is when cancer has spread from the place it started to one or more other places in the body. Severe health problems that would make you unable to tolerate the surgery Serious health problems other than heart disease that would not get better after transplant Substance or alcohol abuse There may be other risks depending on your specific health condition. Be sure to discuss any concerns with your healthcare provider before the surgery. How do I get ready for a heart transplant? . Not everyone is a candidate for heart transplant. A wide range of information is needed to determine if a person is eligible for transplant. A transplant team will evaluate the information. The team includes a transplant surgeon, a transplant cardiologist (doctor specializing in the treatment of the heart), nurse practitioners or physician assistants, one or more transplant nurses, a social worker, and a psychiatrist or psychologist. Other team members may include a dietitian, a chaplain, hospital administrator, and an anesthesiologist (doctor who uses medicines to keep you asleep during surgery). The transplant evaluation process will include: Psychological and social evaluation. Some psychological and social issues that are involved in organ transplant include stress, financial issues, and support from family or significant others. These factors can greatly affect how you do after the transplant. Blood tests. You will need blood tests to help find a good donor match and help improve the chances that the donor heart will not be rejected. Diagnostic tests. You will need tests to assess your lungs as well as your overall health. These tests may include X-rays, ultrasounds, CT scan, pulmonary function tests (PFTs), right heart catheterization, and dental exams. Women may need a Pap test, gynecology evaluation, and a mammogram. Other preparations. You will get several vaccines to decrease the chances of developing infections that can affect the transplanted heart. The transplant team will consider all the information from interviews, your health history, the findings from your physical exam, and your diagnostic test results when deciding if you are eligible for a heart transplant. Once you have been accepted as a transplant candidate, you will be placed on the United Network for Organ Sharing (UNOS) list. When a donor organ becomes available, candidates are selected based on the severity of their condition, body size, and blood type. If the heart is to be yours, you will need to go to the hospital right away so you can get ready for the transplant. (Most hearts must be transplanted within 4 hours after they’ve been removed from the donor.) These things will need to be done before the transplant: Your healthcare provider will explain the procedure and let you ask questions. You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if anything is unclear. You should not eat or drink anything (fast) as soon as you have been told that a heart has become available. You may be given medicine to help you relax (sedative). Based on your health condition, your healthcare provider may request other specific preparation. What happens during a heart transplant? . A heart transplant requires open heart surgery and a stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practice. Generally, a heart transplant follows this process: You will be asked to remove any jewelry or other objects that may interfere with the procedure. You will change into a hospital gown. A healthcare professional will start an IV (intravenous) line in your hand or arm to inject medicine and to give IV fluids. Additional catheters will be put into the blood vessels in your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples. Other sites may be used for additional catheters, including under the collarbone and the groin. A soft, flexible tube (Foley catheter) will be put into your bladder to drain urine. A tube will be put through your mouth or nose into your stomach to drain stomach fluids. If there is a lot of hair on your chest, it may be clipped or shaved. You will be given general anesthesia to put you in a deep sleep during surgery. Once you are asleep, a breathing tube will be put through your mouth into your lungs. The tube will be attached to a machine (ventilator) that will breathe for you during the surgery. The anesthesiologist will watch your heart rate, blood pressure, and blood oxygen level during the surgery. The skin over your chest will be cleaned with an antiseptic solution. The surgeon will make a cut (incision) down the center of your chest from just below the Adam's apple to just above the navel. The surgeon will cut the breastbone (sternum) in half. Once cut, the surgeon will separate the two halves of the breastbone and spread them apart to reach your heart. The surgeon will put tubes into your chest so that your blood can be pumped through your body by a heart-lung (cardiopulmonary bypass) machine while your heart is stopped and replaced. Once the blood has been completely diverted into the bypass machine and is being pumped by the machine, your surgeon will remove the diseased heart. The surgeon will sew the donor heart into place. Once your new heart is in place, they will connect the blood vessels carefully so there are no leaks. When your new heart is fully connected, the blood circulating through the bypass machine will be allowed back into the heart and the tubes to the machine are removed. Your surgeon will shock the heart with small paddles to restart the heartbeat. Once your new heart starts to beat, the healthcare team will watch the heart to see how it’s working and make sure there are no leaks. Wires for pacing may be put into the heart. Your surgeon can attach these wires to a pacemaker outside your body for a short time to pace your new heart, if needed, during the initial recovery period. The surgeon will rejoin the sternum and sew it together with small wires. The surgeon will sew the skin over the sternum back together using stitches or surgical staples to close the incision. Tubes will be put into your chest to drain blood and other fluids from around the heart. These tubes will be connected to a suction device to drain fluids away from the heart as it heals. A sterile bandage or dressing will be applied. What happens after a heart transplant? . In the hospital. After the surgery, someone will take you to the recovery room or the intensive care unit (ICU) and monitor you closely for several days. A nurse will connect you to machines that will display your electrocardiogram (ECG) tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. Heart transplant surgery requires a hospital stay of 7 to 14 days, or even longer. You will have a tube in your throat that connects to a breathing machine (ventilator) until you are stable enough to breathe on your own. The breathing tube may stay in for a few hours up to several days, depending on your status. As you recover and start to breathe on your own, the breathing machine will be adjusted to allow you to take over more of the breathing. When you are able to breathe completely on your own and are able to cough, your healthcare provider will remove the breathing tube. After the breathing tube is out, a nurse will help you cough and take deep breaths every 2 hours. This will be uncomfortable due to chest soreness from the surgery. But it's very important that you do this to keep mucus from collecting in your lungs and possibly causing pneumonia. Your nurse will show you how to hug a pillow tightly against your chest while coughing to help ease the discomfort. You may get pain medicine as needed, either by a nurse, or by giving it yourself by pushing a button attached to a device connected to your IV line. You may have a thin, plastic tube that goes through your nose and into your stomach to remove air that you swallow. The tube will be taken out when your bowels are working normally. You will not be able to eat or drink until the tube is removed. Blood samples will be taken often to monitor your new heart, as well as other body functions. These include your lungs, kidneys, liver, and blood system. You may be on special IV medicines to help your blood pressure and your heart, and to control any problems with bleeding. As your condition stabilizes, your healthcare provider will gradually decrease, then stop, these medicines. If you have pacing wires in your heart, they will be removed, too.   Once your healthcare provider removes the breathing and stomach tubes and you are stable, you may start to drink liquids. You can gradually add more solid foods to your diet as you can handle them. Your healthcare team will closely watch your anti-rejection (immunosuppression) medicines to make sure you are getting the right dose and the best combination of medicines. Nurses, respiratory therapists, and physical therapists will work with you as you start physical therapy and breathing exercises. When your healthcare provider decides you are ready, you will be moved from the ICU to a private room on a surgical unit or transplant unit. Your recovery will continue there. You can gradually increase your activity as you get out of bed and walk around for longer periods. You can eat solid foods as tolerated. Nurses, pharmacists, dietitians, physical therapists, and other members of the transplant team will teach you what you will need to do to take care of yourself when you go home. Your healthcare team will arrange for you to go home and schedule a follow-up visit with your healthcare provider. At home. Once you are home, it will be important to keep the surgical area clean and dry. Your healthcare provider will give you specific bathing instructions. During a follow-up visit, your stitches or surgical staples will be removed if they weren't removed before you left the hospital. Don't drive until your healthcare provider tells you it's OK. Other activity restrictions may apply. You will need frequent follow-up visits after a heart transplant. These visits may include blood tests, chest X-rays, and a biopsy. In a biopsy, your healthcare provider uses a thin needle to remove tissue from the heart so it can be checked under a microscope. The transplant team will explain the schedule for these visits and tests. The rehab program will continue for many months. Tell your healthcare provider right away if you have any of the following: Fever, chills, or both. These may be a sign of infection or rejection. Redness, swelling, bleeding, or drainage from the incision site or any of the catheter sites Increase in pain around the incision site Trouble breathing Excessive fatigue Low blood pressure Your healthcare provider may give you other instructions after the procedure, depending on your own case. Be sure you understand and follow these instructions. To allow the transplanted heart to survive in your body, you will need to take medicines for the rest of your life to fight rejection. Each person may react differently to medicines, and side effects can be serious. Your healthcare provider will tailor medicine plans to meet your needs. You may get several anti-rejection medicines at first. The doses of these medicines may change often, depending on your response. Because anti-rejection medicines affect the immune system, you will be at higher risk for infections. It's important to keep a balance between preventing rejection and making you very susceptible to infection. Some of the infections you will be especially susceptible to include oral yeast infection (thrush), herpes, and respiratory viruses. Avoid contact with crowds and anyone who has an infection, especially for the first few months after your surgery. Regular dental care also is important. Your healthcare provider or dentist may prescribe antibiotics before any dental work to help prevent infections. To watch for signs of rejection, you will likely get routine right heart biopsies. A biopsy is typically done once a week in the early period after a transplant. Then the frequency gradually changes to monthly or longer intervals. The biopsy procedures may eventually stop. The right heart biopsy procedure may be done as an outpatient or as an inpatient if you are already in the hospital. The procedure involves a right heart catheterization. A special catheter is threaded through a vein in your neck or groin and into the right atrium of your heart. Your healthcare provider takes 4 to 6 tiny tissue samples through the catheter and checks them for signs of rejection. If they find signs of rejection, the provider may adjust your anti-rejection medicine. The biopsy procedure has its own instructions and risks, and your healthcare provider will discuss these with you. Next steps. Before you agree to the test or the procedure make sure you know: The name of the test or procedure The reason you are having the test or procedure What results to expect and what they mean The risks and benefits of the test or procedure What the possible side effects or complications are When and where you are to have the test or procedure Who will do the test or procedure and what that person’s qualifications are What would  happen if you did not have the test or procedure Any alternative tests or procedures to think about When and how you will get the results Who to call after the test or procedure if you have questions or problems How much you will have to pay for the test or procedure Back to Top
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Result 57
TitleChild Heart Transplant | Children's Hospital of Philadelphia
Urlhttps://www.chop.edu/treatments/heart-transplant
DescriptionA heart transplant may be recommended for children with heart disease who cannot be treated with medication or conventional cardiac surgery
Date
Organic Position56
H1Child Heart Transplant
H2What is a heart transplant?
Preparing for surgery
During surgery
Recovery and rehabilitation
Follow-up care
Rejection and infection
Living with transplant
H3Search
Infection
H2WithAnchorsWhat is a heart transplant?
Preparing for surgery
During surgery
Recovery and rehabilitation
Follow-up care
Rejection and infection
Living with transplant
BodyChild Heart Transplant Contact Us Heart Failure and Transplant Program Main Hospital Contact Us 1-877-ORGAN50 Referrals 215-590-6051 Contact Us Online What is a heart transplant? . For some children with heart disease, even the most aggressive treatment with medication or conventional cardiac surgery is not enough to restore health and maintain a good quality of life. These children may be considered for heart transplantation. The most common reasons for heart transplantation in infants, children and young adults include: Congenital heart disease that can not be treated with conventional surgery A failing circulation correction for congenital heart disease Cardiomyopathies or primary disease of the heart muscle Persistent life-threatening arrhythmias (abnormal heart rhythms) Hearts that are transplanted come from deceased organ donors. Organ donors are adults or children who have become critically ill (often due to an accidental injury) and will not live as a result of their illness or injury. If the donor is an adult, he/she may have agreed to be an organ donor before becoming ill. Parents or spouses can also agree to donate a relative's organs. Donors can come from any part of the United States. CHOP's Heart Failure and Transplant Program has performed more than 200 heart transplants since the inception of our Heart-Lung Transplant Program in 1990, with outcomes among the best. Learn more about why you should choose CHOP's Heart Failure and Transplant Program. Preparing for surgery. Once an organ becomes available to your child, you and your child will be immediately called to the hospital. This call can occur at any time, so you should always be prepared to go to the hospital, if needed. Once at the hospital, the child will have some more final blood work and tests to confirm the match of the organ. The child will then go to the operating room. During surgery. Surgery usually takes from four to six hours. During surgery, your child’s nurse and members of the transplant team will visit you in the waiting room with frequent updates. After surgery, the surgeon and the transplant cardiologist will talk with you, and your child will be taken to the Cardiac Intensive Care Unit (CICU) where he will receive round-the-clock attention from a team of dedicated cardiac critical care medicine specialists. Recovery and rehabilitation. After surgery, your child will go to the Cardiac Intensive Care Unit (CICU) to be monitored closely. The length of time your child will spend in the CICU will vary based on your child's unique condition. In the CICU, your child: Will be in a private room. One parent may sleep overnight in the room. May be very sleepy from anesthesia medicines. Will have IV tubes, to provide fluids and medications through the veins, and drainage tubes in place. Will have a breathing tube connected to a ventilator (respirator). The ventilator will help your child breathe until he wakes up from anesthesia and usually stays in place for a few days. Your child will not be able to talk while the breathing tube is in place. Will have a large bandage covering the incision site on your child’s chest and he will have one more chest tubes to drain fluids. Will be attached to monitors to keep track of heart rate, blood pressure, breathing rate, and the amount of oxygen in his blood. After your child is stable, he will be sent to the Cardiac Care Unit (CCU) for continued monitoring. During this time, you will be educated on all aspects of caring for your child once he leaves the Hospital. This will include information about medications, activity, follow-up, diet, and any other specific instructions from your child's transplant team. The post-transplant period can be challenging for families. As you support your child, you may feel many emotions. In addition to relief and renewed hope for your child's future, you may have new concerns about keeping her healthy. Members of our psychological team can be very helpful before and after discharge, assisting you and your child during this time of transition. Follow-up care. Your child will have very close follow-up with the transplant team after leaving the Hospital. This will allow for close monitoring of your child and the function of the transplanted heart. Follow-up visits may include the following: Complete physical examination Blood work Echocardiogram Cardiac catheterization Continued education for you and your child Medication changes Children who have received a heart transplant will need life-long follow-up with physicians who are specialized in transplant medicine. Keeping appointments with your child's transplant physician, as well as maintaining contact with the transplant team when symptoms occur is vital. Rejection and infection. After heart transplantation, the major health concern for your child will be rejection of the new heart. Medications will be monitored and adjusted to suppress your child's immune system (and thus prevent rejection) without putting your child at undue risk for infection and other side effects. Rejection Rejection is a normal reaction of the body to a foreign object. When a new heart is placed in your child's body, the body sees the transplanted organ as a threat and tries to attack it. The immune system makes antibodies to try to destroy the new organ, not realizing that the transplanted heart is beneficial. To allow the organ to successfully live in a new body, medications must be given to trick the immune system into accepting the transplant and not thinking it is a foreign object. Your child's transplant team will instruct you on rejection symptoms, and who to call if any of those symptoms occur. Medications must be given for the rest of the child's life to fight rejection. Each child is unique, and each transplant team has preferences for different medications. Some of the anti-rejection medications most commonly used include: Cyclosporine Tacrolimus Mycophenolate mofetil Prednisone Azathioprine Infection. Because anti-rejection medications affect the immune system, children who receive a transplant will be at higher risk for infections. A balance must be maintained between preventing rejection and making your child very susceptible to infection. Blood tests are performed periodically to measure the amount of medication in the body to ensure your child does not get too much or too little of the medication. White blood cell counts are also an important indicator of how much medication your child needs. Some of the infections your child will be especially susceptible to include oral yeast infections (thrush), herpes, and respiratory viruses. Living with transplant. The majority of children who receive new hearts resume a relatively normal and age-appropriate lifestyle. They are able to attend school, own pets, and participate in team sports and other active pursuits. Our team will work with your family to determine the best lifestyle for your child. Next Steps Contact Us Heart Failure and Transplant Program Main Hospital Contact Us 1-877-ORGAN50 Referrals 215-590-6051 Contact Us Online
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  • cardiac
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TitleBerlin Heart Mechanical Heart Assist | Great Ormond Street Hospital
Urlhttps://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/berlin-heart-mechanical-heart-assist/
DescriptionProcedures and treatments from Great Ormond Street Hospital on Berlin Heart Mechanical Heart Assist
Date
Organic Position57
H1Berlin Heart Mechanical Heart Assist
H2What is the Berlin Heart?
How does it work?
Inserting the Berlin Heart
What are the risks to your child on the Berlin Heart device?
Heart transplantation
How long will your child be on the Berlin Heart device?
How will you take care of your child?
Transfer to ward
Family involvement and enhancing normality
Support for you
Parent’s perspective
Glossary
More information
Disclaimer
H3Useful documents
Useful links
H2WithAnchorsWhat is the Berlin Heart?
How does it work?
Inserting the Berlin Heart
What are the risks to your child on the Berlin Heart device?
Heart transplantation
How long will your child be on the Berlin Heart device?
How will you take care of your child?
Transfer to ward
Family involvement and enhancing normality
Support for you
Parent’s perspective
Glossary
More information
Disclaimer
BodyBerlin Heart Mechanical Heart Assist This page explains about the Berlin Heart Ventricular Assist Device (VAD) which can be used to support children in severe heart failure, either until recovery or until a heart transplant is possible. The Berlin Heart is used to take over the function of a child’s own heart when it becomes too weak to pump sufficient amounts of blood to the lungs and/or around their body. There are many different types of conditions which can cause the heart to fail,the most common being a weak heart muscle (Cardiomyopathy) or an infected heart muscle (Myocarditis).The Berlin Heart pumps blood around the body in order to keep the brain and other organs healthy, allowing the child to grow and get stronger. It will be required until the child is transplanted, or for a small number of children, until their own heart recovers.Unfortunately not all children with heart problems are suitable to be supported with this kind of device. What is the Berlin Heart? The Berlin heart is a type of “Ventricular Assist Device” or” VAD”. It is a simple air driven pump which takes over the work of one or both sides of the child’s own heart.Your child may need a single pump to support the left side of the heart whilst the right side continues to work naturally. This is known as a “Left ventricular Assist Device” or “LVAD”. Some children need two pumps, one to support the left side of the heart and one to support the right. This is known as a Biventricular Assist Device or “BiVAD”.Your Doctors will be able to let you know whether your child is likely to need an LVAD or a BiVAD before the operation, but you should be aware that this cannot be predicted with absolute certainty and the decision may change during the operation itself.The Berlin Heart VAD consists of a plastic pump or chamber which sits outside of the body. It has a blood filled side and an air filled side, separated by a flexible membrane. The blood filled side of the pump is connected directly to the child’s own heart and main artery by means of two tubes or “cannulae”. The air filled side of the pump is connected via a long plastic tube or “driveline” to a driving unit. How does it work? The driving unit simply drives air into and out of the Berlin Heart pump(s). As air is pulled out of the pump, the membrane separating the two sides of the pump is drawn back, pulling blood into the pump from the main pumping chamber of the child’s own heart.As air is pushed back into the pump, the membrane is pushed forwards, pumping blood back into a main artery of the body. If your child has a Berlin Heart supporting the left side of the heart (LVAD), then the blood that is pumped out of the Berlin Heart goes into the aorta, the main artery which circulates blood all around the body.If your child has a Berlin Heart supporting the right side of the heart, then the blood that is pumped out of this pump goes into the pulmonary artery, which sends blood to the lungs to collect oxygen. Inserting the Berlin Heart. In order for your child to have the Berlin heart implanted, they will need to have an operation. This will be explained to you in greater detail by the surgeons and the anaesthetic team. The operation involves inserting the cannulae in to the heart and main artery.Your child will be supported with cardiopulmonary bypass (heart lung machine) while this is done. The operation will take around four to eight hours. When your child returns to the intensive care ward they will be supported on a ventilator (breathing machine) andwill require lots of medication to keep them sleepy and comfortable and to help support their heart. Your child will have many wires attached to them, these will be explained to you and you will have a chance to see the equipment before the operation. What are the risks to your child on the Berlin Heart device? The Berlin Heart can be a life saving device for children in severe heart failure, but it does have risks associated with it which you should understand before you agree to treatment.The risks may be divided into four main categories, the risks surrounding the surgery itself, the risk of infection, mechanical problems, and the risk of stroke. There are risks involved with any operation and the surgeons will explain this to you in more detail before the surgery takes place. The most common complication seen as a result of surgery is bleeding, and this will be monitored closely in theatre and on the intensive care unit and controlled where required by the transfusion of blood and blood products. Occasionally further exploratory surgery may be required on the intensive care unit in order to help to stop the bleeding.Whenever there is a tube inserted into the body there is an increased risk of infection. Signs of infection are monitored closely and antibiotic treatment is given promptly if needed.The third risk is the possibility of mechanical problems. The Berlin heart is a mechanical device, and as with any piece of machinery there is always the possibility that it will develop mechanical problems. These happen very rarely, and the Berlin Heart has many ‘backup’ systems and safety features to ensure the safety of the child should problems occur.The final risk is the risk of stroke. You will probably have heard of stroke, it is a brain injury which happens mostly to older people. However children on the Berlin heart are also at risk of stroke. The natural reaction of the blood when it comes into contact with the plastic of the Berlin Heart device is to form a clot. To try to prevent this, the children are given blood thinning medicines and the effect is monitored closely. Despite this, clots can still form over time, and you will see us looking closely at the pump with a torch every few hours to check for this.If a clot is seen in the Berlin Heart pumping chamber then the pumping chamber may need to be changed. This is a relatively short and simple procedure which is done in the operating theatre, and will be explained to you if it is needed.Sometimes a clot can “fly off” from the pump and enter the child’s blood stream. If the clot is carried to the brain then it can cause damage to the brain tissue, and this is what we know as a stroke. Roughly two to three children out of every ten that we put onto the Berlin Heart will experience a stroke.This may cause problems with movement and speech, or even problems with hearing or seeing or their ‘higher functions’ (parts of the brain that do our thinking, control our personality). In many cases children recover and adapt, returning to normal activity in amatter of weeks.However, some may be left with a permanent problem with speech or movement, and in some children, the damage is so severe that the children die despite our best efforts.These risks do sound very frightening, but must be considered in the context of the severity of the child’s heart failure, and the poor outcome for the child if they are not given Berlin Heart support. Approximately eight out of every ten children who are placed on Berlin Heart support will survive to transplant or recovery. Heart transplantation. For most children, the Berlin Heart is used as a “bridge to transplantation”, that is, a way to support your child until a suitable organ becomes available for transplantation. The decision to agree to transplantation is entirely yours, though we will support you through this and ensure you have all of the information you need. Should you choose not to agree to transplantation then we will respect this decision, but your child is unlikely to be offered Berlin Heart support under these circumstances unless there is a good chance of your child’s heart recovering after a period of time.A heart transplant is a good option for children with serious heart conditions but it is not a cure. In most situations transplantation can lead to an extension of life with good quality which enables your child to return to normal activities. Once your child has undergone a transplant they will have to take immunosuppressive (anti-rejection) medication every day for the rest of their life. This medication prevents the body from rejecting your child’s new heart. They will also need to be followed up closely at GOSH, with regular blood tests, outpatient clinics, biopsies and annual reviews.If it is likely that your child will need a heart transplant, then this will be thoroughly discussed with you by the transplant nurses and doctors before you have to make any decisions about the Berlin Heart. How long will your child be on the Berlin Heart device? It is very difficult to predict how long your child will need support from the Berlin Heart as every child and his or her situation is different. Some children are only on the device for a few weeks while others can be on the Berlin heart for many months. There is no timeframe for finding a heart donor. How will you take care of your child? After surgery to implant the Berlin heart, your child will return to the intensive care unit. He or she will need some support with their breathing and will be attached a mechanical breathing machine. Your child will be kept quite sleepy with medicines initially, ensuring that he or she is comfortable and is not too active.You will be able to help with some aspects of your child’s care if you feel able, such as cleaning their eyes or mouth, or perhaps rubbing moisturising cream onto the skin. Let the nurse caring for your child know if you would like to get involved. Your child will be monitored very closely by the nursing staff at this time.Once your child is more stable and the breathing machine has been removed, you can start to work with the nurses to familiarise yourself with the Berlin Heart device, and if you feel ready, to start to learn how to do the Berlin Heart wound dressings.Sometimes children have needed a lot of medicines to keep them sleepy, or to help them tolerate being on a breathing machine, before they go onto a Berlin Heart. If so, it may be necessary to reduce these medicines slowly to avoid children getting withdrawal symptoms. This can sometimes be a difficult period for families as reducing the medicines can temporarily make children feel quite low in mood, restless and clingy. Distraction is helpful during this time, and bringing in your child’s favourite toys, music orstory books can be helpful.Once children are stable on the Berlin Heart, they will usually need to return to theatre for a further small operation to insert a long term central venous catheter. This can be used for giving medicines and taking blood. Regular blood tests are essential for children on the Berlin Heart to allow the effects of the drugs given to thin the blood and prevent clots to be monitored. The central venous catheter allows us to take these blood tests painlessly. Transfer to ward. After a few weeks on the Cardiac Intensive Care Unit (CICU), plans will be made to move your child to the high dependency unit (HDU) of the cardiac ward (Bear ward). With support you can now start to take over more of your child’s care, and start to establish a more normal daily routine.We encourage parents where possible to learn to do the dressings around the area where the Berlin Heart cannulae enter the skin. There are two main reasons for that, firstly is that it helps you to establish a routine with your child, where dressings always get done before breakfast, or before bedtime for example. This level of routine is not possible with a nurse doing the dressings as they may be caring for other patients and be busy at the desired time.Secondly, and most importantly, having the same person(s) doing the wound dressing consistently keeps infection rates low, as it allows for any small changes in the appearance of the wound to be noticed as early as possible, Please don’t worry about this aspect of care as you will be well supported by the nursing staff until you are confident.On the ward, once well enough, your child will be able to participate in activities and/or schoolwork, and will be able to leave the ward at times to go the hospital activity centre, physiotherapy gym, coffee shop, or even outside of the hospital building. To enable you to have a little more freedom the nursing staff will do some teaching with you and you will be given a Berlin Heart training “competency book” to work through. Again, please don’t let this worry you, there is no rush to do this before you feel ready, and most parents find that they pick up an awful lot of the information they need to learn just by spending time with their child every day. Family involvement and enhancing normality. The time spent waiting for transplant while on the Berlin heart, is not necessarily lost time. With appropriate stimulation your child will continue to learn and develop, and with adequate heart function provided by the Berlin heart device, physical rehabilitation can be started before transplant. This can speed up recovery and shorten hospital stay following your child’s heart transplant.You and your family play an important part in helping your child’s to continue to meet physical, developmental and educational milestones whilst on the Berlin Heart, and our team of physiotherapists, school teachers and play workers are here to support you. They will be able to provide age appropriate toys and activities to keep your child stimulated, and help you to develop a normal daily routine Support for you. Having a child on the Berlin Heart can be a difficult and stressful time for families. You may have had a challenging period immediately prior to the Berlin Heart being inserted as a result of your child’s deterioration in their cardiac condition or your child may have become acutely unwell after being fit and healthy. Either way, the journey to the Berlin Heart can be traumatic and upsetting.Waiting for a donor heart to become available whilst your child is living in hospital on the Berlin Heart can be challenging and even though you might feel thankful that your child is being supported by this device, it is very normal to also feel sad, worried and angry at the situation. It can feel hard to wait for an undefined length of time and families often need to spend time apart, maintaining homes, jobs, and a degree of normality for other siblings. We recognise that having to stay in hospital for lengthy periods can put a huge pressure on a family, some of whom may be far away from their extended family and friends.To help support you and your family with these difficulties, we have a dedicated paediatric psychologist and a specialist nurse who can offer support. These members of the team will make contact with you early on in your child’s admission, sometimes even before, and provide regular support for you throughout your stay here. In addition, there is also a cardiac psychosocial team consisting of a social worker, family support worker (for practical and financial advice and support), chaplains (for religious and spiritual support) and play specialists (who can help prepare children for procedures and set up activity timetables to provide structure and routine to their day). Your bedside nurse can tell you how to contact these professionals or they can arrange a visit to the ward. Parent’s perspective. Ollie was diagnosed with ‘Dilated Cardiomyopathy’ aged seven months. As his heart condition deteriorated he was rushed to our local hospital where he spent three weeks in intensive care becoming increasingly frail and unfortunately suffered a cardiac arrest. Ironically it was on the same day that Mark and I had travelled to Great Ormond Street Hospital (GOSH) to discuss the option of Ollie becoming assessed for a heart transplant. This was something we had always hoped wouldn’t be necessary but it was no longer possible to control Ollie’s condition with medication alone.One of the topics covered during the day was the option of Ollie being put on the Berlin Heart, which would ‘bridge’ him to transplant. This was something that neither Mark or I had ever heard of before, but time was running out and this looked like being the only option.While on the Cardiac Intensive Care Unit (CICU) it became apparent that Ollie needed mechanical support for his heart and four days later the Berlin Heart (sized specifically for Ollie) arrived from Germany. Thankfully after a six-hour operation Ollie was back on CICU and doing well. It was two days after Ollie’s first birthday and the most fantastic present we could have wished for. We had been told what to expect but I must admit it felt odd to see Ollie’s blood pumping through the cannula and to feel the warm pulsating diaphragm (VAD: Ventricular Assist Device).Initially we were very cautious when handling Ollie due to the number of wires and tubes that were attached to him, but these reduced in number fairly quickly over the next few days leaving him attached only to the Berlin Heart. Over the previous three weeks we had become used to our little boy lying in his hospital cot ventilated and unable to do anything but amazingly within a few days of being extubated he began to interact and started eating from a spoon again which felt like a real step forward.We soon moved onto Ladybird Ward and continued to be amazed by how much Ollie thrived while on the Berlin Heart. As parents we were very much involved in his care, for example we learnt how to change his dressings which became almost routine, we were also taught about the function of the Berlin Heart so that we could get off the ward and spend time in the Activity Centre, go to the coffee shop and spend time with his older brother and sister. We had fantastic support from the ECMO Team throughout Ollie’s time on the Berlin Heart.In all Ollie spent four months on the Berlin Heart before he received his transplant. Post transplant he has done really well and we feel so thankful that in Ollie’s case the Berlin Heart was available as an option for us.Written by: Edwina Drew Glossary. We try to avoid using abbreviations but some creep into our language when we speak or write. We may also use medical words, which you have not heard before. The following list explains what they mean, but it is important to remember that this list contains meanings which apply to the heart and your child’s treatment in the cardiac wing.Some words may have different meanings if used elsewhere in the hospital. If you do not understand anything, do please ask us to explain again.Antibiotic: A drug that slows the growth of or destroys bacteria or germs. Used to prevent or eliminate infection.APTT: Activated partial thromboplastin time – a test which measures the speed at which some parts of your child’s blood clots. It is used to monitor the effect of heparin on your child and can help inform the doctors as to the dose that is required.Arterial Blood Gas (ABG): A small amount of blood that is drawn from the artery and tested to determine the amount of oxygen and carbon dioxide it contains.Cannula: Plastic tube used for draining and return of blood to the body.Cardiomyopathy: Deterioration or failure of the heart muscle, making it difficult or impossible to pump adequate blood supply to the body.Cardiopulmonary bypass (CPB): A machine that temporarily takes over the function of the heart and lungs and supports the circulation while surgery is performed on the heart.Chest drain: A tube placed into the space between the lung and the chest wall that removes fluid or air. Used to treat a collapsed lung or a build up of air around the lung (pneumothorax).Echocardiogram (ECHO): Ultrasound scan of the heart.Electroencephalogram (EEG): A recording of the electrical activity of the brain.Heparin: A drug used to help prevent the blood from clotting.Infection: The growth of an organism within or on the body.Intracranial haemorrhage: An abnormal bleeding in the brain.INR: A test which checks the effectiveness of your child’s blood to clot.Myocarditis: Inflammation of the heart muscle.Nasogastric tube: A tube which is passed in to the stomach and used for feeding and medications.Neuro: Relating to the brain.Perfusionist: A person with specialised knowledge and training in cardiopulmonary bypass (heart/lung machine).Platelets: Blood cells which help prevent bleeding.Thromboembolism: Formation of a blood clot (thrombus) that breaks loose, and is carried by the blood stream to block another vessel.Ventilator: An automatic breathing machine that moves air into and out of the lungs, through a tube in the windpipe.Ventricular assist device: A mechanical device used to partially or completely replace the function of the failing heart.  More information. Cardiac Intensive Care Unit Tel: 020 7829 8828 Compiled by: The Bridge to Transplant team in collaboration with the Child and Family Information GroupThis information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. Last review date: July 2017 Ref: 2017F0866 Disclaimer. Please note this is a generic GOSH information sheet. If you have specific questions about how this relates to your child, please ask your doctor. Please note this information may not necessarily reflect treatment at other hospitals. Useful documents. Download Berlin heart F0866 FINAL Jul17.pdf (0 bytes) Useful links. Information about the Cardiology department Information about the Cardiac Intensive Care Unit (CICU) More about Heart and Lung transplants Clinical support services for parents and visitors Extra Corporeal Membrane Oxygenation (ECMO)
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Title50th Anniversary of the first Human Heart Transplant—How is it seen today? | European Heart Journal | Oxford Academic
Urlhttps://academic.oup.com/eurheartj/article/38/46/3402/4706200
Description
Dateby K Sliwa · 2017 · Cited by 7
Organic Position58
H150th Anniversary of the first Human Heart Transplant—How is it seen today?
H2The event
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Innovation in context of time
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Body50th Anniversary of the first Human Heart Transplant—How is it seen today? Karen Sliwa, PhD FESC, Karen Sliwa, PhD FESC Director: Hatter Institute for Cardiovascular Research in Africa Faculty of Health Sciences, University of Cape Town, Chris Barnard Building 2 Anzio Road, Observatory Cape Town, South Africa Tel: +27 21021406 6457 [email protected] Search for other works by this author on: Oxford Academic PubMed Google Scholar Peter Zilla, MD PhD Peter Zilla, MD PhD Christiaan Barnard Chair Head: Department of Cardiothoracic Surgery Director: Cardiovascular Research Unit University of Cape Town Groote Schuur Hospital and Red Cross Children s Hospital Cape Town, South Africa Tel: +27 21 406 6137 / 6182 / 6476 / 6181 / 6385 [email protected] Search for other works by this author on: Oxford Academic PubMed Google Scholar European Heart Journal, Volume 38, Issue 46, 07 December 2017, Pages 3402–3404, https://doi.org/10.1093/eurheartj/ehx695 Published: 07 December 2017 PDF Split View Views Article contents Figures & tables Video Audio Supplementary Data Cite Cite. Karen Sliwa, PhD FESC, Peter Zilla, MD PhD, 50th Anniversary of the first Human Heart Transplant—How is it seen today?, European Heart Journal, Volume 38, Issue 46, 07 December 2017, Pages 3402–3404, https://doi.org/10.1093/eurheartj/ehx695 Close Permissions Icon Permissions Share Email Twitter Facebook More Navbar Search Filter This issueAll European Heart Journal All ESC FamilyAll Journals Mobile Microsite Search Term Search Sign In Register Close search filter This issue All European Heart Journal All ESC Family All Journals search input Search Advanced Search Search Menu The event. On 3 December 1967, a large medical, nursing, and technical team led by the surgeon Christiaan Barnard performed the world’s first human to human heart transplant, placing Groote Schuur Hospital in Cape Town, South Africa, on the international map. This led to unprecedented media coverage. Indeed, this first heart transplant was the world’s most widely reported medical event ever, resulting in the celebrity status of a previously unknown physician. In addition to its importance in the medical realm, the first human to human heart transplant had great political importance, as this moment of medical history contributed to substantial publicity for the increasingly isolated apartheid state. Why did the first human heart transplant lead to such media frenzy never seen before or anticipated by Christiaan Barnard and his colleagues around the world?For centuries, the heart had been equated with the soul of human beings. This concept was e.g. present among several pre-Columbian indigenous populations, including the Aztecs. By far the most common form of human sacrifice in the 15th century Aztec empire was heart-extraction, which seems to have related to the Aztec belief that the heart was both the seat of the individual’s soul and a fragment of the sun’s heat. As such, transplanting the heart was perceived as ‘the surgical equivalent of the ascent of Everest’ as the Times phrased it.There will probably never again be a similar medical achievement in the public eye. The team. History does not appear to have provided sufficient credit to the exceptional team of specialised operating room nurses, technologists, biochemists, anaesthetists, perfusionists, and others who contributed to the achievement of this monumental medical breakthrough. In addition to the lack of recognition for the entire team of individuals responsible for the success of the surgery, the fundamental importance of the basic research done not only by Barnard but by other researchers in outstanding laboratories was not always sufficiently highlighted.It may not alleviate the criticism that Barnard himself is less known for his other truly novel concepts, from congenital heart disease to aortic aneurysm surgery, culminating in the so-called piggyback heterotopic heart transplantation which used the approach of adding a donor heart to the patient’s ailing heart. Yet, does the poor recognition of entire research teams or contributing technologists, independent of race or gender, reduce the role of the pioneering individual researcher? Probably not.A truly innovative researcher has to face the fact that fame and shame lie very close together in the development of exceptionally novel concepts. Had this first cardiac transplant gone wrong other than for a late pneumonia, voices would have been even louder, claiming the procedure to be irresponsible, and premature and that failure could have been predicted from the start. Chris Barnard and other famous researchers have taken this risk. He received immediate recognition for this success, but there are many examples in history where researchers have been isolated and victimized by colleagues for many years before the uniqueness of their research and its contribution to the betterment of humankind has been recognized.There was also little mention of Hamilton Naki, in the media. Naki was a black gardener who, based on his enthusiasm and gifted hands, worked in the famous animal laboratory at Groote Schuur Hospital and participated in the research leading to the first and subsequent human cardiac transplants. Naki, who came from a relatively wealthy family from rural Transkei, had no access to higher education due to the political situation in South Africa at the time.Chris Barnard stated in several interviews how important Naki was for his expertise at running the animal laboratory and in training an entire generation of future surgeons. ‘I stole with my eyes’ Hamilton Naki said when asked how he learned his formidable surgical skills without any formal training (Refs. 1and 2) In 2003, Naki received his honorary Master of Medicine degree from the University of Cape Town, in recognition of a man who may have ended up with a different career were it not for the limitations imposed by apartheid. Laudatory obituaries appeared after his death in the press, suggesting that he was the surgeon who harvested the donor heart at the epoch-making first human cardiac transplant.Inevitably, comparisons with Vivian-Thomas’ role in the so-called Blalock–Taussig procedure were drawn. The original procedure—providing palliation to patients with cyanotic heart defects which commonly cause blue baby syndrome—was named after Alfred Blalock, a surgeon, and Helen Taussig, a cardiologist from the Johns Hopkins Hospital in Baltimore, USA in the 1940’s. Thomas, Blalock’s African American laboratory technician, was fundamental in the development of that procedure, performing the operation alone in about 200 laboratory dogs and adapting the surgical instruments for the first human operation. However, because of the racial prejudices in the USA at the time and the academic custom which precluded mention of laboratory assistants without university degrees that persist into modern times, Thomas did not receive recognition for his contributions until much later.Yet, claiming that Hamilton Naki was involved in the actual first heart transplant and that he even did the harvesting procedure of the donor heart did harm to the legacy of a great man, as it was not reflecting the truth. These claims were strongly refuted by those present at the operation. Amongst those who set the record straight were several who otherwise praised Naki for his contribution including Marius Barnard, the surgeon who had performed the harvest with Terry O’Donovan. Innovation in context of time. As much as pioneering milestones in human history are realised by curious, strong-willed individuals, they occur within the context of enabling background developments. Cardiac surgery had only been performed for less than 10 years. Driven by the high burden of rheumatic heart disease in Europe and North America in the post war era, technological developments finally allowed the replacement of diseased heart valves in patients who would have died without surgery. The first patients received a replacement valve only 9 years before the first heart transplant. The invention of the heart lung machine in 1953 made this possible, invalidating the dogma of Theodor Billroth, the pioneer of gastric surgery in the 19th century. He famously stated that he who touches the heart would lose his respect. As much as general surgery had its foundation and flourished in Europe a hundred years earlier, cardiac surgery naturally saw its cradle in the technologically booming USA of the 1950s. The Man. The Times magazine (Ref. 3) printed a personal letter by Christiaan Barnard the day after his death. This letter provides a reflection of his personal life in the context of his upbringing and achievements and portrays a different picture of the ‘glamorous man’ as seen by so many. Christiaan Barnard was born in Beaufort West in the harsh but strikingly beautiful Karroo. His father was a missionary who did not accept differences between ethnic groups in his church and Barnard claims that his tolerance towards people from various background came from his father. His father also taught him his love for nature, pointing out plants, and animals leading to Christiaan’s love for the veldt and wilderness of this vast special region of South Africa.After his retirement in 1983 he could buy a farm outside of Beaufort West—returning to his roots. In this letter, he describes his challenges and his truly remarkable career from being for a few years a general practitioner in Ceres, the Western Cape, from being rejected for a bursary in England, leading to his general surgical training in the USA under Professor Wagensteen, University of Minnesota. Because his job application at the National Heart Institute in London was unsuccessful, he returned to South Africa to establish his own cardiac surgical unit culminating in the 1967 first heart transplant.In his letter, Chris Barnard writes that he retired rather early because he wasn’t eager for work anymore and that the arthritis was more of an excuse. He wrote several books, started lecture tours and set up the Chris Barnard Foundation. He felt that medical technology had replaced the personal doctor–patient relationship.Days before his death, at the age of almost 79 he stated that he had no regrets. The celebration. To mark this anniversary within the cardiovascular community, a high-profile event titled: ‘50 Years of Heart Transplantation: Courage and Innovation’, is held at Groote Schuur Hospital, Cape Town, South Africa, 2–4 December 2017. The world’s first human-to-human heart transplant, performed by Christiaan Barnard and his team 50 years ago in Cape Town, was a truly iconic event. It positioned the African region at the forefront of medical innovation and inspired the next generation of health professionals in Africa and worldwide. Developments in cardiac surgery continued to be impressive in the 50 years since then. Many of the inventors of this journey will have come together in Cape Town.Yet, an event celebrating the most outstanding example of courage and innovation in cardiac surgery must also address today's need for a quantum leap of comparable magnitude. Rather than surgical, contemporary challenges are socio-economic in the developed and the developing world. Both, cardiovascular life-style diseases of the ‘North’ such as obesity and its associated metabolic syndrome and the endemically prevailing rheumatic heart disease of the ‘South’ mainly affecting the poor are abundant. While access to cardiac surgery may be suboptimal for some of these patients in the ‘North’, it is often absent in the ‘South’.Planned for a long time with the active support of all major international cardiothoracic societies as well as humanitarian organizations, the editors-in-chief of the major journals as well as the top echelons of industry, will engage in a day-long ‘South-North Dialogue’ to address the plight of ‘the many’ i.e. the millions of patients with rheumatic heart disease who have no access to life-saving heart valve surgery.This was also recently highlighted at the first African Summit held by the World Heart Federation in Khartoum, Sudan 10–11th October 2017. Data recently presented in the New Eng J Med Report (Ref. 4) reported that Central Sub-Saharan Africa has among the highest age standardized prevalence of adults living with Rheumatic Heart Disease. South African has a prevalence of 220/100 000 people vs. 415/100 000 in Ghana and 360/100 000 in Nigeria.It is timely, as the WHO Executive Board, supported by the World Heart Federation unanimously recommended a World Health Assembly Resolution on Rheumatic Heart Disease to be adopted in May 2018. The event ‘50 Years of Heart Transplantation: Courage and Innovation’, will bring together leaders in cardiothoracic surgery, cardiologists, policymakers and representatives of the device industry, condensing their vision for the way forward in a ‘Cape Town Declaration’.It is the intention of all participants to create a focused and prioritised blueprint for all stakeholders, to improve awareness, education and access, for a deadly disease which may affect more than double the number of patients infected with HIV.Conflict of interest: none declared. References. References are available as supplementary material at European Heart Journal online. Published by Oxford University Press on behalf of the European Society of Cardiology 2017. Issue Section: CardioPulse Download all slides Supplementary data Supplementary data. Supplementary Data - doc file Advertisement 58,971 Views 5 Citations View Metrics × Email alerts. 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