Copywriteroffice

Serp data

Request Result

The request result help you to show your API requests results.

stdClass Object
(
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        (
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            [hl] => en
            [gl] => GB
            [search_engine] => google.co.uk
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                (
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                        (
                            [title] => heart transplant procedure step by step
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                        )

                    [1] => stdClass Object
                        (
                            [title] => heart transplant surgery survival rate
                            [url] => https://www.google.co.uk/search?num=60&hl=en&gl=gb&q=Heart+transplant+surgery+survival+rate&sa=X&ved=2ahUKEwiHvcOC_qX1AhUglYkEHfQ-BTsQ1QJ6BQjKARAB
                        )

                    [2] => stdClass Object
                        (
                            [title] => heart transplant life expectancy 2020
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                        )

                    [3] => stdClass Object
                        (
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                        )

                    [4] => stdClass Object
                        (
                            [title] => how long can someone live without a heart transplant
                            [url] => https://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
                        )

                    [5] => stdClass Object
                        (
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                    [6] => stdClass Object
                        (
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                    [7] => stdClass Object
                        (
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                            [title] => Heart transplant - What happens - NHS
                            [url] => https://www.nhs.uk/conditions/heart-transplant/what-happens/
                            [source] => https://www.nhs.uk › Health A to Z › Heart transplant
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                            [serp_title] => Heart transplant - What happens - NHS
                            [serp_description] => 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.
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                                (
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                            [body] => What 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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                            [title] => Heart transplant - NHS
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                            [destination] => https://www.nhs.uk › conditions › heart-transplant
                            [description] => Find out why heart transplants are carried out, what the procedure involves, what the risks are, and what you can expect while you recover
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                            [serp_title] => Heart transplant - NHS
                            [serp_description] => A heart transplant is an operation to replace a damaged or failing heart with a healthy heart from a donor who's recently died.
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                                    [1] => What happens during a heart transplant
                                    [2] => Recovering from a heart transplant
                                    [3] => Risks of a heart transplant
                                    [4] => Outlook for heart transplants
                                    [5] => NHS Organ Donor Register
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                            [body] => Overview - 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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                            [title] => Heart Transplant | BHF
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                            [description] => A 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
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                            [body] => Skip to main content Close Home > Information & support > Treatments > Heart transplant
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                            [title] => Heart Transplant Surgery: How to Prepare and What to Expect | UPMC
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                            [destination] => https://www.upmc.com › ... › Transplant Journey
                            [description] => When 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
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                            [serp_title] => Heart Transplant Surgery: How to Prepare and What to Expect
                            [serp_description] => 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 ...
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                            [body] => Heart 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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                            [body] => Heart 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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                            [body] => 8 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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                            [body] => Heart 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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                            [body] => Heart 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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                            [body] => Transplant 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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                            [title] => Heart Transplantation Procedure - Health Encyclopedia - University of Rochester Medical Center
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                            [title] => Experience a Heart Transplant in 360° | Heart Transplant | UT Southwestern Medical Center
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                            [body] => Experience 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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                            [body] => When 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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                            [body] => Transplant 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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                            [title] => FAQ: Heart Transplant | Patient Education | UCSF Health
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                            [body] => FAQ: 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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                            [body] => Heart 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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                            [body] => Heart 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. Hardy Adrian Kantrowitz Richard Lower Norman Shumway Kidney J. Hartwell Harrison John P. Merrill Joseph Murray Michael Woodruff Liver Fikri Alican James D. Hardy Thomas Starzl Lung Fikri Alican Joel D. Cooper Vladimir Demikhov James D. Hardy Pancreas Richard C. Lillehei Penis André van der Merwe Other Alexis Carrel Jean-Michel Dubernard Donna Mansell Bruce Reitz List of organ transplant donors and recipients Related topics Biomedical tissue Edmonton protocol Eye bank Immunosuppressive drugs Lung allocation score Machine perfusion Total body irradiation Frankenstein's monster Authority control General Integrated Authority File (Germany) National libraries United States Japan Other Microsoft Academic 2 3 Retrieved from "https://en.wikipedia.org/w/index.php?title=Heart_transplantation&oldid=1061415063" Categories: Cardiac surgeryOrgan transplantationHidden categories: CS1 errors: missing periodicalArticles with short descriptionShort description is different from WikidataArticles needing additional references from January 2020All articles needing additional referencesArticles containing potentially dated statements from 2018All articles containing potentially dated statementsAll articles with unsourced statementsArticles with unsourced statements from May 2018Articles with GND identifiersArticles with LCCN identifiersArticles with NDL identifiersArticles with MA identifiersArticles with multiple identifiers Navigation menu. 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                            [title] => The first human heart transplant and further advances in cardiac transplantation at Groote Schuur Hospital and the University of Cape Town
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                            [body] => PMC 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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                            [title] => Department of Surgery - Heart Transplant
                            [url] => https://surgery.ucsf.edu/conditions--procedures/heart-transplant.aspx
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                            [serp_title] => Heart Transplant - UCSF Department of Surgery
                            [serp_description] => What To Expect After a Heart Transplant — Heart transplant surgery is done in a hospital when a suitable donor heart is found. After the transplant, ...
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                                    [2] => What To Expect Before a Heart Transplant
                                    [3] => What To Expect After a Heart Transplant
                                    [4] => What Are the Risks of a Heart Transplant?
                                    [5] => Links to Other Information About Heart Transplant
                                    [6] => Heart Transplant Program
                                )

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                                    [4] => Waiting Times
                                    [5] => Ongoing Medical Treatment
                                    [6] => Contact With the Transplant Center During the Wait
                                    [7] => Staying in the Hospital
                                    [8] => Watching for Signs of Rejection
                                    [9] => Preventing Rejection
                                    [10] => Managing Transplant Medicines and Their Side Effects
                                    [11] => Preventing Infection
                                    [12] => Pregnancy
                                    [13] => Emotional Issues and Support
                                    [14] => Failure of the Donor Heart
                                    [15] => Primary Graft Dysfunction
                                    [16] => Rejection of the Donor Heart
                                    [17] => Cardiac Allograft Vasculopathy
                                    [18] => Complications From Medicines
                                    [19] => Infection
                                    [20] => Cancer
                                    [21] => Other Complications
                                    [22] => Complications From Not Following a Lifelong Care Plan
                                    [23] => NHLBI Resources
                                    [24] => Non-NHLBI Resources
                                    [25] => Clinical Trials
                                    [26] => Clinics & Appointments
                                    [27] => Heart Transplant Program
                                    [28] => Clinical Team
                                    [29] => Patient Stories
                                    [30] => Related News
                                )

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                                    [6] => stdClass Object
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                                            [2] => stdClass Object
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                                            [3] => stdClass Object
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                                            [4] => stdClass Object
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                                            [6] => stdClass Object
                                                (
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                                            [7] => stdClass Object
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                                            [10] => stdClass Object
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                                            [20] => stdClass Object
                                                (
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                                            [21] => stdClass Object
                                                (
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                                                    [isOutbound] => 1
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                                            [22] => stdClass Object
                                                (
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                                            [23] => stdClass Object
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                                                    [hrefDomain] => nih.gov
                                                    [isOutbound] => 1
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                                            [24] => stdClass Object
                                                (
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                                                    [hrefDomain] => nih.gov
                                                    [isOutbound] => 1
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                                            [25] => stdClass Object
                                                (
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                                                    [href] => http://www.nhlbi.nih.gov/health/health-topics/topics/ca
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                                                    [isOutbound] => 1
                                                )

                                            [26] => stdClass Object
                                                (
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                                                    [href] => http://www.nhlbi.nih.gov/health/health-topics/topics/echo
                                                    [hrefDomain] => nih.gov
                                                    [isOutbound] => 1
                                                )

                                            [27] => stdClass Object
                                                (
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                                                    [isOutbound] => 1
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                                            [28] => stdClass Object
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                                            [30] => stdClass Object
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                                                    [hrefDomain] => nih.gov
                                                    [isOutbound] => 1
                                                )

                                            [31] => stdClass Object
                                                (
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                                                    [hrefDomain] => nih.gov
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                                            [32] => stdClass Object
                                                (
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                                                    [isOutbound] => 1
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                                                    [hrefDomain] => nih.gov
                                                    [isOutbound] => 1
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                                            [38] => stdClass Object
                                                (
                                                    [text] => Current Research
                                                    [href] => http://clinicaltrials.gov/ct2/results?term=heart+transplant+OR+cardiac+transplant&recr=Open&rslt=&type=&cond=&intr=&outc=&lead=&spons=&id=&state1=&cntry1=&state2=&cntry2=&state3=&cntry3=&locn=&gndr=&fund=0&fund=1&rcv_s=&rcv_e=&lup_s=&lup_e=
                                                    [hrefDomain] => clinicaltrials.gov
                                                    [isOutbound] => 1
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                                            [39] => stdClass Object
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                                                    [href] => http://www.nhlbi.nih.gov/studies
                                                    [hrefDomain] => nih.gov
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                                            [40] => stdClass Object
                                                (
                                                    [text] => NIH Clinical Research Trials and You
                                                    [href] => http://www.nih.gov/health/clinicaltrials/
                                                    [hrefDomain] => nih.gov
                                                    [isOutbound] => 1
                                                )

                                            [41] => stdClass Object
                                                (
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                                                    [href] => https://www.researchmatch.org/
                                                    [hrefDomain] => researchmatch.org
                                                    [isOutbound] => 1
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                                                    [href] => http://www.nhlbi.nih.gov/exitdisclaimer
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                                                    [isOutbound] => 1
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                                            [43] => stdClass Object
                                                (
                                                    [text] => Request an Appointment
                                                    [href] => http://www.ucsfhealth.org/clinics/heart_transplant/
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                                                    [isOutbound] => 1
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                                                (
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                                            [children] => Array
                                                (
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                                                            [name] => The Heart Transplant Process. 
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                                                            [children] => Array
                                                                (
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                                                            [children] => Array
                                                                (
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                                                (
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                                                            [children] => Array
                                                                (
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                                                            [children] => Array
                                                                (
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                                                                (
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                                                                (
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                                                                (
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                                                            [children] => Array
                                                                (
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                                                        )

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                                                            [children] => Array
                                                                (
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                                                            [children] => Array
                                                                (
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                                                        )

                                                    [3] => stdClass Object
                                                        (
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                                                            [children] => Array
                                                                (
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                                                        (
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                                                            [children] => Array
                                                                (
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                                                        (
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                                                            [children] => Array
                                                                (
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                                                            [children] => Array
                                                                (
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                                                (
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                                                    [2] => stdClass Object
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                                                            [children] => Array
                                                                (
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                                                        (
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                                                            [children] => Array
                                                                (
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                                                    [4] => stdClass Object
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                            [body] => Heart 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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                            [body] => Heart 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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                            [body] => Heart 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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                            [body] => Heart & 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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                            [body] => Heart 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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                            [body] => Heart 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? 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                            [title] => Heart-lung transplant | NHS inform
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                            [body] => Heart-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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                            [body] => What 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. 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