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Heart Transplantation Surgery: Procedure, risks, complications, reasons

  • Posted on- Jul 19, 2016
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Written by site author.

Heart Transplantation is a procedure that surgically removes a damaged or diseased heart and replaces it with a healthy heart from a donor. The procedure is also known as cardiac transplantation, heart grafting or transplantation of heart.

What are the reasons for heart transplantation?

A Heart Transplantation is performed for the following reasons:


How heart transplantation procedure is performed?

A heart transplantation procedure involves 3 steps:

First step

  • In this step, the heart is removed from the donor
  • Typically, donors are those who are brain dead (i.e., when the brain has suffered an irreversible injury, but all other organs are functioning well with medications and life support measures)
  • A cardiac transplant team of physicians, nurses, and technicians, removes the donor’s heart (after travelling to the hospital of the donor)
  • The heart is then transported on ice, to keep it alive until it can be implanted
  • It has to be implanted within 6 hours and so, the organ is often flown by an airplane, helicopter, or taken by an ambulance, depending on the proximity to the recipient's hospital

Second step

  • In this step, the recipient's damaged heart is removed
  • A skin incision is made on the chest. The incision is deepened and the chest opened
  • The damaged heart removal may sometimes be difficult depending on whether the recipient has had a previous heart surgery (as is often the case) or not
  • If there has been previous surgery, cutting through the scar tissue may prolong and complicate removal of the heart

Third step

  • In this step, the donor heart is implanted
  • All the blood vessels entering and leaving the heart are connected with sutures
  • Once the connection is established with all the blood vessels, the chest is then closed in layers with stitches

A heart transplantation procedure is performed in a hospital. A cardiovascular surgeon performs a heart transplantation procedure. The procedure to replace the heart, may take anywhere between 6 to 8 hours.

Preparations needed before heart transplantation procedure

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Normally local anaesthesia is not used however do inform the physician if you are allergic to any local anaesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range if not their diabetologist may have to control blood sugar by recommending insulin or a combination of oral medicines

Diagnostic lab tests needed before heart transplantation procedure

Prior to a heart transplantation procedure, the individual may have to undergo certain tests, such as:

Risks and complications during heart transplantation surgical procedure

The possible risks or complications that may arise during the surgery are:
  • Excessive bleeding
  • Infection in the surgical wound
  • Anaesthetic complications
  • Donor heart rejects its new host
  • Contraction of the arteries connected to the donor heart
  • Failure of new donor heart to pump normally (primary graft dysfunction)

Risks and complications after heart transplantation surgical procedure

Post heart transplantation procedure, the following complications may arise:
  • Infection in the surgical wound
  • Donor heart rejects its new host
  • Failure of new donor heart to pump normally (primary graft dysfunction)
  • Heart rhythm abnormalities
  • Heart rate abnormalities
  • Complications related to immuno-suppressant medications that are started after heart transplantation

Post-operative care needed after heart transplantation surgical procedure

At home, the following post-operative care is recommended, after a heart transplantation procedure:
  • Avoid all activities that are physically strenuous for about 6 weeks, or as advised by your physician
  • Resume regular/daily activities, as early as possible (under advice by the physician). This aids in a faster recovery
  • Use a heat pad or warm compress to relieve pain due to the incision
  • Avoid taking baths until the surgical wound is completely healed. Resume showering and keep the wound clean and dry, after advise from physician
  • Take stool softeners to prevent constipation
  • Take antibiotic medication to help combat or prevent infection, as prescribed by the physician
  • Take immunosuppressant medications to reduce the possibility of rejection, as prescribed by the physician
  • Avoid taking non-prescription medications
  • Complete the course of prescribed medication under advice of the physician
  • Elevate legs while resting to prevent the formation of blood clots and reduce the possibility of swelling
  • Avoid sex till complete healing has taken place, or follow physician’s advice

Comments

user profile image
04-06-2017 05:36 AM

I was suffering from coronary artery disease which further leaded to heart failure, then my doctor suggested me to go through a heart transplant. I went through the procedure and it feels good after the surgery.

user profile image
22-09-2016 12:06 AM

My father went for a heart transplant in 2010, I am very happy with the results. He is totally fine now and living a happy life.

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