Definition of Heart transplant:

A heart transplant is surgery to remove a damaged or diseased heart and replace it with a healthy donor heart.

Description:

Finding a donor heart can be difficult. The heart must be donated by someone who is brain-dead but is still on life support. The donor heart must be matched as closely as possible to your tissue type to reduce the chance that your body will reject it.

You are put into a deep sleep with general anesthesia, and a cut is made through the breastbone.

• Your blood flows through a heart-lung bypass machine while the surgeon works on your heart. This machine does the work of your heart while your heart is stopped, and supplies your body with blood and oxygen.
• Your diseased heart is removed and the donor heart is stitched in place. The heart-lung machine is disconnected. Blood flows through the transplanted heart.
• Tubes are inserted to drain air, fluid, and blood out of the chest for several days, to allow the lungs to fully re-expand.
• In some cases, the surgeon will not remove the old heart, but will put the new heart on top of it (heterotopic transplant).

Indications:

A heart transplant may be done to treat:

• Severe angina that can no longer be treated with medications or other surgeries
• Severe heart failure, when medicines, other treatments, and surgery no longer help
• Severe heart defects that were present at birth and cannot be fixed with surgery
• Life-threatening abnormal heartbeats or rhythms that do not respond to other treatments

Heart transplant surgery may NOT be used in patients who:

• Are malnourished
• Are older than age 55 - 60
• Have had a severe stroke or dementia
• Have had cancer
• Have HIV infection
• Have infections such as hepatitis that are active
• Have insulin-dependent diabetes and other organs that aren't working correctly
• Have kidney, lung, nerve, or liver disease
• Have no family support and do not follow their treatment
• Have other diseases that affect the blood vessels of the neck and leg
• Have pulmonary hypertension (thickening of blood vessels in the lung)
• Smoke or abuse alcohol or drugs, or have other lifestyle habits that may damage the new heart

The doctor may not recommend a heart transplant if the patient may not be able to keep up with the many hospital and doctor's office visits, tests, and medications needed to keep the new heart healthy.