Heart transplantation: how it is done, indication, risks and recovery

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Heart transplantation consists of replacing the heart with another, coming from an individual who is brain dead, who does not have heart disease and changes and is compatible with that of the patient who has a potentially fatal heart problem.

In this way, surgery is only performed in cases of serious heart disease that put the patient’s life at risk, such as congenic heart disease, severe valvular heart disease and cardiomyopathies, for example.

This procedure is complex and delicate and, therefore, must be done in the hospital under general anesthesia and the person must remain in hospital after the surgery and maintain care after discharge so that there is no risk of organ rejection.

when is indicated

Heart transplantation is indicated in case of serious heart disease in advanced stages, which cannot be solved with the ingestion of medicines or other surgeries, and which jeopardize the person’s life, being mainly indicated in cases of:

  • severe coronary disease;
  • cardiomyopathy;
  • congenital heart disease
  • Heart valves with severe changes.

The transplant can be done in people of all ages, even newborns, however the indication for heart transplantation will also depend on the state of other organs, such as the brain, liver and kidneys, because if they are severely compromised, the individual may not benefit from the transplant.

How is the surgery done

Heart transplantation is performed by a specialized medical team within a properly equipped hospital, as it is a complex and delicate surgery, where the heart is removed and replaced by a compatible one, however, some part of the heart of the cardiac patient always remains.

The surgery is performed following the following steps:

  1. anesthetize the patient in the operating room;
  2. Make a cut in the chest of the patient, connecting him to a machine heart-lung, which during surgery will help to pump blood;
  3. remove the weak heart and placing the donor heart in place, suturing it;
  4. close the chest, making a scar.

The heart transplant takes a few hours and after the transplant the individual is transferred to the intensive care unit and will have to stay in the hospital for about 1 month to recover and to avoid infections.

When not recommended

Heart transplantation may be contraindicated in the following situations:

Patients with AIDS, hepatitis B or C Blood incompatibility between recipient and donor Insulin-dependent diabetes or difficult-to-control diabetes mellitus, morbid obesity
Irreversible liver or kidney failure severe psychiatric illness severe lung disease
active infection Active peptic ulcer Pulmonary embolism less than three weeks old

Cancer

Amyloidosis, sarcoidosis, or hemochromatosis Age greater than 70 years.

Although there are contraindications, the doctor always evaluates the risks and benefits of the surgery and, together with the patient, decide whether the surgery should be performed or not.

possible risks

Heart transplant surgery is associated with some risks, so it is necessary that the patient remains in hospital after the surgery and is regularly monitored after discharge. As with any other invasive procedure, there is an increased risk of infection after the procedure.

In addition, there is a possibility of rejection of the transplanted organ, especially during the first 5 years, an increased chance of developing atherosclerosis, which corresponds to clogging of the heart arteries, and an increased risk of developing cancer.

Recovery after heart transplant

Some important care that the transplant patient should take after a heart transplant include:

  • Taking immunosuppressive drugs, as indicated by the doctor;
  • Avoid contact with people who are sick, polluted or very cold environments, as the virus can trigger an infection and lead to organ rejection;
  • Eat a balanced diet, eliminating all raw foods from the diet and, choosing only cooked foods to reduce the risk of infection.

These cares must be followed for life, and the transplanted person can have a practically normal life, and even perform physical activity.

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