Transplant - heart

Alternative names

Cardiac transplant; Heart transplant

Definition

Heart transplantation is a surgical procedure to remove a damaged or diseased heart and replace it with a healthy donor heart.

Description

Heart transplants are the fourth most common (corneas, kidneys and liver are the most common) transplant operations in the U.S. (over 2,200 cases per year). A healthy heart is obtained from a donor who has suffered brain death but remains on life-support. The healthy heart is transported in a special solution that preserves the organ.

While the patient is deep asleep and pain-free (general anesthesia), an incision is made through the breast bone (sternum). The patient's blood is re-routed through tubes to a heart-lung bypass machine to keep the blood oxygen-rich and circulating. The patient's diseased heart is removed and the donor heart is stitched in place.

Indications

A heart transplant may be recommended for:
Heart failure caused by

• coronary artery disease
  
• cardiomyopathy (noninflammatory disease of the heart)
  
• heart valve disease with congestive heart failure
  
• severe congenital heart disease
  
• life-threatening abnormal heart rhythms that do not respond to other therapy
  

Heart transplant surgery is not recommended for patients who have:

• kidney, lung, or liver disease
  
• insulin-dependent diabetes with other organ dysfunction
  
• other types of vascular disease of the neck and leg arteries
  
• other life-threatening diseases
  

Risks
Risks for any anesthesia are:

• reactions to medications
  
• problems breathing
  

Risks for any surgery are:

• bleeding
  
• infection
  

Heart transplants carry major risks. There is a greater risk of infection because of the immunosuppressive drugs that must be taken to prevent transplant rejection. Call your doctor if there are signs of infection (redness, drainage, fever) or if there is a general worsening of health.