Heart transplant is the procedure of replacing a damaged and dysfunctional heart with a healthy heart of a deceased donor (definitive diagnosis of brain death). The transplant is the last remedy for patients with heart failure, after all treatments fail.
Heart failure may develop secondary to coronary artery disease, damaged heart valves or myocardium (cardiac muscle), congenital heart defects or viral infections of the heart.
Heart transplant is reserved for patients with end-stage heart failure. In other words, it is performed if the one-year life expectancy is below 50% and signs and symptoms persist despite all treatment options.
Blood type compatibility is a must in the heart transplant. Blood type of the recipient and the donor should usually be identical. For special cases, the compatibility is based on overall rules of blood donation for universal donors and universal recipients.
The preferred age range is 1 to 50 years, although there is no strict age limitation for heart transplant.
Timing is important in heart transplant. The heart of donor should be removed and activated in the recipient within 4 hours. Therefore, there is a race against time in heart transplant surgeries and it is necessary to take action quickly.
Heart transplant patients are recorded on the Heart Transplant Waiting list at Organ and Tissue System (TODS) of the Ministry of Health. For emergencies, an urgent notice can be sent that is subject to approval by our Heart Transplant Committee.
Patients may be placed on Heart Transplant Waiting List of only one Transplant Center. One cannot be recorded on lists of more than one center. The system hinders recording one patients in more than one transplant center. An appropriate donor heart can be found very soon after the patient is recorded to the system, but it may also take a very long time. Unfortunately, some patients lose their chance for heart transplant due to very long waiting period.
Recipient’s immune system is activated and the body reacts against the donor heart, after the deceased-donor heart is transplanted. This condition is called “rejection” in organ transplant literature and it usually causes dysfunction of the transplant organ. Therefore, “immunosuppressive” medications (chemicals that suppress the immune system) are used to have the donor heart not rejected by the recipient’s body. However, these drugs have adverse effects. For heart transplant patients, the most important side effect is the increased risk of infection. The heart is biopsied at certain intervals along with coronary angiography and echocardiography to evaluate the heart and monitor the rejection after a heart transplant surgery.
Quality of life boosts substantially after the transplant. One can go to school, work, get married and should even exercise. However, one should observe the rules that require attention after a cardiac surgery and present for follow-up visits regularly.