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What Are The Advantages And Disadvantages Of This Procedure

Experience a Heart Transplant in 360°

The biggest advantage of heart transplantation is that its a life-saving option when other options didnt work, were too risky to use, or were unlikely to help.

The biggest disadvantages of heart transplant are:

  • More people need a heart transplant than there are available donor hearts.
  • Its an extremely complicated surgery, limiting it to only the most well-equipped and best-staffed hospitals.
  • Some people may be too ill to survive the procedure.
  • The procedure has several potential risks and complications .

What are the risks or complications of this procedure?

The most common risks and complications of heart transplant include the following:

  • Organ rejection.
  • Graft failure .

What Will I Need In The Future

After your heart transplant, your medical team will monitor you closely for heart rejection, which can happen in the heart muscle cells or in the heart’s arteries. They will also watch for side effects of the immunosuppressive medications, which include diabetes, infection, kidney disease, cancer or high blood pressure. If any of these problems arise, your doctor will change the medication type or dose. You and you’re your doctor may also decide to change your immunosuppressive medications as new drugs become available.

What Is The Recovery Process After A Heart Transplant

Following your heart transplant surgery, you will need to adhere to a recovery program in order to increase your chances of staying healthy.

Medications

You will need to take medications for the rest of your life after a heart transplant. They prevent your immune system from attacking your new heart. These drugs are known as immunosuppressants or antirejection drugs.

Heart-healthy diet

A balanced diet rich in fresh fruits, vegetables, and whole grains will help keep your new heart healthy and lower your risk of complications and future heart disease.

Some of the medications that you will be given following your transplant surgery may increase your risk of high blood pressure, high cholesterol, diabetes, and weight gain, which could increase your risk of heart disease. Your diet is a critical factor in reducing these risk factors.

When it comes to food preparation, you will need to be especially cautious since your immune system may be compromised and make you more susceptible to food poisoning. Always handle and store food carefully and exercise caution when dining out.

Exercise

Exercise will help lessen some of the side effects of the medications you’ll be taking, especially steroids. Another advantage of regular exercise is that it helps you maintain good blood pressure, cholesterol, and weightall of which are critical for heart health.

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Potential Complications Of A Heart Transplant

There are several potential risks of complications that may follow surgery. The most common complications include:

  • Rejection: One of the most serious risks is that your body will reject the donor heart. Your immune system may perceive the donor heart as foreign tissue and try to reject it, causing harm to the heart. Every heart transplant recipient is given antirejection medicine to reduce the rate of rejection. If rejection occurs, a change in drugs can sometimes stop it. To prevent rejection, it’s vital that you take medications exactly as prescribed by your doctor and keep all of your medical appointments. Rejection frequently occurs in the absence of symptoms. During the first year after your transplant, you will need to have frequent heart biopsies to determine whether your body is rejecting the new heart.
  • Infections: Mortality rate from infections is 50%. Immunosuppressive medications reduce your ability to fight infections. Many heart transplant recipients get an infection that requires hospitalization within the first year of their transplant.
  • Malignancy: Mortality rate from malignancy is 33%. Immunosuppressive medications can potentially increase your risk of cancer such as skin and lip tumors and non-lymphomacancer.
  • Graft dysfunction: This occurs when the donor heart does not function properly, which is the most common cause of mortality in the first few months following a transplant.
    • Active infection

    Who Is Not A Good Candidate

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    There are some general contraindications to receiving a heart transplant, though these vary by location, transplant center, and even surgeon. What one transplant center may say is a contraindication to being listed for a transplant may not be an issue for a different center.

    Some of these issues may only temporarily prevent transplantation. For example, a patient would not receive a transplant while they have a current high fever and an active infection, but would be eligible once they are well.

    People who are not candidates for a heart transplant include those with:

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    Q Can I Continue To Exercise After A Heart Transplant

  • Exercise is great for enhancing your overall health, and it is recommended by doctors after a heart transplant, as well. Regular exercise helps you reduce stress and control other conditions, so you can stay healthy it helps you recover faster too so that you have strength. Not all types of exercises may be recommended though depending on your particular condition. You must consult with your doctor about the types of exercise that you can perform after a heart transplant.
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    What Problems Can Happen

    One of the most common problems after transplant surgery is rejection. Rejection happens because the body doesn’t recognize the new heart and doesn’t know that it is helpful. So the immune system tries to attack it.

    Medicines help to control this reaction. In a sense, they trick the body into accepting the new heart. Taking them can make your child more likely to get infections, especially in the days right after surgery. So keep your child away from sick people, and have everyone at home wash their hands well and often.

    The risk of rejection is greatest in the first few weeks after transplant surgery. But the body never completely accepts the new heart. So anti-rejection medicines are taken for life.

    Usually, the amount of immunosuppressants taken is reduced as the body gets used to the new heart. Rarely, the body refuses to accept the new organ and another transplant is needed.

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    Can My Family Stay With Me

    Your family can accompany you until you go into the transplant surgery. While you are in the intensive care unit, family members may not stay in your room. If you need assistance finding guest housing, a social worker will help you.

    We have very open visiting hours and encourage family members to spend time with you. However, in order to protect you from infection, anyone who is ill with a cold or flu, for example should not visit.

    What Happens During This Procedure

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    A heart transplant is a complicated surgery that usually involves the following steps.

    General anesthesia

    Heart transplant always involves general anesthesia, which puts you into a deep sleep. While youre asleep, providers will insert a tube down your throat, attaching the end of the tube outside your body to a machine called a ventilator. The ventilator will keep you breathing even though youre under anesthesia.

    After youre under anesthesia, providers will lower your body temperature to around 82 degrees F . Lowering your body temperature means the activity of your cells slows down. That prevents damage to your cells when blood flow stops during various steps of the surgery.

    Removing your heart

    At some point, providers will also add blood thinners like heparin to your blood to keep it from clotting at the wrong time. Theyll then reroute all the blood in your body through a device called a heart-lung bypass machine. That device adds oxygen and removes carbon dioxide from your blood, and also keeps your blood circulating.

    To make room for the donor heart you’ll receive, doctors have to perform a procedure called cardiectomy to remove your heart. This procedure involves clamping off all the major blood vessels that connect to your heart and disconnecting your heart from them.

    Implanting the donor’s heart

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    How Are Organ Donors Found

    Donors for heart transplants are individuals who may have recently died or become brain dead, which means that although their body is being kept alive by machines, the brain has no sign of life. Many times, these donors died as a result of a car accident, severe head injury, or a gunshot wound.

    Donors generally give their permission for organ donation before their death. The donors family must also give consent for organ donation at the time of the donors death.

    Donor organs are located through the United Network for Organ Sharings computerized national waiting list. This waiting list assures equal access and fair distribution of organs when they become available. When a heart becomes available for transplantation, it is given to the best possible match, based on blood type, body size, UNOS status and the length of time the recipient has been waiting. The race and gender of the donor have no bearing on the match.

    Unfortunately, not enough hearts are available for transplant. At any given time, almost 3,500 to 4,000 people are waiting for a heart or heart-lung transplant. A person may wait months for a transplant and more than 25% do not live long enough to receive a new heart.

    Many people who are waiting for transplantation have mixed feelings, because they are aware that someone must die before an organ becomes available. It may help to know that many donor families feel a sense of peace knowing that some good has come from their loved ones death.

    Precautions To Take After Surgery

    Once the heart transplant surgery is completed, there are several precautions that you need to keep in mind. These adjustments might seem overwhelming, but they ensure that you can recover fast and can lead a normal life after a heart transplant.

    Your doctor will prescribe immunosuppressants which are used to ensure your immune system does not attack the new healthy donor heart after it has been transplanted. Immunosuppressants ensure the risk of heart rejection is decreased. These are usually prescribed lifelong. Even with the help of immunosuppressants, your immune system might still not fully accept the new heart. The problem with immunosuppressants is there are many side effects, especially in the beginning.

    Immunosuppressants can make you prone to infections because your immune system is suppressed and is not working optimally. For this, your doctor will prescribe additional medication. Sometimes, immunosuppressants can worsen some health issues, such as diabetes and high blood pressure. It can increase the risk of developing other health problems, like high cholesterol, as well.

    The key to recovery, after a heart transplant surgery, is to ensure you listen to what your doctor advises. You need to make lifestyle changes so that you dont develop any infections, in the future. You may need to include exercise and healthy eating habits in your routine.

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    Wait Time For Transplant

    How long someone must wait for a transplant depends on many factors. The sickest patients have first priority and include patients living in the hospital, mostly in the intensive care units, awaiting heart transplants. Patients who are at home on LVADs are next, followed by patients at home on oral heart failure medications. Wait time also depends on a persons blood type, body size, and whether they have antibodies in their blood that may make finding a donor match more difficult.

    How Long Is The Waiting List

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    Unfortunately, the waiting times for heart transplants are long often more than six months. Each patient on our waiting list returns for an outpatient visit to our transplant clinic every two to three months, or more frequently if necessary.

    While many patients can wait at home, sometimes it is necessary for patients to be admitted to the hospital in order to remain in satisfactory condition until transplantation.

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    What To Expect Before A Heart Transplant Procedure

    A heart transplant usually needs to occur within four hours of organ removal for the donor organ to remain viable. As a result, hearts are offered first to a transplant center close by, then to centers within certain distances of the donor hospital.

    • When you’re notified that a potential organ is available, you and your transplant team have a limited amount of time to consider whether to accept the donation. You’ll be expected to travel to the transplant hospital immediately.
    • Once you arrive at the hospital, your doctors and transplant team will conduct a final evaluation to determine if the donor heart is suitable for you and if you’re ready to have surgery. If it is decided that you are not, you may not be able to have the transplant.

    Each Patients Journey Is Different

    Heart transplants are done in people of all ages, even children. Heart failure can affect anyone in fact, it is the number one cause of death and a leading cause of disability in the United States, says Tariq Ahmad, MD, MPH, medical director of the Advanced Heart Failure Program. We’ve had people in their 20s, 30s, and 40sand our oldest transplant patient last year was 73 years old. One of our patients later completed a 100-mile bike ride up in Maine, and he’s doing incredibly well.

    A routine heart transplant surgery can be performed in less than four hours, while some complex ones may take seven, eight, nine hoursor more, especially if we need to remove a heart pump or clean up scar tissue from previous surgeries, says Arnar Geirsson, MD, chief of cardiac surgery. Regardless, the basic procedure remains the same. The patient is given general anesthesia and connected to a bypass machine that takes over the hearts function. Surgeons make an incision in the chest, divide the breastbone and remove the diseased heart. They sew the donor heart into place and connect it to the remnants of the old heart and the major blood vessels.

    But given todays shortage of available organs, the sickest patients are prioritized for transplants, so many patients waiting for a heart to become available are already in the hospital on various types of medicine or heart pumps, he says.

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    How Do I Get Ready For A Heart Transplant

    Not everyone is a candidate for heart transplant. Because of the wide rangeof information needed to know if a person is eligible for transplant, atransplant team will review the evaluation. The team includes a transplantsurgeon, a transplant cardiologist , nurse practitioners or physician assistants, one or moretransplant nurses, a social worker, and a psychiatrist or psychologist.Other team members may include a dietitian, a chaplain, hospitaladministrator, and an anesthesiologist .

    The transplant evaluation process will include:

    • Psychological and social evaluation. Some psychological and social issues that are involved in organ transplant include stress, financial issues, and support from family or significant others. These factors can greatly affect how you do after the transplant.

    • Blood tests. You will need blood tests to help find a good donor match and help improve the chances that the donor heart will not be rejected.

    • Diagnostic tests. You will need tests to assess your lungs as well as your overall health. These tests may include X-rays, ultrasound procedures, CT scan, pulmonary function tests , and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram.

    • Other preparations. You will get several vaccines to decrease the chances of developing infections that can affect the transplanted heart.

    These things will need to be done before the transplant:

    How Do I Know If I Need A Transplant

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    Some patients with severe heart disease may benefit from transplantation. Your cardiologist or pulmonary medicine specialist may refer you to a transplant center for an evaluation. The purpose of the evaluation is two-fold:

    • To determine the severity of your disease and whether there are any more conventional treatments
    • To determine whether you would be able to survive the transplant operation and have a good long-term result afterwards

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    Heart Transplants In New Jersey

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    Heart transplantation is a type of open-heart surgery performed to remove a persons diseased or failing heart and replace it with a healthy heart from a deceased donor. Most heart transplants are done on patients who have end-stageheart failure. Heart failure is a condition in which the heart cannot keep up with its workload to pump enough blood to meet the bodys needs. End-stage means the condition is so severe that most medical treatments have failed.

    Although a great solution for many, a heart transplant isnt the right treatment for everyone. There are many factors that may disqualify someone, including: advanced age a separate medical condition that could shorten your life active infection, recent personal medical history of cancer and the unwillingness to make lifestyle changes necessary to keep your donor heart healthy .

    For those who do not qualify for a heart transplant, aventricular assist device provides an alternative. They are commonly used to provide a temporary solution for patients waiting a heart transplant , when heart failure is temporary due to an infection or another acute condition , when individuals are not qualified for a heart transplant .

    How To Prepare For A Heart Transplant Procedure

    Preparations for a heart transplant often begin long before the surgery. You may begin preparing for a heart transplant weeks, months or years before you receive a donor heart, depending upon the waiting time for transplant.

    Taking the first steps

    • If your doctor recommends that you consider a heart transplant, you’ll likely be referred to a heart transplant center for an evaluation.
    • During an evaluation, your doctors will order several tests, including:Diagnostic tests and procedures

    Waiting for a donor organ: If the transplant team determines you’re a candidate, then the transplant center will register you on a waiting list. While on this list:

    • Your medical team will closely monitor your condition.
    • Your doctors may recommend acardiac rehabilitation program.
    • Your doctors may also suggest having a VAD implanted to support your heart while you wait for a donor organ.

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