Transplant Life By Organ
As you look at these, a note where you see graft half-life: Many patients get discouraged because they misunderstand this concept, Diez says. It doesnt mean thats all the time the patient hasit means that if you take 100 patients transplanted today, half of those organs will last longer than the half-life and half will last less.
Doctors caution patients against getting hung up on averages. You cant predict how long your transplanted organ will last as evidenced by the 60-year-old kidney, it could be a very long time.
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 donor’s family must also give consent for organ donation at the time of the donor’s death.
Donor organs are located through the United Network for Organ Sharing’s 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 one’s death.
A Practice Called Donation After Cardiac Death May Increase The Number Of Heart Transplants
United Network for Organ Sharing , a private, non-profit organization under contract with the federal government to manage the organ transplant system in the U.S., allocates newly available hearts based on such priorities as medical urgency. Patients who are hospitalized or dependent on mechanical assist devices to help their heart function are at the top of the list.
About 3,500 people in the U.S. are waiting for a heart, and many will wait more than six months. But some will die before a heart becomes available to them. Thats why one of the greatest breakthroughs in heart transplantation may be the practice of accepting donor hearts that most other programs do not have the expertise to accept. This means that more sick patients who are eligible may be able to receive one. A limited number of programs in the U.S. are starting to do this. Yale Medicine is one of them.
I remember we said to ourselves as a team: We’re going to switch gears now. We can be more aggressive and take some risks,’ says Muhammad Anwer, MD, associate director of the Center for Advanced Heart Failure at Yale New Haven Hospital and a key cardiac surgeon for heart transplantation. Now all the data that’s coming in is showing that the outcomes may be just as good with the more aggressive approach.
During DBD heart transplant, the heart is still beating, allowing for a controlled procurement, says Christopher Maulion, MD, who is spearheading the DCD program at Yale Medicine.
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Living A Full Life Again
During the months of illness before heart transplant surgery, you and your family made many adjustments. The purpose of having heart transplant surgery was to make you feel better and to live a full life again. Let’s review some areas of life often affected by your transplant.
- Return to Work
Daily Activity and Exercise Guidelines
Caring for your personal hygiene
Light chores
It takes about six weeks for your sternum to heal after heart transplantation. During this time, you may do light household chores such as laundry, shopping, cooking, and washing dishes. But, do not lift objects that weigh more than 10 pounds. These include suitcases, grocery bags, full laundry baskets, pets or children.
Also avoid activities that require pushing or pulling heavy objects, such as shoveling snow or mowing the lawn. Your doctor will tell you when you can resume these activities during your heart transplantation follow-ups.
Driving after your heart transplantation
You may not drive for at least six weeks. However, you may be a passenger as often as you like. For the first two weeks after your heart transplantation, you may want to stick close to home to avoid infections or becoming overtired. Over time, increase your outings and begin to get back to activities you enjoy after your heart transplantation. Your doctor will tell you when you can begin driving a car.
Pace yourself
Get a good night’s sleep
Begin a Lifelong Exercise Program After Your Heart Transplantation
Cardiac Rehab
Q Can I Continue To Exercise After A Heart Transplant
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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.
Slowly Increase Your Activity Level
Your recovery will continue after you go home. Once you are at home, you will need to slowly increase your activity level, protect and care for your TAH, and get the right nutrition and exercise.
When you go home after TAH surgery, you will likely be able to do more activities than you could before the surgery. The machine with the power supply and device controls is portable, so you will probably be able to get out of bed, get dressed, and move around the house. You may even be able to drive. Your healthcare team will advise you on the level of activity that is safe for you.
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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:
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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.
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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.
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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.
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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:
What To Expect After Surgery
When you wake up after surgery, you will find an assortment of tubes and monitoring equipment on your body. You may also experience a number of symptoms after surgery and in the weeks following including pain, nausea, weakness and increased heart rate. Most patients are able to walk by the third or fourth day after they enter the ICU. You will be continuously monitored and may require a week, a month or more to recover. The recovery process involves a combination of chest physiotherapy , exercise and proper nutrition. Learn more about what to expect after surgery
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Q What If A Heart Transplant Is Not Possible Is There An Alternative
What Happens During A Heart Transplant
A heart transplant requires open heart surgery and a stay in a hospital.Procedures may vary depending on your condition and your healthcareprovider’s practice.
Generally, a heart transplant follows this process:
You will be asked to remove any jewelry or other objects that may interfere with the procedure.
You will change into a hospital gown.
A healthcare professional will start an intravenous line in your hand or arm to inject medicine and to give IV fluids. Additional catheters will be put in blood vessels in your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples. Other sites for the additional catheters include the under the collarbone and the groin.
A soft, flexible tube will be put into your bladder to drain urine.
A tube will be put through your mouth or nose into your stomach to drain stomach fluids.
If there is a lot of hair on your chest, it may be shaved.
Heart transplant surgery will be done while you are in a deep asleep . Once you are asleep, a breathing tube will be put through your mouth into your lungs. The tube will be attached to a machine that will breathe for you during the surgery.
The anesthesiologist will watch your heart rate, blood pressure, and blood oxygen level during the surgery.
The skin over your chest will be cleaned with an antiseptic solution.
The surgeon will make a cut down the center of your chest from just below the Adam’s apple to just above the navel.
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Q What Is The Survival Rate For Heart Transplant Patients
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What Happens During Heart Transplant Surgery
When you get to the hospital, the transplant team will prepare your child for surgery. They may run a few tests to be sure that the new heart is a good match. Then, your child goes to an operating room.
In the operating room, your child will get anesthesia to sleep through the operation. The surgeon makes an incision in the chest and removes the sick heart. The new heart is placed in the chest, and the surgeon connects it by sewing its blood vessels to the blood vessels in your child’s body. So that doctors can check heart function, the incision might not be closed right away.
Most heart transplant surgeries last between 4 and 6 hours. Someone on the transplant team will keep you informed about how the surgery is going while you wait.
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Preventing Infection At Home
Remember these points to protect yourself from infection:
- Take care of cuts or wounds and wash hands thoroughly:
Keep minor cuts and wounds clean. Wash them with soap and water or hydrogen peroxide, dry your skin and cover the cut with a sterile bandage.
Go to the emergency room near your home if you have a deep cut, or one that bleeds a lot. Be sure to tell the health care providers that you are a transplant patient.
Frequently wash your hands with soap and warm water, especially before preparing food, and after using the bathroom or after touching soiled linens or clothes. Lather well, rubbing your hands back and forth together, to clean all surfaces, including the nail beds and webbing between your fingers.
Shower or bathe daily using a mild soap. Special soap is not needed at home. If you have dry skin, apply a mild skin lotion after bathing.
Prednisone and cyclosporine, two medications that you must take, can cause acne.
Keep your skin as clean and oil free as possible and use a washcloth and mild soap. You may want to avoid soaps that contain pumice or coconut oil. Some over-the-counter acne products may be helpful, but be sure to use non-comedogenic skin care products and cosmetics
Make an appointment with a dermatologist if acne becomes a problem.
Overexposure to the sun can also cause skin irritation as well as cause dry skin, sunburn, blisters and can increase the risk of skin cancer. Some of your medications may make you more sensitive to the sun’s rays.
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Why Heart Transplants Are Carried Out
A heart transplant may be considered if you have severe heart failure and medical treatments are not helping.
Conditions that may eventually require a heart transplant include:
- coronary heart disease a build-up of fatty substances in the arteries supplying the heart, which block or interrupt blood flow to the heart
- cardiomyopathy where the walls of the heart have become stretched, thickened or stiff
- congenital heart disease birth defects that affect the normal workings of the heart
If your doctor thinks you might benefit from a heart transplant, you’ll need to have an in-depth assessment to check whether you’re healthy enough to have one before being placed on a waiting list.
Read more about who can have a heart transplant and being on the heart transplant waiting list.
How Do You Get On A Heart Transplant List
To be placed on the UNOS heart transplant waiting list, you first need to receive a referral from your physician. You can also refer yourself by reaching out to a member of our heart transplant team. Once a referral is submitted, a member of the transplant team will contact you to discuss next steps. This will include scheduling a time to come to the hospital to be evaluated. After your evaluation is completed, the members of the transplant team will discuss your case and decide if heart transplant is in your best interest. Once the transplant team decides that heart transplant is a good fit for you, then you will be added to the national waiting list.
Once you’ve selected a hospital, you should schedule a time to be evaluated. During this time, if the team members you meet with think you’re a good candidate for a transplant, they will add you to the national waiting list.
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