A heart transplant gives a patient the opportunity to have a normal heart with normal blood circulation. If the transplant goes well, heart function and blood flow will be better than ever.
What is a heart transplant?
A heart transplant replaces the patient's failing heart with a donor heart. The failing heart may be a result of heart failure, coronary heart disease, irregular heartbeat or some other severe heart condition. In the procedure, doctors remove the patient's heart. The surgeon connects the donor heart by sewing together the recipient and donor vena cavae (two large veins that bring blood back from the upper and lower body), aorta, pulmonary artery and left atrium. In patients with congenital heart disease, the surgeon might also transplant the lungs with the heart.
How does a transplant affect the heart?
The donor heart is matched to the recipient by blood type and body size. 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. As a heart transplant recipient, you must take immunosuppressive medications to prevent your immune system from rejecting the new heart. Your medical team will balance the amount of immunosuppressive medication you need to prevent rejection of your new heart with the risk of side effects, which include infection or cancer.
What can I expect if my child is a heart transplant recipient?
When a child receives a heart transplant, the transplanted heart grows to adult size as the patient grows. Your child will need to take immunosuppressive medications and other medicine for the rest of his or her life to control the sides effects of the transplant. During young adulthood, your child's medical care will be transitioned from a pediatric to an adult heart transplant cardiologist.
You will require regular checkups by a transplant cardiologist after your transplant. At these visits, your cardiologist will do blood tests to check the levels of your immunosuppressive drugs and look for side effects. The doctor might also order electrocardiogram (EKG), echocardiogram and Holter monitoring to help monitor your heart rhythm and function, or an endomyocardial biopsy, which is a diagnostic procedure to obtain samples of heart muscle to detect rejection of the donor heart. Your doctor will evaluate your coronary arteries yearly or every other year to monitor for signs of narrowed coronary arteries in your transplanted heart. You should also have routine medical checkups to maintain overall health.
Heart transplant recipients have no specific activity restrictions. Discuss activity ideas with your transplant cardiologist.
Endocarditis is an infection of the inner lining of the heart. While some people who have congenital heart disease must take antibiotics prior to some medical and dental procedures to prevent endocarditis, most heart transplant recipients don't need them unless they also have significant heart valve disease.
Women who have had a transplant could have complications during pregnancy. Depending on the type, immunosuppressive medications may negatively affect the fetus. You may also have a greater risk of rejection once the baby is born. If you are considering pregnancy, discuss the pros and cons with your transplant cardiologist and obstetrician.
Will I need more surgery?
A transplant heart can help you lead a more active, fulfilling life, but there may be times when additional surgery is required. For instance, if the rhythm of your transplant heart becomes slow, you may need to have a pacemaker. Rarely, a valve can become damaged by the endomyocardial biopsy procedure; if that happens it will need to be repaired or replaced. Patients with congenital heart disease who have had a coarctation repair or problems with narrow or small pulmonary arteries may need surgery or interventional catheterization after the transplant to increase the size of these areas. Sometimes, a transplanted heart may fail because of rejection, damage to the heart cells or coronary arteries of the heart, which leads to heart failure. If this happens, doctors can sometimes transplant another heart.