As we all know among the three most integral parts of the human body, our heart holds the second position, while the first is our brain and the third is our lungs. The heart is also counted among the most delicate parts of our body. So what if one fine day this heart of ours fails to do its daily functions? What if the “lub-dub” sound slowly begins to fade away? Scary to imagine, isn’t it?
What is a heart transplant, why is it needed, what are the conditions or biological factors that can lead a person to need a heart transplant, and whether there are any chances that this heart transplant procedure can actually save us. If yes then how long?
1. Need for a Heart Transplant
So a person requires a heart transplant when their heart begins to fail and it isn’t responding to any medical treatment. In this procedure, this failing heart needs to be replaced with the healthy heart of a donor who has recently died. It is said that the donor’s heart is usable for only 4-6 hours after it is removed from the body, after that the heart slowly begins to die. So, the transplant needs to be performed within that golden period.
2. Causes for Heart Failure
There are three main conditions that can lead to a person’s heart failure.
2.1 Coronary Artery Disease
It is also known as atherosclerosis which arises due to blockages that form in the patient’s arteries. Every person has 4 arteries connected to their heart. But due to excessive fat and cholesterol getting built up in the wall of their arteries, the arteries begin to choke. As a result, blood isn’t able to enter the heart and get pumped to other organs as it does normally. This can also result the patient in having a heart attack.
2.1.1 How is it Treated?
Normally Cardiologists perform Coronary angioplasty to open up the clogged arteries through a tiny balloon. This balloon is then pushed through that artery to expand the blockages and let the blood flow into the heart. But if this medical procedure doesn’t work, then a heart transplant is suggested.
It is often inherited or acquired, You can inherit such a heart condition from your parent through genes or you can acquire this condition as a result of another condition. For example, due to a heart attack, the heart muscles may thicken or the main pumping chamber gets enlarged. Thus damaging your heart tissues in the process.
2.2.1 How to Control It?
Normally your Cardiologists would suggest that you reduce your intake of alcohol and perform daily light exercises or prescribe some medicines. These can help you to control your blood pressure and help your heart to pump effectively. He may even suggest you surgically reduce the thickening or implant devices to maintain the rhythm of your heart. But if the heart is severely damaged, then a heart transplant is advised as the last and final option.
2.3 Congenital Heart Disease
It is a heart defect present at birth. It is estimated that in India itself, there are over two lakh children born with this defect per year. This defect can affect the heart wall, valves, and blood vessels of the patient. There is a wide range of congenital heart defects. Some of these are simple heart conditions, while others can have life-threatening symptoms.
2.3.1 How to Control It?
In such conditions, the Cardiologists will prescribe certain medications to prevent irregular heartbeat clots from forming. In order to prevent future complications some patients are suggested to implant peacemakers to regulate their heartbeats. To avoid any surgeries on small children, Cardiologists would also try the Catheter procedure.
2.3.2 Catheter Procedure
In this procedure, they try to correct the defect by inserting a thin tube into the leg’s vein and guiding it toward the heart. After that, they would fix the defect by using small tools which would be pushed through the catheter. But if the condition of the heart is too complex, then here too a heart transplant is suggested.
3. Requirements for a Smooth Heart Transplant
Not everyone can undergo a heart transplant, the patient needs to meet certain medical conditions.
Both the recipient and the donor should not have any infection or diseases related to organs. As it can increase the complexity of the transplant during and after the surgery. Also if any of them is suffering from cancer, then the surgery cannot be performed.
If the donor has it, then there are chances for it to spread into the body of the recipient after the transplant. If the recipient has it, then first that needs to be cured before undergoing a transplant.
4. How is Heart Transplant Performed?
If both the recipient and the donor meet the medical requirements, only then the Cardiologists would agree to perform the heart transplant. The whole surgery is performed while the recipient is placed under general anaesthesia, which means he or she is asleep and numb to any sort of pain. This ensures that the recipient doesn’t wake up in the middle of the cardiac surgery.
4.1 Heart-Lung Bypass Machine
As such an event can pose a risk to the recipient’s life. While the recipient’s heart is being removed from his body, his or her heart’s upper chambers are connected to a heart-lung bypass machine. This machine then carries the blood to a special reservoir called an oxygenator. This reservoir ensures that your blood is being circulated with oxygen-rich blood.
The need for a heart-lung bypass machine is to make sure that the recipient, for whom this surgery is being done, is kept alive through this heart transplant procedure. Normally the donor’s heart is brought inside the operating theatre within a sterile container packed with wet ice. When the donor’s heart is removed from the body, he or she is declared dead.
Then the donated heart is attached to the recipient’s arteries. This complex surgery takes up to four to six hours to finish it. Successful surgery requires good timing, highly skilled surgeons, and flawless execution.
5. Advanced Technology in Heart Transplant
When you are enlisted as a recipient for a heart transplant, you normally would have to wait for as long as six months for a donor. As a result, many patients would pass away while waiting for a new heart. So Professor Peter MacDonald introduced a new technology called ‘Transmedics organ care system’ also known as ‘heart in a box’.
5.1 What is ‘Heart in a Box’?
Now the recipient is not confined to getting donors from his or her state only. Now you may wonder, what about the golden period? Yes, earlier such donated organs could only be transported in an ice cooler which had a golden period of four hours.
But this innovative technology has increased the golden window in which the heart is in good condition and beating outside the donor’s body for up to twelve hours. This lets the donated organ be moved to great distances, That means, now the recipient can get donors from outside their state too.
In the ‘heart in a box’, the donor’s heart is kept beating by flowing warm blood and nutrients into the heart. They can even inject anti-rejecting drugs into the heart so that the possibility of the new heart being rejected by the recipient’s body is low.
6. Risks Involved after the Heart Transplant
When you get done with the whole heart transplant surgery, you are asked to stay in the hospital for two to four weeks under observation. To ensure that your transplanted heart is healthy and compatible with your system. Now there is a still risk for your body to start rejecting the newly transplanted heart. If the immune system identifies your new heart as a foreign object.
By default, our immune system is designed in such a way that it fights a foreign object as it considers it a disease-causing microorganism. This rejection may not show any physical symptoms, so you need to visit your doctor for the first year after your transplant for regular heart biopsies.
7. How Long Does a Heart Transplant Last?
Now if everything goes smoothly, without any problems in the surgery and the years after it, then a healthy heart transplant can last up to 11 to 14 years. But it really depends on the health of the patient. You need to take good care of your body, take the prescribed without skipping any days and visit your doctors on a regular basis.
The first few years of what the patient does are very important for the longer survival of the transplanted heart. The longest-surviving heart transplant patient ever to be recorded is Harold Sokyrka, a Canadian who had his heart transplant in his early 30s and went to live for 34 years more.
8. How to Keep Your Transplanted Heart Healthy?
After your body accepts your new heart, you need to make a few changes for its better functionality. For starters, you need to change your diet and avoid foods that contain high salt and are raw like oysters, sushi, undercooked eggs, or raw meat. You need to avoid eating all such foods, in order to control your blood pressure and sugar levels.
You should try replacing your regular diet with healthy fruits and vegetables. This will strengthen your body and muscles. Then you need to modify your lifestyle.
No matter what happens, you cannot smoke a cigarette after a heart transplant. As it can again increase your risk of having a stroke or even lung problems. As a result, it can cause irreversible damage to your organs, especially to your heart.
You also need to perform exercises regularly to prevent the formation of blood clots in your arteries. Start this practice in the first few weeks after your surgery. After a couple of weeks, you will feel the urge to exercise more. By staying active, you can also maintain a healthy weight. As too much weight on your body can cause a strain on your heart and blood vessels.
Every patient needs to know about the ways they can maintain a healthy heart even after their surgery.
Following those ways can help them to increase their heart’s longevity. Even now new studies are being conducted by researchers to understand how the risks involved in this surgery can be minimized.
They are even trying to introduce robotic precision in heart surgery. So that they can reduce the number of patients dying from surgical complexations or the absence of highly experienced and skilled surgeons.
1. Can you live 20 years with a heart transplant?
Yes, you can live with a heart transplant for 20 years. But for that, you need to take a number of health precautions. After your surgery, you can’t smoke anymore, as it can pose a risk to your lungs. You can’t eat food that contains high salt or sugar and raw meat.
This reduces your chances of having high blood pressure and diabetes. Instead of risking your health, try replacing your diet with nutritious food and fruits. Then you need to aim at strengthening your body and muscles. For that, you need to perform specific light exercises, so that your body weight is also under control. As too much body weight can cause strain on your heart and blood vessels.
2. What is the average life expectancy of a heart transplant patient?
Researchers state that 9.16 years is the average life expectancy of a heart transplant patient. However, it is also said that the life expectancy of a heart transplant is largely based on the recipient’s age and medical condition.