The Heart
Transplant Procedure
Basic guidelines to the heart
transplant procedure including before and after the transplant. (Information
sauce thanks to THE BRITISH HEART
FOUNDATION)
What sort of People need a Heart transplant?
Most Heart Transplants are
carried out on people with severe heart failure. The cause of heart failure is
usually coronary heart disease, or cardiomyopathy
(A disease of the heart muscle).
However not everyone who has severe heart failure is
suitable for a transplant and the number of transplants is limited by the lack
of available donors.
In a small number of cases, transplants are carried out on
people who have abnormalities of the heart valves or congenital (Problems at
birth) abnormalities of the heart.
I Need a Transplant… what next?
If you are referred for a
heart transplant you will need to have a transplant assessment. This involves
a range of tests and assessments to make sure that a transplant is the best
option for you.
You will probably need to go into hospital for about three
to five days to have the assessment.
Some of the tests that are carried out are:
Blood tests.
Urine tests
Tests to find out how well your lungs are working
Tests on your heart –
catheterization, stress tests,
thallium tests and a biopsy.
The transplant assessment also gives you and your family the
chance to meet the members of the transplant team, and to ask any questions.
The team
includes the surgeon, specialist transplant nurses, physiotherapists and
psychologists.
You may also
get the chance to speak to others such as myself who have had a transplant.
The Results of the Assessment
After your assessment the
doctors at your medical centre will decide whether you will need a transplant
and whether you are suitable for this form a treatment. They may decide on one
of the following:
1.
That you should go on the active transplant waiting list – this means
you may be called for a transplant at any time.
2.That you are acceptable
for a transplant but that you do not have severe heart failure – This means
you will be put on a provisional waiting list and will only have a transplant
if your condition gets worse.
3.That you need further
investigation or treatment before a decision is made.
4. That you
should be referred to another centre for a second opinion. – This doesn’t
often happen as most transplant centres in the U.K. have very similar
conditions for accepting patients for a heart transplant.
Waiting for a Heart Transplant.
Once you are on the
waiting list, the right heart might come along in a few days, months or years.
Unfortunately, suitable hearts do not become available in time for everyone
who is on the waiting list.
When you are on the waiting list it is important that you
can be contacted at short notice. Your transplant centre may supply you with a
bleeper or radio bleeper.
The doctor who referred you to the transplant centre will be
responsible for your care during this waiting time. If your condition changes
or if you need to start a new treatment, your doctor will tell the transplant
team.
If your condition changes you may need to have another
assessment to make sure that you are still suitable for a transplant. Some
people may have to be taken off the waiting list either temporarily (For
example, why they are having treatment.) or permanently; if this happens your
doctors will explain why and work out a follow up plan for you.
Receiving the Call
Your
transplant centre will contact you when they find a donor heart, which they
think, is suitable.
They will check that you have no new medical problems and
will ask you to go to the centre.
It is important to remember the following:
1.
Do not eat or drink anything from the time you get the call from the
transplant centre.
2.
Bring all your current medications with you.
3.
Bring a bag with essential items for a hospital stay.
When you are admitted to
your hospital you will be assessed quickly. Some of the tests you may have had
before will be done again.
All the usual preparations
for major surgery will be carried out, including shaving your chest if
necessary and bathing.
What happens after the operation?
After the operation you
will be moved to the intensive care unit, just as you would be after routine
heart surgery.
You will have wound along your breastbone, as the surgeon
has to cut into the breastbone to get access to your chest.
You will have
chest drains – tubes – which have been inserted into the chest area to
drain fluid from your chest. Other tubes will be attached to veins in your
arms and neck, to pass fluid and blood into your circulation. You will be
sedated and continue breathing with the help of a ventilator machine for at
least several hours until your condition is stable and you are able to breathe
for yourself.
Many patients wake the following morning – others take a
little longer. If all is well you will be moved out of the intensive care unit
as soon as you are in a stable condition. You may be moved to a
high-dependency ward or step-down ward.
Some transplant patients are nursed in special areas but
often these will be on the same wards as other patients who have had routine
surgery on the heart and chest.
It is usual for transplant patients to be kept in a separate
room or bay and for a number of visitors to be restricted. Your visitors will
only be asked to wear gloves, masks, and gowns if there is a particularly high
risk of infection.
What medication will I need to take after the
transplant?
All transplant recipients
will need to hold the up most commitment to making sure there heart remains
healthy.
All transplant
recipients will take medication for the rest of their lives.
All patients
will be asked to take immunosuppressants – medication that reduces the
body’s immune system and protecting the transplanted organ from rejection,
other medication may also be given.