Are you considering undergoing a heart transplant and you don’t know what happens before, during and after surgery? Then this article will help you answer those questions.
BEFORE THE SURGERY
A Heart transplant surgery is an open heart surgery that usually takes several hours, barring any complications. If you’ve previously undergone heart surgeries, then the surgery will be more knotty and complicated and will take longer. Before the surgery, you’ll receive medication that causes you to sleep (general anesthesia). You will be connected you to a heart-lung bypass machine to keep blood that is rich in oxygen flowing throughout your body.
Your surgeon then extracts the diseased heart and sews the donor heart into place. He or she will then attach the major blood vessels to the donor heart. The new heart often starts beating once flow of blood is restored and sometimes, an electric shock is needed to make the donor heart beat properly.
You’ll be given pain relief medication to help with pain after the surgery. You’ll also have a ventilator to help you breathe and tubes in your chest to drain fluids from around your lungs and heart. After surgery, you’ll also receive fluids and medications through intravenous (IV) tubes.
AFTER THE SURGERY
After you’ve had the surgery to place your donor heart, you’ll stay in the intensive care unit (ICU). Generally, you’ll be moved to a regular hospital room after a few days in the Intensive Care Unit and usually, you’ll remain in the hospital for at least a week or two. There may be a difference in the amount of time you’ll spend in the Intensive Care Unit and in the hospital.
After you leave the hospital, you’ll be closely monitored by your transplant team at your outpatient transplant center. Due to the regularity and intensity of the monitoring, many people stay close by the transplant center for the first three months. Afterward, the follow-up visits are less frequent, and it’s easier to travel back and forth for follow-up visits.
You’ll also be monitored for any signs or symptoms of rejection, such as shortness of breath, fever, fatigue, not urinating as much as you should or abnormal weight gain. It’s important to let your transplant team know if you notice any signs or symptoms of rejection or infection.
After your heart transplant, you’ll have several follow-up appointments at the transplant center. You’ll have routine tests and check-ups, including blood work, echocardiograms, electrocardiograms and heart biopsies.
To find out whether your body is rejecting the new heart, you’ll have regular heart biopsies in the first few months after heart transplantation, when rejection is most likely to occur. The regularity of necessary biopsies decreases as time goes on.
During a heart biopsy, a doctor inserts a tube into a vein in your neck or groin and directs it to your heart. A doctor runs a biopsy device through the tube to remove a tiny sample of heart tissue, which is then examined in a laboratory.
You’ll need to make several long-term adjustments after you’ve had your heart transplant. These include:
- Taking Immunosuppressants. These medications decrease the activity of your immune system and prevent it from attacking your donated heart and because your immune system will most likely never completely accept the new organ, you’ll have to take some of these medications for the rest of your life.Immunosuppressant medications may cause noticeable side effects. For example, when taking post-transplant drugs such as corticosteroids, your face may become round and full, and you may gain weight, develop acne or facial hair, or experience stomach problems. Some side effects of immunosuppressant drugs may be more noticeable when you first start the drugs, but their severity may decrease as time goes on.Because immunosuppressants decrease the activity of your immune system, your body becomes more open and vulnerable to infection, your doctor may also prescribe antibacterial, antiviral and antifungal medications.Some immunosuppressants could also worsen conditions — or raise your risk of developing conditions — such as high blood pressure, high cholesterol, cancer, osteoporosis or diabetes.Over time as your body reduces the risk of rejection, the doses and number of anti-rejection drugs can also be reduced, but you’ll need some immunosuppressant medications indefinitely.
- Managing medications, Therapies and a Lifelong Care Plan: After a heart transplant, taking all your medications as your doctor instructs and following a lifelong care plan is important.Your doctor may give you specific instructions regarding lifestyle guidelines, such as wearing sunscreen, not using tobacco products, exercising, eating a healthy diet and being careful to lower your risk of infection in daily life.Follow all of your doctor’s instructions, see your doctor regularly for follow-up appointments, and let your doctor know if you have any signs or symptoms of complications.It’s a good idea to set up a daily routine for taking your medications so that you won’t forget. Keep a list of all your medications with you at all times in case you need emergency medical attention, and tell all your doctors what you take each time you’re prescribed a new medicine.
- Cardiac Rehabilitation. Cardiac rehabilitation programs embodies exercise and education to help you improve your health and recover after a heart transplant. Staff members trained in cardiac rehabilitation may help you adjust to healthy lifestyle changes — such as regular exercise and a heart-healthy diet — after your transplant. Your transplant team may also suggest that you begin a cardiac rehabilitation program before your transplant to improve your health.
- Emotional Support. Your new medical therapies and the stress of having a heart transplant may make you feel overwhelmed. Many people who have had a heart transplant feel this way.Talk to your doctor if you’re feeling stressed or overwhelmed. Transplant centers often have support groups and other resources to help you manage your condition.
THE OUTCOME OF THE SURGERY
Most people who undergo a heart transplant surgery enjoy a high quality of life. Depending on your condition, you may be able to return to many of your daily life activities, such as returning to work, participating in hobbies and sports, and exercise. Ensure you talk to your doctor about what activities are appropriate for you.
Some women who have had a heart transplant can become pregnant. Make sure you talk to your doctor if you’re considering having children after your transplant. You’ll likely need your medication to be adjusted before becoming pregnant, as some medications can lead to complications during pregnancy.
The survival rate of recipients of heart transplant differ based on a number of factors. Factors like the regimentation of your immunosuppresants exercise, therapy, etc.
WHAT IF YOUR NEW HEART FAILS?
It is a known fact that heart transplants aren’t successful for everyone. Your new heart may fail because of organ rejection or because of the development of heart valve disease or coronary artery disease. Should this happen, your doctor may recommend that your medications should be adjusted or in more severe cases, another heart transplant.
In some cases, additional treatment options are limited, and you may choose to stop treatment. Discuss with your heart transplant team, doctor and family to address your general expectations and preferences for treatment, emergency care and end-of-life care.