Cardiac transplantation, also known as heart transplantation, has emerged as the best treatment choice for many patients with severe heart failure & also for patients who have serious cardiac symptoms despite maximum medical therapy. Survival among heart transplant recipients has increased as a result of improvements in advanced treatments that suppress the immune system of patients & prevent infection. Sadly, the figure of heart donors has reached a plateau in spite of an increasing number of heart recipients. More than 4500 heart transplants occur every year across the world, although it is predicted that up to 46,000 patients are potential candidates for cardiac transplantation. This severe heart shortage signifies that cardiac surgeons must strictly examine who should receive a cardiac transplant. However, benefits associated with heart transplant surgery are enormous. Heart transplant surgery can save valuable lives of a majority of patients suffering from fatal cardiac conditions.
What is Heart Transplantation?
Heart transplantation is a surgical procedure performed on patients with end-stage heart failure of severe coronary disorders by replacing the defective heart with a healthy heart through an allograft (deceased donors). This is the last resort to restore normal coronary functions in patients after all other non-surgical & alternate procedures have proved unsuccessful. Heart transplant is a major type of surgery & is either performed as an orthotopic procedure (removal of defective heart) or as a heterotopic procedure (retaining partially defective heart as well) in cases where the defective heart still retains certain coronary functions.
Heart transplant is needed by patients when their hearts are no longer working effectively & which in turn puts their life at potential risk. Heart transplant is commonly recommended for the following patients.
Heart transplant is basically needed when a person is suffering from severe coronary heart disorders & which have failed to respond to other conventional non-surgical & surgical procedures. Patients need to undergo cardiac transplant when the risk of heart failure gets extremely high. Adults require a heart transplant under following severe conditions.
- Heart Failure - Patients who have serious heart failure in which the heart is unable to pump blood adequately to different parts of the body.
- Risk of Death - Patients who are at risk of dying within a year without a heart transplant.
- Unsuccessful Treatments - Patients who have not experienced relief from other conventional forms of heart treatments.
- Coronary Birth Defects - Heart transplant is sometimes also needed in younger children & infants with congenital heart defects (coronary birth defects).
Children mostly require a heart transplant when they suffer from either weakened heart muscles (cardiomyopathy) or congenital (birth) heart disorders.
Following tests may be needed to diagnose patient’s heart conditions & determining if they are eligible for heart transplant. Besides blood tests & x-ray, various tests to diagnose the severity of heart disease can include the following.
- Coronary Diseases - Patients may need a cardiac transplant when their coronary heart diseases are persistent.
- Cardiomyopathy - When condition of cardiomyopathy or the weakening of heart muscles is seen; in such cases patients may require a heart transplant.
- Valvular Heart Disease - When a serious valvular heart disease is observed in patients.
- Birth Defects - When congenital heart defects get worse, cardiac surgeons may suggest heart transplant surgery.
- Unsuccessful Heart Transplant - When previous heart transplant is unsuccessful, additional heart transplant surgery may be required.
Not everyone is a suitable candidate for heart transplant surgery. As a broad range of information is required to know if a patient is eligible for heart transplant, cardiologists & their team will precisely review evaluation. Heart transplant evaluation tests will include the following.
- Electrocardiogram (ECG) - This test involves recording of electrical signals of patient’s heart & it can be helpful in deciding the condition of the patient’s heart.
- Echocardiogram - This is a non-invasive test, which basically includes an ultrasound evaluation of patient’s chest. It shows detailed images of patient’s internal structure.
- Cardiac Computerized Tomography (CT) Scan -This test is mostly used to diagnose for dreadful heart problems. During this test, patients lie on a table inside a machine in which an x-ray tube collects precise images of patient’s chest & heart.
- Cardiac Magnetic Resonance Imaging (MRI) - During this test, patients lie on a table inside a large tube-like device/machine that generates a magnetic field. This magnetic field creates images to help surgeons evaluate condition of patient’s heart.
Cardiac surgeons will consider all information of patients including their health history, findings from physical examination & diagnostic test results while deciding eligibility for heart transplant surgery. Following things will need to be done before heart transplant surgery.
- Blood Tests - Patients will be required to undergo blood tests to help them find an appropriate donor match & help increase chances that the heart of the donor will not be rejected.
- Diagnostic Tests - Patients will need various important tests to examine their lungs as well as their overall health condition. These tests generally include ultrasound, x-rays, CT scan, dental exams & pulmonary function tests. Women may get a gynecology evaluation, Pap test & mammogram to be done.
- Psychological & Social Evaluation - Several psychological & social problems that are involved in heart transplant comprise high stress, financial problems & support from family or friends. These are some of the significant factors that can greatly affect patients following their heart transplant surgery.
- Other Preparations - Patients will get certain vaccines to minimize risks of developing harmful infections that can affect the transplanted heart.
- Cardiac surgeons will explain the whole procedure to patients & let them ask questions as well.
- Patients will be told to sign a consent form that gives permission to doctors to perform heart transplant surgery. Read the form carefully and ask questions if anything is unclear.
- Patients should not drink or eat anything as soon as they have been asked to do so by their cardiac surgeons.
- Patients may be given specific medicines to help them relax (sedative).
Heart transplant surgery needs an open heart surgery & a long stay in hospital as well. Procedures may vary depending upon patient’s condition & surgeon’s experience. Usually, heart transplant surgery maintains the following process.
- What is heart transplant surgery?
- What symptoms make me eligible for heart transplant surgery?
- What tests are important to determine if I am a good candidate for heart transplant surgery?
- Can you elaborate benefits of undergoing a heart transplant?
- What are the major risks & potential complications of undergoing heart transplant?
- How long will I need to stay in hospital after my heart transplant surgery?
- When can I get back to normal routine?
- How much time will it take for complete recovery?
- Will I be able to lead a normal life post-surgery?
- Do I have to follow a special diet after my operation?
After heart transplant procedure, surgeons might suggest at least 1 - 2 weeks of hospital stay to monitor patients for signs of any complications that may arise following heart transplant surgery. Cardiologists will perform regular tests such as blood tests, echocardiograms, lung function tests, electrocardiograms & heart biopsies (if needed) to check for possible complications. It may take a few months for patients to recover from effects of a heart transplant & will require regular check-up regimen to be followed with the cardiologist at the transplant center. Heart transplant will necessitate patients to quit smoking & abstain from alcohol consumption if they are in the habit of consuming. Following are few adjustments patients will need to make following heart transplant procedure in order to make it successful.
- Anesthesia - Heart transplant surgery will be performed while patients are in deep sleep under influence of general anesthesia. Anesthesiologists will watch the blood pressure, heart rate & oxygen level of patients during surgery.
- Incision - Skin over patient’s chest will be properly cleaned with an antiseptic solution. The cardiac surgeon will make an incision down the center of their chest. They will then cut the patient’s breastbone into half in order to reach the patient’s heart.
- Heart-Lung Machine - Cardiac surgeons will put tubes into the chest of patients, so that, normal blood can be pumped through the body by a heart-lung machine or cardiopulmonary bypass while the heart is stopped & transplanted.
- Closing Incision - At the end of the procedure, surgeons will sew the donor heart into proper place. Once the new heart is in a proper position, cardiac surgeons will connect blood vessels appropriately so there are no leaks. Subsequently, cardiac surgeons will give a shock to restart the patient’s heartbeat. Finally, surgeons will use surgical staples or sutures to close the incision. A sterile dressing or bandage will also be applied.
As with any other surgery, certain complications may also occur with heart transplants. Potential complications of heart transplant may include the following.
- Immunosuppressant Medications - When a foreign body is introduced into patient’s body the immune system automatically detects it as such & tries to reject it. This may also occur for the transplanted heart as it comes from a donor. Immunosuppressants are medications that prevent suppression from the body’s immune system from attacking the newly transplanted heart. These medicines may have certain significant side effects. When taken with post-transplant corticosteroids, patients may experience an overall swelling in the face as well as weight gain. Patients may also develop acne & facial hair in some cases due to these immunosuppressant medications. Most of these side effects are prominent in the beginning but gradually decrease in severity later on. These immunosuppressants also basically decrease the immune ability of the body & therefore doctors will also prescribe antibiotics to fight against infections.
- Managing Therapies & Medications - It is important to follow each & every instruction given by the doctor regarding medications & therapies after heart transplant for it to gain maximum success.
- Cardiac Rehabilitation - Doctors will suggest a few changes regarding the patient’s diet & exercise after heart transplant procedure & cardiac rehabilitation programs are most effective in helping them regain strength & health as well as improve their quality of life.
Patient’s immune system may reject the newly transplanted heart. Rejection is normal body's reaction to a foreign tissue or organ. When patients get a new heart, their immune system reacts to what it sees as a threat & attacks the new heart. To allow the transplanted heart to survive within body, patients will need to take certain medications. Due to these medications repeated infection may occur & which does not get cured with treatment. Other problems with taking these medications for long-term, may include the following side-effects.
- Bleeding during or after surgery
- Breathing problems
- Blood clots that can cause stroke or heart attack
- Kidney failure
- Failure of the donor’s heart
There may be some other risks depending upon the patient’s health. Patients should, therefore, make sure to discuss any doubts & concerns with their cardiac surgeons before undergoing heart transplant surgery.
Most patients who undergo a heart transplant surgery enjoy a high quality of life. Depending upon their overall health condition, they may be able to return to most daily routine activities, such as exercises, participating in hobbies & sports & returning to work. Patients should frankly discuss with doctors as to what activities are suitable for them. If a female candidate who has had a heart transplant becomes pregnant, she should discuss with her doctor if she should consider having children after heart transplant surgery. Heart transplant recipient survival ratio may vary based upon a number of factors. Recent reports have stated that overall survival rate of patients after heart transplant in the world is about 85 percent after one year & about 70 percent after five years.
- Poor blood circulation in the brain & whole body
- Severe health problems
- Metastatic cancers
Benefits of Medical Tourism in India for Heart Transplant Surgery
India is a prime medical tourism destination in the entire world. Top-notch cardiac surgeons & multi-speciality hospitals providing hi-class cardiac surgeries, such as heart transplant surgery make India a preferable medical tourism destination for international patients. Many cardiac surgeons in India are globally renowned & in fact initially trained & practiced for decades in advanced western countries including the UK, Canada & United States before returning to their homeland.
Affordable Heart Transplant Surgery with Travcure Medical Tourism
Travcure Medical Tourism is one of the top-most medical tourism consultant companies with a wide range of services to offer. Travcure is well connected to a vast network of cardio-specialist hospitals & clinics in all major cities of India such as Delhi, Mumbai, Chennai, & Bangalore that boast of the most modern & latest medical technologies as well as have the most experienced & extensively trained cardiac specialist doctors & surgeons. Travcure provides the best heart transplant surgery & other global quality services to their international patients at moderate costs.