Our Summary

This paper is a historical look at the important milestones in the development of heart transplantation. It started with Alexis Carrel’s early work on connecting blood vessels and preserving organs. Then, John Gibbon invented the heart-lung machine in 1953 which was a big step forward. James Hardy performed the first heart transplant from a chimpanzee to a human in 1964. The first human-to-human heart transplant was done by Christiaan Barnard in 1967, and Euryclides Zerbini brought this technique to Brazil the next year.

Two other major advancements were made by Richard Lower and Norman Shumway, who developed new methods of heart transplantation, and the use of a drug called cyclosporine in 1983 which greatly improved how organ rejection is managed.

In 1986, a program in Brazil called the Programa Nordeste de Transplante Cardíaco showed how to overcome challenges related to logistics and finances. The most recent achievement is the first successful transplant of a genetically modified pig heart into a human in 2022, which could help address the shortage of donor organs and improve transplant results. The story of heart transplantation is a testament to human creativity and determination in finding ways to save lives from severe heart disease.

FAQs

  1. Who are some of the key pioneers in the history of heart transplantation?
  2. How has the introduction of cyclosporine in 1983 impacted heart transplants?
  3. What is the significance of the first successful xenotransplantation using a genetically modified pig heart in 2022?

Doctor’s Tip

A doctor might tell a patient considering a heart transplant that while the procedure can offer a new lease on life, it is important to understand that it is a major surgery with potential risks and complications. Patients should be prepared for a lengthy recovery process and commit to following a strict post-transplant care plan, including taking immunosuppressant medications to prevent rejection of the new heart. It is crucial to work closely with your medical team, attend regular follow-up appointments, and make lifestyle changes to ensure the best possible outcome after a heart transplant.

Suitable For

Patients who are typically recommended for heart transplant are those with end-stage heart failure who have exhausted all other treatment options and are not responding well to medication or other interventions. These patients may have severe symptoms such as fatigue, shortness of breath, chest pain, and fluid retention, and may have a significantly reduced quality of life. Patients are evaluated based on their overall health, age, severity of heart failure, ability to tolerate surgery and post-transplant medications, and their willingness to adhere to a lifelong regimen of medications and follow-up care. Patients with certain coexisting medical conditions or significant organ dysfunction may not be considered suitable candidates for heart transplant.

Timeline

Before heart transplant:

  • Patient is diagnosed with end-stage heart disease
  • Patient undergoes extensive medical evaluation to determine eligibility for heart transplant
  • Patient is placed on the waiting list for a donor heart
  • Patient may experience worsening symptoms and decreased quality of life while waiting for a transplant

After heart transplant:

  • Patient undergoes heart transplant surgery, which typically lasts several hours
  • Patient is closely monitored in the intensive care unit post-surgery
  • Patient begins a lifelong regimen of immunosuppressant medications to prevent organ rejection
  • Patient undergoes regular follow-up appointments and monitoring to ensure the success of the transplant
  • Patient experiences improved quality of life and increased life expectancy following a successful heart transplant.

What to Ask Your Doctor

Some questions a patient should ask their doctor about heart transplant include:

  1. Am I a candidate for a heart transplant?
  2. What are the risks and potential complications associated with a heart transplant?
  3. How long is the recovery process after a heart transplant?
  4. What medications will I need to take after the transplant and what are the potential side effects?
  5. How often will I need to follow up with my transplant team after the surgery?
  6. How long can I expect a transplanted heart to last?
  7. What lifestyle changes will I need to make after a heart transplant?
  8. How will the cost of the transplant and follow-up care be covered?
  9. Are there any restrictions on activities or diet after a heart transplant?
  10. What are the signs of rejection or complications that I should watch out for after the transplant?

Reference

Authors: de R Carvalho Lima, de JT Mendonça, Wanderley J Neto, de MAS Escobar, Lobo JG Filho, de JRL Sales Cabral. Journal: Braz J Cardiovasc Surg. 2025 May 30;40(4):e2024128. doi: 10.21470/1678-9741-2024-0128. PMID: 40445149