Our Summary

The first human heart transplant was performed by Christian Barnard in 1967. Initially, the biggest challenge in heart transplants was the body rejecting the new organ. However, the discovery of a drug called cyclosporine significantly improved the success of heart transplants. Nowadays, heart transplants are a beneficial treatment for people with very severe heart failure, with the average patient living over 12 years after the surgery.

Despite these advancements, there are still limitations to heart transplants. There are not enough donor hearts available for all the patients who need them. Additionally, sometimes the new heart doesn’t function properly, or the body rejects it. Patients can also experience long-term health issues not related to the heart after the transplant.

This research paper reviews the most recent information about heart transplants. It looks at the new system for allocating donor hearts, efforts to increase the number of available donor hearts, issues related to the new heart not functioning properly, the body’s rejection of the new heart, blood vessel issues in the new heart, and post-transplant cancer and kidney issues.

FAQs

  1. Who performed the first human heart transplantation?
  2. What are the limitations of heart transplantation?
  3. What revolutionized the field of heart transplantation?

Doctor’s Tip

A doctor might tell a patient undergoing a heart transplant to adhere to a strict medication regimen to prevent rejection, attend regular follow-up appointments, maintain a healthy lifestyle with regular exercise and a balanced diet, and seek immediate medical attention if experiencing any concerning symptoms such as chest pain, shortness of breath, or swelling. It is also important for the patient to communicate openly with their healthcare team about any concerns or changes in their health.

Suitable For

Patients with end-stage heart failure who have exhausted all other medical and surgical options are typically recommended for heart transplant. These patients must meet certain criteria, including being younger than 70 years old, having a life expectancy of less than 1 year without a transplant, and being physically and psychologically able to undergo the surgery and post-transplant care. Patients with severe heart failure symptoms, such as shortness of breath, fatigue, and fluid retention, despite optimal medical therapy, are also considered for heart transplant. Additionally, patients with certain types of heart disease, such as dilated cardiomyopathy, ischemic cardiomyopathy, or restrictive cardiomyopathy, may be candidates for heart transplant. Ultimately, the decision to recommend a heart transplant is made on a case-by-case basis by a team of cardiologists, surgeons, and other healthcare providers.

Timeline

Before heart transplant:

  • Patient is diagnosed with end-stage heart failure and is referred to a transplant center
  • Patient undergoes extensive evaluation to determine eligibility for transplant, including medical, psychological, and financial assessments
  • Patient is placed on the transplant waiting list and waits for a suitable donor heart
  • Patient may experience worsening symptoms and complications of heart failure while waiting for a transplant
  • Patient receives notification of a potential donor match and undergoes surgery for heart transplant

After heart transplant:

  • Patient undergoes post-operative care in the hospital, including monitoring for complications such as rejection and infection
  • Patient begins long-term immunosuppressive therapy to prevent rejection of the donor heart
  • Patient undergoes regular follow-up appointments and monitoring to assess the function of the transplanted heart
  • Patient may experience complications such as graft dysfunction, rejection, cardiac allograft vasculopathy, and post-transplant malignancies
  • Patient may need to make lifestyle changes, such as adhering to a strict medication regimen and following a healthy diet and exercise plan
  • Patient may experience improvements in symptoms and quality of life, with a median survival over 12 years post-transplant.

What to Ask Your Doctor

  1. What is the success rate of heart transplant surgery?
  2. How long is the typical recovery time after a heart transplant?
  3. What are the potential risks and complications associated with a heart transplant?
  4. How will I need to adjust my lifestyle after receiving a heart transplant?
  5. What medications will I need to take after the transplant, and what are the potential side effects?
  6. How often will I need to follow up with my transplant team after the surgery?
  7. What signs or symptoms should I watch for that may indicate rejection or other complications?
  8. How will I be monitored for signs of rejection or complications post-transplant?
  9. Are there any dietary restrictions I need to follow after a heart transplant?
  10. What support services are available to me as a heart transplant patient?

Reference

Authors: Awad MA, Shah A, Griffith BP. Journal: Rev Cardiovasc Med. 2022 Jan 11;23(1):11. doi: 10.31083/j.rcm2301011. PMID: 35092203