"Straight from the heart.....about the heart....by a heart surgeon"

Heart transplantation is done in patients with end-stage heart failure for whom there are no other treatment options available.

Due to the advanced stage of the disease, all available medicines have been used in maximal doses and yet the patient is still severely symptomatic. Nothing more can be done either by the cardiologist in the catheter lab or by the surgeon in the operating room.

The donor is a person who is brain dead but has a normal heart. A detailed study of all parameters in the donor is done by the transplant team to ensure a good heart is in place to give the recipient an excellent long term survival with a good quality of life.

Time is at a constraint since from when the donor heart is stopped, removed, packed, transported and sewn in the recipient, only four hours are available. A excellent synchronization is ensured by the heart transplant team at both the donor and the recipient sites, to obtain a good result.

Since our body rejects anything foreign to it, the body's defense system (immunity) needs to be suppressed (using medicines called immunosuppressants), to ensure acceptance of the heart from another person. 

Immunosuppression decreases the recipient's defenses against infections and some cancers. It requires careful meticulous monitoring of drug levels, blood parameter values, kidney function,etc.

Small pieces of heart tissues are done by a procedure called endomyocardial biopsy (EMBx) at planned time intervals to ensure well being of the implanted heart.

Given the very complex nature of this whole process, the heart transplant team compromises of well trained surgeons, cardiologists, immunologists, pathologists, microbiologists and infectious disease experts. 

The recipient stays in the hospital for two to three weeks and is then gradually phased into every day life with regular follow up in the transplant out patient clinic. 24/7 availability of the transplant team is paramount to the sucess of this operation.

The cost of a heart transplantation varies at various centers but is usually in the range of 15 - 20  lakhs. The transplant team financial counselor and social worker will advise you before the procedure about the expected approximate cost so that you can plan your finances accordingly.

Heart transplantation has been successfully performed with excellent results since 1983 when landmark advances were made in the field of immunosuppression. Today with vastly improved surgical techniques and peri-operative care, structured long-term care protocols, newer insights into immunosurveillance and immunosuppression, an excellent 10 yr result are seen.

 

There are two operative techniques in heart transplantation - bicaval and biatrial.

Bicaval technique is followed universally nowadays.                 

                          

                                  Nitric oxide                                           ECMO

                   

                 Immunosurveillance

                

             

 

          

     Noble gift   

       A donor card