Heart Transplant - When Should One Go For It?

A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't sufficiently improved.

While a heart transplant is a major operation, your chance of survival is good, with appropriate follow-up care.

When faced with a decision about having a heart transplant, know what to expect of the heart transplant process, the surgery itself, potential risks and follow-up care.

Why is it done?

Heart transplants are performed when other treatments for heart problems haven't worked, leading to heart failure. In adults, heart failure can be caused by several conditions, including:

1. A weakening of the heart muscle (cardiomyopathy)
2. Coronary artery disease
3. Heart valve disease
4. A heart problem you're born with (congenital heart defect)
5. Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
6. Amyloidosis
7. Failure of a previous heart transplant
8. In children, heart failure is most often caused by either a congenital heart defect or a cardiomyopathy.

Another organ transplant may be performed at the same time as a heart transplant (multiorgan transplant) in people with certain conditions at select medical centers. Multiorgan transplants include:

1. Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure.
2. Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions.
3. Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases, if the conditions aren't able to be treated by only a heart transplant or lung transplant.

Factors that may affect your eligibility for a heart transplant:

A heart transplant isn't the right treatment for everyone. Certain factors may mean you're not a good candidate for a heart transplant. While each case is considered individually by a transplant center, a heart transplant may not be appropriate if you:

1. Are an advanced age that would interfere with the ability to recover from transplant surgery
2. Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
3. Have an active infection
4. Have a recent personal medical history of cancer
5. Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking

What happens after the transplant?

Most people leave hospital within about four weeks of the operation, but depending on your condition, you may need to stay in hospital for longer.

In the first few months after your surgery you will need to spend a lot of time visiting the hospital – you might even need to stay near the transplant centre. Your transplant team will talk to you about practical arrangements for after your surgery.

Although you will be weak after the operation, recovery can be very quick. It is important to build up your level of activity gradually. You should avoid activities involving lifting and pushing until your breastbone is fully healed, which can take up to three or four months.

Once you feel fit and able, you can start doing things like light vacuuming or light gardening.