Heart Transplant: Indications and Complications

The surgery for a diseased heart to be removed and replaced with a healthy one is called a heart transplant. It is performed by a heart surgeon and is considered a major surgery. Most heart transplants are done on patients with severe heart problems or who are in the end stages of heart disease. A heart transplant is considered a lifesaving procedure, but because donor hearts are in short supply, heart transplants are only performed on people who absolutely need them.

Indications for Heart Transplant

Before a person can be referred for a transplant, doctors look for certain indicators that help them decide if a transplant is necessary. Some of those indicators may help doctors diagnose the exact issues with the heart. Some common indications include:

• Patients who are receiving therapy for exertion
• Patients who require frequent admission to hospital
• Patients with poor renal function
• Patients with worsening right ventricular function
• Patients with rising pulmonary artery pressure
• Patients with rising natriuretic peptide levels
• Patients in late stages of heart failure

Heart Transplant Candidacy

There are over 3,000 people on the waiting list for a heart transplant. About 2,000 heart transplants are performed each year. While heart transplants are meant for patients who have severe heart disease, there are other people who are candidates for the procedure. Some candidacy requirements include:

• Congenital defects
• Coronary artery disease
• Valve dysfunction
• Cardiomyopathy

There are also conditions that make it less likely that a heart transplant will be effective, and can prevent a person from receiving one. Those things include:

• Age
• Circulation problems
• History of cancer
• Inability to follow lifelong care program
• Pulmonary hypertension
• Active infections
• Diabetes
• Organ damage
• Kidney disease
• Lung disease

Patients who are eligible to receive a heart transplant are put on a waiting list until a donor is available. Some people are on the waiting list for just a few weeks while others stay on it for years. If a person becomes ill or suffers a health issue that causes them to be ineligible for the procedure, they will be removed from the list.

Medications after Heart Transplant

Patients may be prescribed medications before and after the heart transplant. Most medications are used to prevent rejection and infections.

• Antibiotics
• Basiliximab
• Methylprednisolone
• Cyclosporine
• Tacrolimus
• MMF
• Steroids
• Pain medications

Complications of Heart Transplant

It is not uncommon for heart transplant recipients to experience complications after surgery. Some complications are not serious and can be dealt with quickly. Others such as transplant rejection can be life-threatening and lead to more surgeries and procedures. Signs of rejection include:

• Shortness of breath
• Fever due to Infection
• Weight gain due to medication side affects
• Kidney injury
• Failure of Transplant

Prognosis of Heart Transplant

A heart transplant can save a person’s life and greatly improve their quality of life. Recipients must take good care of their new hearts and follow their doctor’s orders to ensure that the new heart stays healthy. The survival rates of people who have heart transplants can vary based on their overall health and willingness to follow a care plan. 88 percent of the patients live through the first year after the transplant surgery, 75 percent for five years, and about 56 percent for 10 years.