side effects from the medications – that may lead to kidney damage or other problems
artery problems – that can lead to cardiac allograft vasculopathy that can make blood circulation through your heart difficult and can cause a heart attack, heart arrhythmias, heart failure or even cardiac arrest
infection – because immunosuppressants decrease your ability to fight off infection
cancer - because immunosuppressants can increase your risk of cancer
4 Preparing for your Procedure
In order to prepare for the procedure, your doctor will refer you to a heart transplant center for an evaluation first. Check with your insurance company is heart transplant is covered.
You can check the center how many had a successful heart transplant in that center. You can also check the additional services the center is offering.
When you are done checking with the center, they will evaluate you if you are a candidate for a transplant.
They will check if you:
will benefit from other less aggressive treatment options
have a heart condition that would benefit from transplantation
will agree to quit smoking
are healthy enough to undergo surgery and post-transplant treatments
can emotionally handle the wait for a donor's heart
have a support group or if your family and friends will help you cope
are willing to follow the medical program outlined by the transplant team
The center will put you on the waiting list if they determine that you are a right candidate. There are not enough hearts in the world for every person in need.
Some patients even die without receiving a heart transplant. Your team will monitor your heart and other organs.
If you develop a significant medical condition such as infection, they will remove your name from the list temporarily.
Your doctor may suggest that you have ventricular assist devices or VADs - a device implanted to support your heart while you wait for a donor organ – if medical therapy fails to support your vital organs.
The factors that will determine if there is a match is the donor-recipient match which includes:
blood type (A, B, AB or O)
the medical urgency of potential recipients
time spent on the waiting list
the size of the donor organ
antibodies the recipients might have developed
To remain usable, a heart transplant usually needs to occur within four hours of organ removal for the donor organ.
Some of the transplant centers will provide you a cell phone so they can contact you if there is a donor organ. You have to make a decision fast because the time is limited.
Some heart transplant centers provide private air transportation so plan ahead of your transplant.
5 What to Expect
Read on to learn more about what to expect before, during, and after your heart transplant procedure.
Heart transplant surgery can take up to four hours. To keep oxygen-rich blood flowing throughout your body, your surgeon will open your chest and connect you to a heart-lung machine.
The damaged heart will be removed then the donor heart will then be sewed. When blood flow is restored, the new heart often starts beating.
In some cases, an electric shock is needed to make the donor heart beat properly. Your doctor will give you medications because you will be in pain after the surgery.
He will also provide you with tubes to drain the fluids in your heart and lungs and ventilator so you can breathe properly. You will stay at the hospital for up to two weeks.
Your team will monitor you even after you leave the hospital for up to four months. You will undergo exams such as echocardiograms, blood work, heart biopsies, electrocardiograms, and lung function tests.
The long-term adjustments that you need to take include:
Drinking immunosuppressants – so that your new heart will not be attacked by your immune system. There will be side effects for some of the medications that you are going to take.
Your face may become round and full, develop acne or facial hair, experience stomach problems or may gain weight if you are taking corticosteroids.
You will also be given antiviral, antifungal and antibacterial medications because immunosuppressants make your body more vulnerable to infection.
The doses and number of anti-rejection drugs can be reduced over time as the risk of rejection is reduced.
Managing medications and therapies – you should keep a list of all the medications that you are going to take so you will not forget them.
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