Being told you need a heart transplant is almost enough to send you into cardiac arrest. Although, chances are, by the time you hear those fateful words you are sick enough and desperate enough to be open to anything that might prolong your life.
Once the shock wears off and the words slowly sink in you are bound to have a myriad of questions about heart transplantation procedure and what to expect afterwards. This article addresses those questions and will hopefully leave you with at least some idea of what is to come.
The first step towards heart transplantation is to be referred to a transplant center for evaluation. Though told by your doctor that a transplant is needed a transplant center will run tests, both physical and psychological, to see if you are a good candidate for a transplant. A spouse or close family member can also expect to be questioned to make certain he/she is willing and able to oversee your immediate recovery.
When all testing is completed and you are deemed a successful candidate for transplant, you will be placed on a waiting list for a donor heart. These lists can vary according to hospitals, states and countries. The wait can be for as little as days or as long as several years, depending on the severity of your condition and the availability of a matching organ.
You will receive all the information available concerning the procedure itself as well as what to expect afterward. You will most likely be told that a heart transplant is not a complete cure but rather an exchange of one problem for another. Yes, you will have a new heart that, hopefully, will give you many more years of quality life. However, you need to also understand that you will have to take anti-rejection medicine for the rest of your life, like clockwork. In fact, when you leave the hospital you will have approximately forty-odd pills to take every day. This amount will decrease somewhat the farther out from transplant you are, but you will have to be vigilant about taking them.
If a heart condition is severe and a person is admitted to the hospital until a doner heart is found an artificial heart pump may be used to help the failing heart function during the wait.
When a donor heart, exactly matching your criteria, is found you will be notified and told to come to the hospital immediately. If all goes well with the additional examination of the heart upon delivery at the hospital, you will be prepped and taken to the operating room. During the surgery your heart will be stopped and an artificial pump will take over until the new heart is attached and pumping blood on its own.
Without complications you can expect to be in the CCU for about a week. You will then be transferred to a regular room, usually on a floor exclusively for transplant patients. A mask covering your nose and mouth should be worn for the first month or two when you are out of your room and when you go home. This will prevent germs and bacteria from causing problems.
A heart biopsy will be done at frequent, regular intervals during the first month, most likely weekly. For these biopsies the doctor will numb an area in your neck or groin and insert a catheter with a small scissors. He will snip off a tiny particle of your new heart to be biopsied for rejection. This is the only way rejection can be detected early enough to halt. These biopsies will decrease in frequency over the months until they are done once a year. Other tests, such as stress tests and chest X-rays, may be done yearly also.
The three most important things you should know and pay attention to are:
1) When cutting out the old heart small nerves that are severed cannot be reattached. These are nerves that tell the brain when a body needs more oxygen upon standing, etc. Therefore, it is important to remember to stand slowly, not suddenly, and let the body adjust before moving. Otherwise lightheadedness or fainting could occur.
2) Secondly, as mentioned previously, your medicine, especially anti-rejection medicines, need to be taken regularly, as prescribed. You'll need to remember to always have enough, better still, extra, on hand and never leave home without it.
3) Lastly, and, unfortunately, the worst part about post-transplant life; these anti-rejection medicines are designed to keep the body's immune system in a greatly lowered level so that the new heart is not rejected. This, of course, leaves you wide open to any germs, bacteria or illness around you. While your new heart may have you feeling fit as a fiddle again, you need to be alert and conscious of your surroundings. Stay away from anyone who is ill, take your prescribed vitamins and refer to the instruction sheet until you know it by heart. It will advise on things such as not swimming in unchlorinated fresh water, avoiding certain animals, etc.
A heart transplant is a very serious procedure, but one that can give you a new lease on life. It helps if you know a little of what to expect beforehand and are committed to following the directions and advisories meant to keep you healthy and happy. If a transplant looms in your future don't panic. Be grateful that you live in an era of medical miracles.