Amazing Heart Transplant
Heart Transplant Making History
This month a heart from a deceased donor was actually revived after that patient’s death. The surgeons used an artificial circulatory mechanism and were able to get the heart beating.
The Duke University surgeons then transplanted the heart into a military veteran on the transplant list. The surgeons were able to revive the donor’s heart before surgically implanting it into the patient. In the past heart donations came have come from a live patient that may be brain dead or not able to recover from an illness or accident.
An average of 3,500 heart transplants are performed worldwide every year and about one half are performed in the US. About 200 heart and heart-lung transplants are performed in the UK due to severe heart failure.
History of Heart Transplants
In the late 1960’s, the first heart transplant was performed on a chimpanzee by Keith Reemtsma, MD. Tulane University then revolutionized organ transplantation, which helped people with organ failure around the world.
South African cardiac surgeon, Dr. Christian Barnard, performed the first human to human heart transplant in 1967. The surgeon used the techniques that had been developed by American surgeons, Norman Sumway and Richard Lower. Unfortunately, the patient died 18 days after the transplant.
The first pediatric transplant was performed in 1967, as well. Dr. Adrain Kantrowitz performed the surgery at Maimonides Hospital in Brooklyn, New York. Again, the child’s heart stopped beating after 7 hours.
On January 6, 1968, Dr. Norman Shumway and Dr. Donald Ross performed a heart transplant at Stanford University Hospital with success. For about a decade, Stanford University Hospital stood alone as they were the only hospital pioneering this operation. They withstood the controversy over the economic and legal issues. However, in 1968, there were 100 heart transplants performed by various doctors worldwide, but only one third of them lived longer than 3 months.
Brain death has been the only allowed ethical standard for a heart donation. The recent donation of the heart that was not beating came was the first adult DCD, which stands for donation after circulatory death in the USA. The new technique used for this heart used warm perfusion, which circulates the blood, oxygen and electrolytes through the heart. This technique was first used in 2015, in the U.K. at Royal Papworth Hospital.
Medical Criteria for a Heart Transplant
If a patient is suitable for transplant they will be put on the transplant list. If a patient is potentially suitable they are reevaluated on a regular basis. The donor heart must be the correct size, it must match the patient’s blood and tissue type. A heart should be transplanted within 4 hours, so the patient has to be available with little notice.
When all other treatments for heart problems has failed and has heart failure the patient is eligible for the transplant list. Children who have a congenital heart defect or cardiomyopathy are candidates for a heart transplant.
For adults heart transplants occur for the following reasons:
- Coronary artery disease
- Heart valve disease
- Severely weakened heart muscle (cardiomyopathy)
- Recurrent and dangerous heart arrhythmias (especially ventricular arrhythmias)
- Failure of a previous heart transplant
Multi-organ transplants are performed when necessary in select hospitals in addition to a heart transplant, and they include:
- Heart and liver transplant
- Heart and kidney transplant
- Heart and lung transplant (rarely done)
A heart transplant is not done on someone of advanced age, when they have another medical condition that can shorten their life, when they have an active infection or a recent history of cancer. Also, if they are unwilling to make the necessary lifestyle changes to keep their donor heart healthy, such as quitting smoking or drinking alcohol as your body might reject the donor heart they are not eligible.
Experience a Heart Transplant in 360°
Problems Causing Rejection or Failure of Donor Heart
Rejection of the donor heart is the most serious factor. Immunosuppressants taken to prevent rejection can sometimes cause kidney damage.
Other potential problems include:
- Primary graft failure - most frequent cause of death in the first few months following the transplant
- Artery problems - the walls of the arteries in the heart may thicken and harden, which may make the circulation of blood through the heart compromised, which may cause a heart attack, heart arrhythmias, heart failure or sudden cardiac death
- The immunosuppressants may cause an increased risk for developing cancer (non-Hodgkin’s lymphoma), and there is an increased risk of skin and lip tumors
- Immunosuppressants also decrease the body’s ability to fight infections.
The patient is monitored for signs of symptoms of rejection. It is imperative that the transplant team is notified for rejection signs, which include new shortness of breath,fatigue, fever, less amount of urine or weight gain.
The intra-aortic balloon pump was successfully used starting in the 1970s. This is a machine that takes over some of the work of the heart while someone is waiting for the right donor heart match. Dr. Ross has headed the research for immunosuppressant medications and mechanical assist devices. His program performs 100 heart transplant surgeries annually.
Pediatric Heart Transplant at Seattle Children's
Heart Transplant Survival Rates
Survival rates are based on numerous factors. The U.S. rate is 88% initially but after 5 years it drops to 75%. Most transplant patients are able to return to work and a fairly normal life. Physical activity should be a part of life as well. Managing medications, therapy and a life-long plan of care if vital for a full life.
- https://www.mayoclinic.org › heart-transplant › about › pac-20384750
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Pamela Oglesby