Heart Transplantation

How the Heart Works

Source www.transplantliving.org

The heart is a strong and muscular organ that is about the size of a fist in adults. It pumps blood throughout the body and is located behind the breastbone between the lungs. Deoxygenated blood flows from the heart to the lungs where it gives up carbon dioxide and is freshly oxygenated. From there, the blood returns to the heart and is pumped to the rest of the body.

U.S. Heart Transplants Performed

The chart below shows the number of heart transplants performed each year from January 1, 2003 - May 31, 2009.

Based on current OPTN data as reported on August 21, 2009. Data subject to change based on future data submission or correction.

Common Diseases That May Lead to Transplantation

• Coronary heart disease
• Cardiomyopathy
• Congenital/valvular heart disease
• Hypertensive heart disease

During the Transplant

Heart

In the three decades since the first human heart transplant occurred in 1967, the procedure has changed from an experimental operation to an established treatment for advanced heart disease. They are now the the third most common organ transplant operation in the U.S.

Arriving at the Hospital

The process of being admitted and preparing for transplant surgery can vary greatly. Talk to your physician about how your transplant hospital will handle this phase of the process.

The Procedure

There are two very different surgical approaches to heart transplantation: the orthotopic and the heterotopic approach. Because the length of this surgery is different for every patient, families should talk with the surgeon about what to expect.

• Orthotopic Approach. The more common of the two procedures, the orthotopic approach, requires replacing the recipient heart with the donor heart. After the donor heart is removed, preserved and packed for transport, it must be transplanted into the recipient within four to five hours. The recipient receives general anesthesia and is placed on a bypass machine to oxygenate the blood while the heart transplant is being performed. After the recipient's heart is removed, the donor heart is prepared to fit and implantation begins.
• Heterotopic Approach. Heterotopic transplantation, also called "piggyback" transplantation, is accomplished by leaving the recipient's heart in place and connecting the donor heart to the right side of the chest. The procedure is rare compared to orthotopic transplantation and is advantageous because the new heart can act as an assist device if complications occur. Your physician can explain why this approach may better suit your needs.

During Recovery

Postoperative care begins with a team of heath professionals within the hospital. Careful, comprehensive post-surgical monitoring constantly evaluates whether the body is accepting the new organ. In addition, the amount of time you spend in the recovery room, waking up and getting to the point that you're ready to go home, will vary from patient to patient. Because individual experience after recovery is so unique, it is important to discuss with your physician what to expect after surgery.