A heart transplant is necessary if the patient's own heart no longer functions properly and no other therapies are possible. In this operation, the heart of a brain-dead organ donor is inserted into the recipient's body and connected to the recipient's blood vessels.
Here you will find further information as well as selected specialists and centers for heart transplants.
The heart is responsible for supplying the body's organs and tissues with oxygen-rich blood. Without oxygen, the cells would quickly die. To do this, the heart must transport the blood, which has been enriched with oxygen in the lungs, through the arteries that lead to the extremities.
The heart must therefore function continuously throughout life, day and night.
If the heart is unable to perform this function, or is unable to perform it adequately, the patient needs a replacement heart. By means of a heart transplant, the surgeons remove the non-functioning heart and insert the heart of a deceased donor instead.
A heart transplant is usually the last resort in cases of advanced heart failure (cardiac insufficiency ). It is only performed when all other treatments, such as medication, pacemakers or oxygen devices, have failed.
The causes of severe heart failure vary. Some children are born with severe heart defects. It is often already clear that only a transplant can help. In adulthood, the most common causes of heart failure are
These diseases are referred to as chronic, i.e. persistent heart failure.
There are also diseases that do not cause chronic heart failure, but acute heart failure. This means that the heart fails within a few hours or days. However, as patients almost always have to wait a long time for a donor organ, acutely ill patients are usually not eligible for the operation.
Before an operation, the patient is first placed on a waiting list for a donor heart. As significantly fewer hearts are donated than are needed, this waiting period can last several months or even years.
Cardiac support systems, such as artificial heart pumps or mini-defibrillators, are often used during this waiting period. These aids can often ensure the patient's survival for several years until a suitable donor organ is found.
As a donor heart cannot be preserved for long, the operation must be performed within a few hours. The faster the heart is implanted, the better it will function later. Anyone waiting for a new heart must therefore be available at all times and be prepared for a longer stay in hospital.
A heart transplant must be quick: The donor heart must be implanted in the patient's body as quickly as possible © Robert Kneschke | AdobeStock
If a donor heart is available, the patient must arrive at the transplant center as quickly as possible. A number of examinations are carried out there to rule out acute illnesses and prepare for the operation. At the same time, the donor heart is brought to the clinic as quickly as possible.
If the examinations are successful, the operation can begin within a few hours. First, the patient's chest is opened and a heart-lung machine is connected. This device takes over the function of the heart during the operation and ensures that blood continues to flow through the body.
In most cases, the patient's diseased heart is then separated from the patient's main artery and removed from the body. However, there are also surgical procedures in which the weakened heart initially remains in the body as a support.
In both cases, the prepared donor heart is inserted in the next step and connected to the blood vessels.
Blood is then pumped into the donor heart to warm it up. In most cases, it starts beating on its own when it reaches operating temperature.
Such an operation normally takes between three and four hours.
Once the operation has been successfully completed, the patient is initially monitored in the intensive care unit. Particular attention is paid to other organs such as the liver or kidneys. Complications can occur here at the beginning due to poorer blood circulation.
It is important to take immunosuppressants from the outset. These drugs inhibit the immune system and ensure that the body does not reject the foreign tissue.
After a while, the patient is transferred to the normal ward. Patients can usually be discharged from the clinic after a few weeks. They usually attend a rehabilitation clinic afterwards. In the first few months after the operation, regular examinations at the transplant center are necessary.
Transplanting a new heart is a complicated procedure that involves many risks. There is a particularly high risk of the body rejecting the donor heart. To prevent this, patients must take immunosuppressants for the rest of their lives.
Optimum dosing of the medication is mandatory: on the one hand, it must reliably prevent rejection of the new organ. On the other hand, they must not suppress the immune system too much to prevent secondary diseases. The health risks cannot be completely prevented, even with good settings.
The following side effects are possible, among others
The risk of these side effects can be minimized by
Despite these risks and restrictions, most patients consider life with a new heart to be a great gift. After the recovery and acclimatization period of the first few months, the quality and enjoyment of life increases significantly for most patients.
With the new heart, they are able to lead a largely normal life again.
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