Heart transplantation is a surgical procedure that is performed in patients with heart failure in the end-stage or severe coronary sickness, when they have exhausted other therapeutic means. The first human heart transplant in the world was made in 1967 by Dr Christiaan Barnard at Groote Schuur Hospital to Louis Washkansky in Cape Town, South Africa.
Before starting the procedures, it should be performed an evaluation of the patient, certain affections may make this operation contraindicated: renal failure, severe lung disease, liver disease, diabetes, and age.
Patients are registered in the so-called transplant list and will benefit from faster operation regarding to the high level of the severity of his condition. It is carefully studied the immunological donor-recipient compatibility to make it as small possibilities of organ rejection.
Preoperatively, initially suitable donor is identified, and then it is taken and inspected carefully by surgeons to see that the body meets the requirements for transplant. Cardiac graft – the heart that will be transplanted – must be taken from a donor being in brain-dead donor, but it has to beat the time of sampling and be transplanted within 10 hours of sampling. Meanwhile, the heart doesn’t receive ice but is kept at body temperature and is connected to a device that allows him to continue pumping function of warm oxygenated blood.
This painstaking intervention calls for a realization of an extracorporeal blood circulation capable to oxygenate the blood to the brain and to the major vital organs. The sick persons heart – the receiver – will be removed, the auricles exterior walls and openings of the vessels that open in the heart (aorta, vena cava, pulmonary vessels, etc.) keeping it, though. The most common complications that may arise from such transplant surgery are the immunological for a possible rejection are required re-transplant or temporary implantation of artificial hearts, inorganic. Prevention of these complications is trying by immunological order by administering immunosuppressive medicines, usually derivatives of cortisone and cyclosporine.
The prognosis is 80% survival in a year and a rate of death of 5%.
If the operation is a success, the patient can leave the health in one unit or two weeks, as the medical team says and will return for regular checkups. Some patients may need psycho-emotional consultations after this kind of intervention. Since the vagus nerve is cut during the operation, the new heart beating about 100 beats per minute, unless it is produced nerve regeneration. The patient is monitored regularly – by performing biopsies and specific tests – to detect possible rejection.
Patients who undergo such intervention may come to lead an almost normal life, to do physical activity and sports even easier.