Duration of a heart transplantation
Nowadays, the duration of the actual surgical procedure for a heart transplantation is on average about four hours from skin incision to the last suture. The heart function is taken over by a heart-lung machine for about two to three hours. Rehabilitation after a heart transplantation is very lengthy.
Due to the seriousness of the intervention, strict continuous monitoring of cardiovascular function is initially necessary in an intensive care unit. If the course of the operation is free of complications, the patient can be transferred to a normal ward after two to seven days. If the operation is successful, the patient can be discharged from the hospital in about two weeks. Afterwards, rehabilitation lasting several weeks is necessary to enable the patient to regain his or her performance and learn to live with the new heart. How long this rehabilitation period lasts varies from individual to individual and depends on accompanying factors of the patient such as age, illness and motivation.
Requirements
The first requirement on the organ donor’s side is the consent to the organ donation. This is done either by the presence of an organ donor card of the deceased in which he or she agreed to the removal of the organ or, in the absence of such a card, the consent of the next of kin. If consent is given, the next step is to declare brain death.
This is done by two independent doctors, each of whom has no relationship to the transplant team. A patient can only be declared brain dead if certain criteria are met. These include the presence of a coma, the absence of cranial nerve reflexes and the absence of spontaneous breathing.
Furthermore, there must be equality between donor and recipient ABO blood group. There should also be a similarity in height and weight. Finally, the presence of contraindications (see below) must be excluded.
How long is the waiting time for a donor heart?
How long one has to wait for a donor heart for a heart transplant can vary greatly. The average waiting time in Europe is usually between six and 24 months. This wide range is mainly explained by the fact that not every donor heart is suitable for every recipient.
In addition to the appropriate blood group, the size and weight of the organ must also be appropriate. The donor organs are arranged through the Eurotransplant Foundation in Leiden (Netherlands). Patients in acutely life-threatening condition are given preference in the allocation process.
If there is currently no suitable donor heart available, there is the possibility of supporting the function of the patient’s own heart through various medical measures to bridge the waiting period. Often a mechanical support system is used to maintain the pumping function into the heart. This is also known as an artificial heart.
