Procedure
Patients who are on the waiting list for a heart transplant must be available practically all the time, as a donor organ is often available very suddenly, for example in the case of organ donors who have been the victim of an accident. In such cases, there is not much time left to explant the organ and implant it in the recipient. As a rule, no more than four hours – six at the most – should elapse between explantation of the heart on the donor and implantation on the recipient.
The actual operation is performed using a heart–lung machine, which – as the name suggests – takes over the function of the heart and lungs for a short period of time, thus enabling the implantation of the new heart. A small portion of the atria of the actual patient’s heart is left behind, to which the new heart is then “connected”. The new heart is then connected to the aorta and the pulmonary artery (arteria pulmonalis).
The operation takes about 2 to 3 hours. After the operation, the patient is monitored in the intensive care unit. Shortly before the transplantation, an immunosuppressive therapy is started to ensure that the recipient’s body does not reject the foreign heart.
At the beginning, it is usually a triple therapy with Ciclosporin, Prednisolon and a third immunosuppressive agent. The immunosuppressive therapy must be continued for a lifetime. After a few days in the intensive care unit, the freshly transplanted patient can usually be transferred to a normal ward if the course of treatment is free of complications. It is not uncommon for the heart of patients waiting for a heart transplant to be too weak to survive the waiting period. For these patients, heart support systems, so-called VADs (ventricle assist devices), can be used.
How long does a transplanted heart last?
How long a transplanted heart lasts and how long life expectancy after transplantation varies greatly. Three years after a heart transplantation about three out of four patients are still alive. After a successful transplantation, the heart can last as long as in a comparable healthy person.
How long the donor heart remains healthy also depends to a large extent on the patient’s lifestyle. In addition to regular follow-up care, a healthy lifestyle and sufficient physical exercise according to one’s own ability to cope with stress are important. In addition, people who have had a heart transplant must consistently take medication that inhibits the body’s own defense system throughout their lives.
This counteracts rejection of the donor organ. As a consequence, however, there is also a higher risk of infection. Patients must therefore pay particular attention to hygiene and should avoid injuries, for example, and make increased use of available vaccinations (e.g. annual flu vaccination).