Heart transplant

• coronary artery disease
• cardiomyopathy (thickening of the heart walls)
• heart valve disease with congestive heart failure
• severe congenital heart disease

Heart transplant surgery is not recommended for patients who have:

• kidney, lung, or liver disease
• insulin-dependent diabetes mellitus (IDDM)
• other life-threatening diseases

What to Expect After:
Heart transplant prolongs the life of a patient who otherwise would die. About 80% of heart transplants are alive two years after the operation. The main problem, as with other transplants, is graft rejection . If rejection can be controlled, then survival can be increased up to 10 years for a person who otherwise would have died. Immunosuppressive drugs must be taken indefinitely. Relatively normal activities can resume as soon as the patient feels well enough and after consulting with his or her doctor. However, vigorous physical activities should be avoided.

The major problems are the same all major organ transplants face:

• finding a donor
• fighting the rejection effect
• the cost of the surgery

Finding a donor can be difficult. In heart transplant, the healthy heart must come from a fresh cadaver. This is different than a kidney transplant where a kidney can be donated by a family member. Also, timing is important because there is no good way to keep the recipient alive on an artificial heart while waiting for the right donor, as is possible with dialysis in kidney transplant (use of an artificial heart is still considered experimental).

Fighting rejection is an ongoing process. The body's immune system considers the transplanted organ as an infection and automatically fights it. Thus, to prevent rejection, organ transplant patients must take drugs (such as cyclosporine and corticosteroids) that suppress the body's immune response . The disadvantage of these drugs is that they weaken the body's natural defense against various infections.

Convalescence:
The recovery period averages 6 weeks. Move legs often to reduce the risk of deep venous thrombosis . The sutures or clips are removed about one week after surgery. Warm pads over the scar can reduce the pain.

Risks:
Risks for any anesthesia are:

• reactions to medications
• problems breathing

Risks for any surgery are:

• bleeding
• infection

Heart transplants carry major risks. There is a greater risk of infection because of the immunosuppressive drugs that must be taken to prevent transplant rejection . Call your doctor if there are signs of infection (redness, drainage, fever ) or if there is a general worsening of the convalescence status.

Cost:
The costs of any surgery varies significantly between surgeons, medical facilities, and regions of the country. Patients who are younger, sicker, or need more extensive surgery will require more intensive and expensive treatment.

Costs for heart transplants often exceed $100,000.

Surgery charges can be separated into five parts: 1) the surgeon's fee, 2) the anesthesiologist's fee, 3) the hospital charges, which includes nursing care and the operating room, 4) the medications, and 5) additional charges.

1. Surgeon's fee: variable
2. Anesthesiologist's fee: averages $350 to $400 per hour
3. Hospital charges: basic rate averages $1,500 to $1,800 per day (more for the intensive care unit (ICU) or private rooms)
4. Medication charges: $200 to $400
5. Additional charges: assisting surgeon, treatment of complications, diagnostic procedures (such as blood or X-ray exams), medical supplies, or equipment use.

Insurance coverage for surgery expenses depends on many factors and should be explored for each individual instance.


This is a cross-sectional view of the interior of the heart. The valves, chambers, and associated vessels are labeled.