The first human heart transplant occurred about 5 decades ago in 1967, and the procedure has changed drastically since then into an established treatment for those suffering from advanced heart disease. Now, heart transplants are the third most common organ transplant in the U.S.
You may require a heart transplant for several reasons. The most common reason is that one or both ventricles aren’t functioning properly and severe heart failure is present. Ventricular failure can happen in many forms of congenital heart disease, but is more common in congenital defects with a single ventricle or if long-standing valve obstruction or leakage has led to irreversible heart failure.
There are two very different surgical approaches to heart transplantation: the orthotopic and the heterotopic approach. Because the length of this surgery is different for every patient, families should talk with the surgeon about what to expect.
The more common of the two procedures requires replacing the recipient heart with the donor heart. After the donor heart is removed, preserved and packed for transport, it must be transplanted into the recipient within four to five hours. The recipient receives general anesthesia and is placed on a bypass machine to oxygenate the blood while the heart transplant is being performed. After the recipient’s heart is removed, the donor heart is prepared to fit and implantation begins.
The second approach, also called “piggyback” transplantation, is accomplished by leaving the recipient’s heart in place and connecting the donor heart to the right side of the chest. The procedure is rare compared to orthotopic transplantation and is advantageous because the new heart can act as an assist device if complications occur. Your physician can explain why this approach may better suit your needs.
After your heart transplant, your medical team will monitor you closely for heart rejection while also watching for side effects of the immunosuppressive medications.
-Vlad Elizarov, Alexander’s Hope Intern