What is a Heart Transplant

A heart transplant is the removal of an extremely damaged heart and replaced with a healthy heart from a donor.

Why would i need a transplant?

A heart transplant occurs when a heart can no longer support the rest of the body by supplying sufficient amounts of blood to other organs. A transplant will only be recommended for someone with end stage heart failure.

Why would a transplant be recommended?

A heart transplant will only be recommended if your medical team consider it as absolutely required. While a transplant sounds scary the post-transplant experience for the majority is very positive, with many people returning to a relatively normal and active life.

Your hospital will arrange for an assessment. The assessment consists of a range of different scans, blood tests and a simple exercise test. Normally these are completed within a day and your medical team will consult you on the outcome shortly after.

During the assessment there is nothing to worry about, the medical staff will explain the different steps. Many people understandably feel anxious about the assessment. The assessment is important to help the medical teams make the best recommendations for your treatment.

You will be spoken to by a Consultant and transplant team. You will also be introduced to your transplant coordinator. Your transplant coordinator will explain the process to you and talk through what happens when a suitable heart becomes available.

A common question is ‘how long is the wait for a heart’? The simple answer is no one knows. Organ suitability is based upon many different things such as blood group, tissue type, height and weight. For the best possible transplant outcome, the medical team will seek out the best match for each individual.

There is only one waiting list for a transplant. However, there is a priority section to this list for people who are in extreme need. For anyone on the priority section they will have to remain in hospital under constant medical supervision. Most people waiting for a heart are able to wait at home and visit hospital for routine checks. Waiting for a heart is hard. The call could come at any time which puts pressure and anxiety on everyone.

Good advice would be to avoid alcohol, eat well and stay as active as possible. It may feel like it will never happen however, it’s important to stay positive and talk to friends. Your hospital will also be able advise on professional psycological support.

Next Step

What happens when a heart become available?

When a heart becomes available you will be notified by your transplant coordinator. You will be collected and brought to the hospital. A medical team will be sent to the donor hospital to collect the heart. Once the collection team has assessed the heart and confirmed suitability it will be transported. While this is happening all the surgical preparation will be taking place.

It is very normal for a transplant not to go ahead. Your surgical team might feel after closer examination the heart is not quite right, so they will not move forward to transplant. Everyone is working to make sure that the best possible heart is transplanted for you.

It is a major operation that takes 4-10 hrs but sometimes can take longer. The surgeon will need to cut open the chest to get access to the heart. During the operation a heart bypass machine will be used. This is so blood can continue to circulate around the body while the unhealthy heart is being swapped. Once the healthy heart is in place the surgeon will connect it all up, think of it like plumbing! Once the surgeon is happy the transplanted heart is working well the chest will be sewn back together so that you will be ready to be taken from surgery into the Intensive Care Unit.

The medical team will wake you up when they feel the body is ready. This can be a few days or possibly weeks. Once you do wake up, you will be connected to lots of dips to deliver medication and have tubes in place to remove access fluid created from surgery.

It’s a significant operation, and you will be on lots of medication, so it’s perfectly normal to feel very disorientated. The medical team will assess if you can be transferred out of intensive care to a ward where you can continue recovery.

You will start to have physical rehabilitation and build up strength ready for going home. It’s important to remember that this surgery is life-changing, and you will need time to adjust both physically and mentally.

Life after a transplant

People feel a whole range of different emotions after a transplant. The first year is really about getting use to the changes. Take life slowly as your body has experienced a huge shock and needs time to recover. Your new heart and your body need to adjust to each other. While the heart will be a very good match, your body’s immune system will recognise it as a foreign object. This means that your body will want to attack the heart, medically this is called rejection. Therefore, you will be on medication that will suppress your immune system to help your new heart and body ‘play nice’ together. It is very important to keep on top of your medications as these will maintain your immune system to the optimum level.

Many people after transplant experience a very good standard of life. Some are able to return to work, start a family and enjoy sport – even run marathons! However, while a transplant is a modern medical miracle it is not a ‘cure’. You will need to continually manage your health and energy levels. Accept all the support that your transplant clinic offers including psychological and cardiac rehabilitation. It very likely you will see life differently after a transplant and value other aspects of your life more.

A patients tips

Hearing the words you need a transplant is not something you hear every day! It was unbelievable to think I had gone from being healthy one minute to needing a new heart! My family and friends helped me to adjust to the idea. The reality was there were two choices, to carry on living or not. I chose living.

Waiting is tough. It could happen at any time any day. There is no normal waiting time, every case is different. I tried not to think about it and stayed busy and rest when I needed.

Talk, talk and talk. Don’t let your own thoughts rattle around in your head. Pick up the phone and tell someone you’re having a bad day.

I hope that this section as helped you and I know it would have helped me to straighten things out.

Andrew – Patient Ambassador