A Heart transplant is an organ replacement surgery done to remove a diseased heart and replace it with healthy heart from a donor to improve your quality of life and increase your lifespan.Heart transplant is usually performed in people whose heart pumping condition does not improve enough with medications or other procedures/surgeries.
A person may require a heart transplant for several reasons, however, the most common being End-Stage Heart Failure. Despite its name, heart failure does not mean the heart is about to stop beating. End-stage heart failure is a disease in which the heart muscle becomes very weak or damaged and start failing severely in its attempt to pump blood through the body. As the heart tries harder to pump blood, it grows larger and with time, the enlarged heart has to work so hard that it just wears out.
Getting ready for the transplant
Not everyone is a candidate for heart transplant. Various aspects are looked into when a person is being considered for a heart transplant. The transplant evaluation process may include:
• Psychological and social evaluation. Reviewing some psychological and social issues including stress, financial issues, and support from family or significant others
• Blood tests. Certain blood tests to help find a good donor match and help improve the chances that the donor heart will not be rejected by the body’s immune system
• Diagnostic tests. Complete evaluation of entire body is done to assess lung function, current heart function and pressures, kidney function, liver function, blood counts, Radiological exams, Genetic testing to assess chances of acquiring infections and rejection etc. The Women may get a Pap test, a mammogram and a gynaecology evaluation
• Other preparations. You may get certain vaccines to decrease the chances of developing infections that can affect the transplanted heart.
Once you have been accepted as a transplant candidate, you will be placed on the Organ Sharing list and when a suited donor organ becomes available, you will be called to the hospital right away to get you ready for the transplant. A heart transplant usually needs to occur within four hours of organ removal from the donor.
Once you arrive at the hospital, your doctors and transplant team will conduct a final evaluation to assess your condition and to see if you are ready for the transplant. As soon as you get to know about the availability of a donor heart for you, you should not eat or drink anything (fast). Based on your health condition, your healthcare provider may request other specific preparations. Do not hesitate to raise any concerns you may have during this time, your healthcare provider will explain the procedure and let you ask questions.
After the necessary evaluation and preparation, you will be taken to the operating room. You will be given medications before and during the operation to prevent your body from rejecting the new heart and anaesthetics that will put you to sleep. A heart transplant requires open heart surgery and a sternotomy is done where the surgeon opens your chest to perform the replacement of your diseased heart.
After the operation, you will be taken to a special unit for recovery and the team will monitor you closely for several days. After having a transplant, you’re likely to remain in the hospital for three weeks.
• Primary graft dysfunction It happens when the donor heart fails and cannot function.
• Rejection of the donor heart Your immune system may reject your new heart considering it as a foreign object. and is most likely to occur within six months after the transplant. You will need to take medicines after your surgery to suppress the immune system and help prevent your body from rejecting the new heart.
• Medication side effects The medications that you take might cause some side effects including kidney damage and other problems.
However, despite these risks, heart transplant vastly improves the person’s quality of life and has a good success rate that has improved over many decades of research.
You will need to make several lifestyle related changes after having a heart transplant which will help improve your quality of life and reduce your risk of infections, including-
• Taking all your medications as per instructions and obtaining routine vaccines
• Complete Abstinence from consuming tobacco
• Adjusting your diet by making more healthy diet related choices to keep your heart healthy and functioning well
• Making physical activity and exercise a regular part of your life to continue to improve your overall health.
• Practicing good hygiene and dental care
• CARE Hospitals Have a robust transplant team under the aegis of Dr. K R Balakrishnan who is international leading Transplant surgeon.
• CARE Hospital has the best Cardiologists team providing a robust pre and post care to the transplant patients alongside the Surgeon.
• International level Transplant infrastructure with cutting edge technology in OT and ICU.
• Streamlined single line packages for transplant.
For more information call 040 – 6165 6565 or discuss with in your local CARE hospital.
Dr. K R Balakrishnan
Clinical Advisor
Heart & Lung Transplant
and Mechanical Circulatory Support
Most people are born with two kidneys. They are bean-shaped organs located in the middle of the back, on either side of the spine. Each kidney weighs about five ounces and is about the size of a fist. One kidney, functioning at 20% capacity, can:
Many diseases, like diabetes and high blood pressure, can cause your kidneys to malfunction, and may lead to kidney disease or failure.
Dr. P. Vikranth Reddy
Chief Nephrologist
Head Department of Nephrology
A liver transplant is an operation that replaces a patient’s diseased liver with a whole or partial healthy liver from another person. This article explains the current indications for liver transplantation, types of donor livers, the operation itself, and the immunosuppression that is required after transplantation.
Lung transplant is a surgery performed to replace a diseased or failing lung with a donor healthy lung. Depending on the medical condition, the transplant may involve replacing a lobe of the lung, one of the lungs or both of them. This decision mainly depends upon the type of lung disease- if the disease involves infection, then both lungs are transplanted to reduce the increased risk of further infection due to the immune-suppressants taken post the transplant, however, if the lungs are damaged, one lung surgery can be suggested. Some other factors like age, pulmonary hypertension also influence the type of transplant required. In the case of a single lung transplant, the lung that is most damaged is the one that is transplanted. In some cases, people with serious heart and lung conditions may need a combined heart-lung transplant.
Lung transplant is an option for people suffering from End-Stage Lung Diseases or in certain conditions where the lungs fail to perform to the capabilities required and all medications or treatments have been tried but the condition fails to improve.
Some of the most common causes include:
• Chronic obstructive pulmonary disease (COPD), including emphysema
• Scarring of the lungs (pulmonary fibrosis)
• High blood pressure in the lungs (pulmonary hypertension)
• Cystic fibrosis
In order to qualify for the surgery, you will need to undergo an evaluation which will help the medical team decide if lung transplant is the right option for you. During evaluation, medical team will assess any medical problem that you may have including-heart or kidney disease, certain types of cancer. Certain tests like CT scan of your chest, lung function tests, echocardiogram will be conducted. Once you have been accepted as a transplant candidate, you will be placed on the Organ Sharing list and when a suited donor organ becomes available, you will be called to the hospital right away to get you ready for the transplant.
The operation will take place while you are under anaesthesia and you’ll be asleep for the entire surgery. The surgeon will make a cut in your chest to remove your diseased lung and will replace it with the donor lung. During the time, you will have a tube guided into your windpipe so that you can breathe. However, the operation can vary from person to person and usually lasts about six to eight hours
Post-surgery, you may spend several days in the intensive care unit (ICU). Initially, a mechanical ventilator will help you breathe for a few days, and with time as your condition improves, you’ll be taken off the ventilator and will be shifted to the recovery room. The medications taken during this time will help control pain and prevent the body from rejecting your new lung(s). You’ll be closely monitored by the medical team for any signs of rejection, shortness of breath, coughing or any other complications. This will help detect problems early, even before you have
symptoms. You may have to stay in the hospital for one-to-three weeks, however, the time will vary depending upon your medical condition.
• Risk of rejection- Your body’s immune system may reject your new lung(s) considering them as a foreign object with the risk being highest soon after the transplant and gradually decreasing over time.
• Side effects of anti-rejection drugs- The medications given may cause certain side-effects including weight gain, facial hair, diabetes, high blood pressure etc.
• Risk of infection- As you are on immune-suppressants, your body becomes more susceptible to infections, particularly in your lungs.
While a lung transplant is a major operation which may involve complications, with proper medical help and self-determination, it can greatly improve your health and quality of life.
• Attend follow-up appointments – You’ll require frequent monitoring by the lmedical team to prevent, detect and treat complications and to assess your lung function. Your follow-up visits may involve laboratory tests, chest X-rays, an electrocardiogram (ECG), lung function tests, a lung biopsy and checkups with a specialist.
• Taking Medications – Your drug regime post transplant will include medications to suppress your immune system to prevent organ rejection. You are likely to take these medicines for the rest of your life and it is crucial for you to take these medicines as per the prescription
• Reduce your risk of catching infections – To help prevent infections, it is important to practice some basic things like-
o Wash your hands regularly
o Brush your teeth and gums regularly
o Protect your skin from scratches and sores
o Avoid crowds and people who are ill
• Leading a healthy lifestyle – It is advised for you to not use tobacco products and to limit alcohol use. Following a nutritious diet will help you feel better and improve your overall health. Along with taking a nutritious diet, keeping active and exercising regularly is also one of the critical part of rehabilitation.
• Care Hospitals Have a robust heart and lung transplant and VAD team under the aegis of Dr. KR Balakrishnan who is an international leading Transplant surgeon. He has done maximum number of transplants in the country and many critical lung transplants.
• Care Hospital has the best Multidisciplinary team of Pulmonologists and Cardiologists providing a robust pre and post-transplant care to the patients alongside the Surgeon.
• International level Transplant infrastructure with cutting edge technology in OT and ICU.
Streamlined single line packages for transplant
Following your doctor’s advice will help you recover and stay as healthy as possible.
For more information call 040 – 6165 6565 or discuss with in your local CARE hospital.
Dr. K R Balakrishnan
Clinical Advisor
Heart & Lung Transplant
and Mechanical Circulatory Support
A pancreas transplant is a surgical procedure to place a healthy pancreas from a deceased donor into a person whose pancreas no longer functions properly.
Your pancreas is an organ that lies behind the lower part of your stomach. One of its main functions is to make insulin, a hormone that regulates the absorption of sugar (glucose) into your cells.
If your pancreas doesn’t make enough insulin, blood sugar levels can rise to unhealthy levels, resulting in type 1 diabetes.
While womb transplants offer “great hope” for women, the practice is still considered to be experimental because its protocols have not been standardised, argue the team of doctors. They carried out review in order to discuss emerging concerns that need to be addressed.
Screening of donors and recipients depends on institutional protocol, such as good health and absence of infection and cancer, but more detailed criteria is needed, they argue.