Although a heart transplant surgery is a life saver, it is fraught with a lot of risks. The major risks of a heart transplant are:
Failure of the donor heart – Our immune system is always working towards eliminating foreign objects from our body. One of the biggest risk of a heart transplant surgery is the rejection of the new heart by the recipient’s body. The recipient’s immune system may try to attack the new heart. All people who receive a heart transplant surgery will need to take immunosuppressants to ‘trick’ the body into accepting the new heart, by lowering the immune system. However, for ten percent of these recipients, the new heart may still get rejected, and they will require additional treatment within the first year.
Complications from medicines – Heart transplant patients will need to take immunosuppressants for the rest of their lives. These immunosuppressants can cause kidney damage and other organ issues. Suppressing the immune system of the body can also make the patient vulnerable to getting frequent infections. Apart from this, these medications can also cause high blood pressure, diabetes or high cholesterol.
Complications due to inappropriate post-transplant care - Post-transplant care can significantly affect the patient’s ability to recover. The success of the heart transplant depends on long-term post-transplant care and if patient is unable to do so, then various complications may arise. Patients will need to make significant changes to their lifestyle and these changes will have to be maintained lifelong, if they wish to enjoy their new heart for a long duration.
Coronary Artery Problems - Occasionally, right after the heart transplant surgery, the walls of the arteries in the heart could harden, causing a disruption in the flow of blood and this may cause a heart attack, heart failure or a cardiac arrest.
Apart from these, heart transplant surgery also comes with the usual risks associated with every major surgery.
• Bleeding from the incision
• Bleeding during the surgery
• Negative reaction to anaesthesia
• Blood clots
Heart Transplant Recovery:
In the hospital-
• The hospital stay will be in the range of three to four weeks
• The patient will be shifted to the ICU soon after surgery
• Ventilator support will be provided till the patient is able to breathe by themselves
• Vital signs will be closely monitored
• Once the patient is removed from the ventilator, he/she is instructed to cough gently and periodically to prevent mucous from collecting in the lungs
• Pain medicines are administered to relieve the pain
• A biopsy of the transplanted heart is performed to look for signs of rejection.
• Blood samples will be taken often to monitor your new heart, as well as other body functions.
• Physical therapy and breathing exercises are taught to get the body back to normal
Once the recipient reaches home, he should strictly follow the prescribed rehabilitation programme. Any untoward occurrence should be immediately reported to the doctor. Family support is crucial at the initial stages. The immediate family members should look for any changes in the recipient’s health condition. Visitors should be strictly restricted to prevent infections. The room should be kept as sterile as possible.
For the transplanted heart to function effectively in the body, one needs to take medicines for the rest of his life to fight rejection. The side effects can be serious and may differ from person to person. Adequate precautions need to be taken to prevent the side effects of the medicine.
Routine heart biopsies will be done to watch for signs of rejection. The frequency of biopsy will reduce from once a week to once a month and will eventually stop.
Dos and don’ts after surgery:
• Keep the surgical area clean and dry
• Follow the specific bathing instructions
• Lookout for signs of infection or rejection
• Do not drive until permitted
• Do not carry heavy objects
• Symptoms like breathing trouble, severe pain, fatigue, low blood pressure should be dealt with on emergency basis
• Regular dental care is important to prevent infections
• Avoid crowded places