What is Heart Transplant?

Heart transplantation is the process of replacing the sick heart that cannot function adequately with a healthy human heart. When a healthy person who has donated an organ dies (donor), organs such as kidney, liver, heart, and lung are prepared and transplanted to patients (recipient) who have already decided for organ transplantation.

Since it is not possible to obtain the heart through a donor, transplantation is done with a healthy heart taken from a cadaver. The healthy heart required for heart transplantation is taken from people who have brain death. For this procedure, the person who has brain death must have donated his organs before.

Apart from other organ transplants, only the heart of a brain-dead person is used in a heart transplant. Heart transplantation is performed on people who have reached the end stage of heart failure despite all medical treatments and whose average life expectancy is predicted to be 1 year or less. Heart transplantation, which can be applied to heart patients under the age of 65, can also be performed to people over this age under certain conditions. This depends on the person's physical characteristics and general health rather than age.

How is it decided whether a person needs a heart transplant or not?

· Factors that determine whether a heart transplant is right for you include:

· Severity of heart disease.

· Other diseases that may affect the success of transplant surgery or increase the risks of surgery.

· Age

· Weight and height, which can affect waiting time and likelihood of receiving a transplant.

· Your compliance with the treatment plan before and after the transplant. After a heart transplant, you must take medications that suppress your immune system.

What are the tests performed before and after a Heart Transplant?

The examinations performed before and after heart transplantation can be listed as follows.

· Electrocardiography (ECG): It is the device in which the electrical activity (rhythm, frequency) of the heart is recorded.

· Echocardiography (ECHO): It is done to determine the pump function of the heart, the movements of the heart wall, the operation of the valves and the dimensions of the heart chambers.

Laboratory tests:

· Determination of blood group

· Determination of tissue type

· Investigation of the presence of infections such as hepatitis, HIV

· Tests for kidney, liver diseases, anemia, bleeding problems.

· Cardiac catheterization and angiography: In this examination, which is performed by entering through the inguinal artery and injecting opaque material into the heart, occlusions in the coronary vessels feeding the heart are shown, the pressures of the heart chambers can be measured and the functions of the heart can be determined.

· Peripheral Artery Doppler test: With this method, occlusions and stenoses in the vessels can be detected.

· Carotid Doppler test: It is the examination of the carotid artery (carotid) by ultrasonography.

· Abdominal (abdominal) ultrasound: It is checked whether there is a problem in the organs in the abdomen.

· Lung X-ray: It is applied to check whether there is a problem in the lungs.

· Lung function tests: It measures the function and aeration capacity of the lungs.

· Heart biopsy: It is a method used to investigate tissue rejection after heart transplantation. The heart is reached with the help of the wire sent into the vein passing through the groin or neck and samples are taken from the heart tissue. The tissue samples taken are sent to the pathology and it is investigated whether there is tissue rejection and its degree, if any. Heart biopsy is performed for the first time on the 15th day after transplantation. It can be applied an average of 4-6 times in the first year after transplantation. Over the years, the frequency of biopsy decreases.

What are the health problems that may increase the risk after Heart Transplant Surgery?

· Vascular disease

· Hepatitis

· Lung disease

· Cancer

· Kidney failure

· Diabetes

How is a Heart Transplant performed?

Doctors connect you to a heart-lung machine. This machine does the heart's job and keeps your lungs strong. It pumps filtered, oxygen-rich blood throughout your body so your heart remains still during the operation.

Then they remove the diseased heart and insert the healthy donor heart.

What should be considered after Heart Transplantation?

After the heart transplant is performed, the patient is informed in detail about what to do and what not to do. After the person is discharged, it is extremely important to use the prescribed drugs regularly and in the specified dose. In the first months, it is recommended that the person rest a lot.

Nutrition: A healthy and balanced diet is of great importance in the rapid recovery of patients after heart transplantation.

Since salt will increase the amount of water in the body and raise blood pressure, foods should be salt-free or less salty.

All kinds of vegetables and fruits should be consumed regularly for vitamin needs (it is recommended to wash fruits and vegetables well and peel them).

Raw and undercooked meat, eggs and seafood should not be consumed. It is recommended to eat after making sure that the food is well cooked.

Pasteurized milk and dairy products should be consumed.

Avoid fried foods. The patient should keep blood sugar and cholesterol levels low with a low-fat and low-sugar diet.

Consumption of floury, sugary and fatty foods should be controlled in order not to gain weight. However, if the person gains weight, this should be reported to the physician.

Transplanted patients should not accept more than two visitors at the same time and should stay away from people with contagious diseases.

Exercise: Rehabilitation with physical therapy may be required for patients whose heart failure lasting for many years causes muscle weakness in the arms and legs. One should avoid walking after meals.

Generally, patients can return to their normal lives 1 year after heart transplantation. Patients who undergo heart transplant surgery in a better general condition recover faster and experience fewer problems in the post-operative period.