Heart transplantation

Hello and welcome to today’s discussion. Today we will try exploring the topic heart transplantation.

Firstly, let us know what is heart transplantation. This is a process by which the part of a cadaveric (that is dead individual’s) heart is transplanted to a living person. Unlike liver or kidney transplantation there is no way to get the heart from the living donor, since we have one heart and we need it in whole to sustain life. This is one of the main reason why there are more number of waiting recipients than the number of donors. Unlike kidney transplantation, criminal racket for heart transplantation are not much popular I suppose.

Next, is who requires a heart transplant. Generally, individuals with severe heart failure (there are some medical grading of heart failures, we are not going in to that) along with other co-morbid features like extreme senility etc. require a heart transplant. Heart failure can occur due to various causes, cardiac and non cardiac causes. We will not explore various causes of heart failure here, and will do that latter in some other post. However, I would like to mention one important cause of heart failure which is called myocardial infarction (or heart attack) where a part of the heart wall receives decreased amount of blood supply, henceforth tends to get necrosed (something like rotten fruits but not exactly, I doubt).

How is the heart from the cadaver extracted? Well this is a surgical process. But you will find it amazing to know that the whole heart as is actually not removed, rather they chop it some where along the atrial line (not going in too much detail of surgical incisions). Just to refresh your basic knowledge about human heart- our heart consists of 4 chambers- 2 atrium and 2 ventricles. The same portion of recipients heart is removed and the donor’s heart is anastomosed (i.e. joined). In my opinion, they chop the heart in that particular region because the atrium has multiple openings through which it is connected to various other vessels. So if they attempt to remove the whole atrium intact anastomosis burden of so many vessels can probably make the operation cumbersome, labour intense and less successful.

How is the life of the transplanted heart after transplantation? Well the heart generally is cut of from its nerve innervation (both sympathetic and parasympathetic) which is useful for heart’s response to fluctuation of blood pressure, exercise etc. However, its responsiveness to certain hormones that influence blood pressure like epinephrine and norepinephrine remains intact. Generally the recipient is expected to be able to do his or her normal light daily activities. But transplantation of heart like any other human to human organ transplantation requires high doses of immune system suppressing drugs. This drugs are required to suppress our own immune system so that our body don’t perceive the donated heart as a foreign body or a villain. As with any other organ transplantation, risk of certain cancers and infections due to the usage of the immuno-suppressive medications. One such common infection in organ transplant recipients is due to a virus called Cytomegalovirus.

Another draw back of heart transplant is coronary artery disease (coronary arteries are those arteries which are found in the wall of heart and blockage of which can precipitate a heart attack). Generally when these arteries are blocked due to atherosclerosis (which may be due to excess lipid deposition etc.) the blockage is at particular areas of the arteries, whereas in case of transplanted hearts the disease is more diffuse. If coronary artery disease compromises the heart severely in its work function, re-transplantation is probably the only option, which again said easily not easy to get due to scarcity of donors.

Recently, artificial heart transplantation attempts are made at various parts of the globe with some success. When this hearts are used the risk of body’s immune reaction don’t persist and also the scarcity of donor issues too gets addressed. Lets hope this new artificial hearts may be the heartiest gift for the heart transplantation requiring patients.

Gift a heart!

Related post: World’s 1st self-regulating artificial heart transplanted in France

PS: The above writing is based on knowledge of the author. Readers are advised to cross check information from other sources too. For all your health concerns please be guided by your healthcare provider and not by this blog.