The Heart Transplant program of Kauvery Hospital offers end to end pre and post-transplant care for those with end stage heart diseases. Heart Transplantation is a gift of life made possible by the altruistic donation of heart from brain-dead patients by their relatives despite their immense grief at the loss of their loved one at that time. Our mission at Kauvery Hospitals is to treat each donation as a precious chance of life and maximize the chance that this opportunity provides at a second chance for another person. For people with end-stage heart disease, a heart transplant offers better hope of survival and long-term quality of life to the recipient.
Kauvery Hospitals, one of the leading Hospital chains in South India, have been at the forefront of high-quality, modern therapies and treatments, and has a strong research orientation. Patients from across India who are undergoing sophisticated procedures such as a Heart Transplant can benefit from the experience and expertise that our dedicated panel of experts bring to the area of Transplant and post-transplant care.
The Heart Transplant Team
Heart failure Cardiologist – A heart failure cardiologist is the primary healthcare professional who assess the heart function and plans the further line of management. Based on the required tests and evaluations the professional would conclude whether a heart transplant is necessary.
Heart Transplant Surgeon – The Surgeon is a professional who performs the transplant and it is his/her duty to educate the patient and caregivers on the process of heart transplant, and the life after the surgery. The heart transplant surgeon prepares the patient for the transplant by addressing all concerns and doubts the family will have.
Transplant Coordinator: Acting as a single point of contact for you and your family, the Transplant coordinator is involved right from the evaluation process, educating you on the test results, the transplant schedule, the surgery and recovery processes. He will coordinate all care, before and after the transplant.
Transplant Medical Secretary: She is required for seamless communication between you and transplant team. She will answer and prioritize phone calls from both parties and ensure lab results are shared with the concerned members of the team.
Transplant Social Worker: The TSW will address the social impact of your transplant process. He will assess your current support system, which includes your family, social habits, relocation to Chennai for the transplant, financial constraints if any, managing recovery and rehabilitation post-transplant. He is also a resource for local social services and counselling.
Medical Psychologist: As the name implies, this person specializes in human behavior. He/She will assess how well you understand the transplant process and its impact on your life, your past history of use/abuse of substances and all those factors that can affect a successful outcome. She will also suggest therapy before and after transplant if the need is felt.
Transplant Physiotherapists: These specialists will assess your musculoskeletal system and your ability to exercise. This is crucial as an inability to perform rehabilitation prior to transplant will disqualify you from transplant unless we can make some progress. Their role post-transplant is to recover the loss of muscle and energy related to surgery and get you as strong as possible once your new heart start working. They will also suggest structured, ambulatory in-hospital observed rehabilitation program and coordinate home-exercises for you that will increase your strength and endurance in order to prepare you for the transplant. Post-transplant, they will monitor your activity and make suggestions as needed.
Transplant Dietitians: They will address your nutritional needs before and after transplant. This is important as a healthy weight at the time of transplant is crucial for a positive outcome. Low or high weight relative to your height can be reasons to decline a transplant till your goals are met.
The Transplant Team at Kauvery Hospital will work closely with you and your family to ensure a positive outcome. You are free to ask them any query at any time.
What is a Heart Transplant and Who Needs It?
A heart transplant is a surgical procedure that removes a failing heart and replaces it with a healthier donor heart. The transplant is done for those with end stage heart failure, where the heart is not able to function anymore and can be fatal. Individuals with severe coronary artery disease may also need heart transplant when other surgeries or medications don’t work.
When do you need a Heart Transplant?
You need to consider getting a heart transplant before you are too sick to handle the surgery and recovery. Your symptoms must be strong and serious enough that they cannot be managed with a less intensive treatment.
Heart Transplant Assessment
You have tests and meetings (consultations) with our team to see if heart transplant is safe and right for you. We want to be sure your body and organs are healthy enough for the surgery. The heart transplant assessment can take weeks or months. Please note: It is important to inform your pre-transplant cardiologist or the transplant assessment coordinator if your condition is worsening during your heart transplant assessment. In this case, you may need to stay in the heart transplant hospital. Several tests are taken as part of the assessments. Blood tests include kidney and liver function, check for viruses (including HIV and hepatitis), and find out your blood group and tissue typing to determine if you have specific antibodies in your blood.
Other tests include
ECG (Electrocardiogram)
This test shows the pattern of electrical activity in your heart. Small adhesive (sticky) tabs with wires are placed on your chest and legs for a short time to record the electrical pattern. This test does not cause any discomfort.
Cardiopulmonary Study (Cardiopulmonary Stress Test)
This test involves both pulmonary function (how well your lungs work) tests and exercising on a bike or a treadmill while you wear electrocardiogram (ECG) wires. The results show how your heart and lungs respond to exercise.
RHC (Right Heart Catheterization)
The right heart catheterization estimates pressures in the heart chambers and lungs. A catheter is inserted into your heart through the groin or neck to check the pressures in all parts of your heart chambers.
It is extremely important to measure the pressures in the lungs. If the pressure in the lungs is abnormally high, it may increase your risk to your health if you were to have a transplant, or it may prevent you from having a transplant at that time.
LHC (Left Heart Catheterization)
The left heart catheterization shows if you have any coronary artery disease. It may be requested if you have not done one in the past couple of years. It is done similar to the RHC but with the help of an x-ray equipment. A dye is injected to show how well the blood flows through your coronary arteries.
Echocardiogram
An echocardiogram uses sound waves to record the position and motion of your heart walls and the internal structures of the heart, such as your heart valves.
Doppler Ultrasounds of the Carotid and Femoral Arteries
A Doppler ultrasound checks how the blood is flowing into your head and into your legs and feet through your arteries. We do this test to check for a buildup of calcium (called calcification) or cholesterol that cause narrowing of the arteries in your neck (carotid artery) or your legs (femoral artery).
If you have narrowing of your arteries, also called atherosclerosis, you are at risk for stroke or other complications during and after your transplant surgery. Atherosclerosis may prevent you from being eligible to have a heart transplant.
Abdominal Ultrasound
An abdominal ultrasound gives us a picture of the major abdominal organs.
Pulmonary Function Test
This test shows how well your lungs are working. During this test, you breathe through a mouthpiece that is connected to an instrument called a spirometer.
Chest CT Scan
This test uses a special x-ray equipment to take detailed pictures of the organs and tissues of the chest including the blood vessels.
Other Tests
You may need other tests such as:
- a PAP test
- a colonoscopy
- a Prostate Specific Antigen (PSA) blood test
- a mammogram
For patients with diabetes:
You need to do these extra tests:
- Ophthalmology Consult: to check the eyes for any damage from diabetes
- 24-hour Urine Test: to check kidney function
- Hemoglobin A1C: to check blood sugar control
Deciding to Have a Heart Transplant
Making a decision to have a heart transplant can be very stressful and emotional for you and your caregivers. We are here to support you. Please let your transplant assessment coordinator know if there is anything you need during the transplant process. We have mental health counselling as well as psychiatric support to offer you at any time. Please speak to your doctor or transplant assessment coordinator for more information or if you have questions. We want to make sure you have all the information you need when deciding to have a heart transplant in Chennai, India
What are the benefits of having a heart transplant?
Having a heart transplant is an effective treatment for most people with advanced heart failure. It can:
- save or lengthen your life
- improve your symptoms
- improve your quality of life (your general well-being)
- improve your overall health
Having a heart transplant is a treatment for heart failure. It is not a cure. Getting a heart transplant means making permanent changes to your life, such as changing what you eat and your habits, coming to the hospital for regular clinic appointments and taking medication every day.
Waiting for a Heart Transplant Donor Heart
Organ donors are people who have recently died from a severe injury, such as a car accident, trauma, bleeding in the brain or drug overdose. The family decides to donate the person’s organs after the person has been declared “brain dead”.
How is the heart transplant wait list managed?
The wait list is organized by current health condition (“status”). Your status can change as you wait for transplant.
Heart Transplant Surgery
The surgery will last from four to six hours depending on your condition. The operation may take longer if you have had heart surgery in the past or have a mechanical heart device. There are two types of heart transplant surgeries. One is called “biatrial” and the other “bicaval.”
For the biatrial technique, the back portions of the right and left atria with a portion of the pulmonary artery and aorta are left intact to serve as connections for the new heart.
For the bicaval technique, only the back portion of the left atrium along with a portion of the pulmonary artery, aorta and both vena cava (superior and inferior) are left intact to serve as connections for the new heart. The recipient right atrium is replaced with the donor right atrium.
What to expect after surgery?
Immediately after your transplant surgery you are brought to the Heart and Lung transplant Intensive Care Unit (HLT ICU).
Specially trained nurses look after you. You have several lines and machines attached to you.
- You are on a ventilator (a machine that helps you breathe) until you wake up and breathe on your own.
- You are connected to a heart monitor and blood pressure machine.
- You have an intravenous (IV) line attached to a pump. The IV gives you medications
Most patients can talk, eat and sit up in a chair a few hours after surgery. Most patients can walk a few days after surgery. It may take longer if you have complications.
Most heart transplant patients stay in the CVICU for 3 or 4 days.
Living with Heart Transplant
Follow-up test and visits
The schedule for follow-up tests and visits changes over time.
- At the beginning there are lots of follow-up tests and visits. The tests are to check on the function of your new heart and monitor for any signs of organ rejection.
- There are a lot of clinic visits during the first year of your transplant. These visits are important to monitor your heart health and to ensure you do not have rejection or other complications. Try not to cancel them.
- The heart transplant team decides how often you visit the Clinic after the first year based on the results of your heart biopsies and tests.
- If at any time the tests show signs of organ rejection, you will have tests more often until those signs go away.
Diet for Post Heart Transplant
- Eat plenty of fresh fruits and vegetables.
- Eat protein foods.
- Drink water most often.
- Eat whole grain foods.
- Continue to follow a lower sodium diet (less than 2 grams of sodium each day).
Return to Driving
- Talk to the transplant team when you feel strong enough to drive again. Most patients can start to drive 8 to 12 weeks after the transplant.
- Do not drive if you feel tired, have dizzy spells, headaches or visual disturbances such as blurred vision, double vision or vision loss.
- Always wear your seatbelt when you are driving or riding in a vehicle. Put a towel under the seatbelt strap if the seatbelt is uncomfortable against your surgery wound.
Return to Exercise and Sports
Your body will react differently to exercise after having a heart transplant. There are many nerve connections to the central nervous system. These nerves control you heart rate. During you transplant, these nerves are cut. Over time these nerves may grow back. We call this denervation. Denervation of your heart is not harmful to your heart transplant. Denervation results in:
- A faster heart rate. Your resting heart rate will likely be around 90-110 beats per minute.
- When you exercise it will be important for you to increase and decrease your heart rate at a slower rate. You will need to warm up and cool down when you are exercising.
How can I exercise safely?
- Do long and progressing warm up activities before exercising. Your transplanted heart needs more time to react to exercise.
- Do cool down activities for at least 10 minutes after exercising. Slowly walk or stretch until you heart rate returns to your resting level.
- Start exercising after the transplant by following the walking program below.
- Exercise at your own pace. Do not push yourself too hard.
- Slowly increase your daily activity over time. Work up to 30 minutes of exercise each day.
- Exercise indoors when the weather is extremely hot or cold.
- You can safely exercise by walking around a mall or working out in a public gym.
- It takes time to build your exercise tolerance. In time you will be able to exercise at an appropriate level.
When to stop exercising
Stop exercising and do a cool down if you have:
- pain on the surgery wound
- trouble catching your breath (excessive shortness of breath)
- dizziness or lightheadedness
- palpitations (heart beating fast or irregular)
- excessive fatigue
- nausea (feeling like you might vomit)
Tell your transplant team if you have these symptoms when exercising. Tell your transplant team if your exercise tolerance is getting worse (less able to exercise).
Travel
Tips when planning a trip:
- Share your travel plans with your transplant team.
- Before travelling, ask your transplant coordinator for a travel letter that lists:
- a record of your medication
- your most recent laboratory results
- emergency contact phone numbers
- Travel Letters: Call your transplant coordinator 2 weeks before travelling to request a letter.
- Always carry your medication with you. Never check your medication with your luggage.
- Bring extra medication with you in case you are delayed returning home. Depending on the length of the trip and your destination, you may want to bring a few extra days or weeks.
- Be prepared to return home at any time if you become ill.
- If you are travelling by car, stop every 2 hours to stand up and stretch your legs.
Cardiac Rehabilitation Program
We refer most transplant patients to a cardiac rehabilitation program about 3 months after the transplant. The timing for your cardiac rehabilitation program referral depends on your healing.
Cardiac rehabilitation programs are supervised exercise programs that help you rebuild your strength and stamina. The program will also provide information on health and fitness. We try to refer you to a cardiac rehabilitation program near your home. To book an appointment with our experts or to learn more about heart transplant costs, contact us at +91 9150277712.
