Heart Failure is one of the serious conditions that affect the heart. It can be caused by a wide range of heart conditions such as cardiomyopathy, which is a weakening of the heart muscle, ventricular arrhythmias (which is a type of abnormal heart-rhythm) that is recurring, diseases of the heart valves, congenital heart defects which are heart problems one is born with, and coronary artery disease (CAD).
When none of the treatments for the above conditions are working out, there is a high risk of heart failure. And when that happens, a heart transplant is the only viable option. A transplant may also be performed when a previous heart transplant has failed.
Patients who need a heart transplant are put on a national transplant list by doctors when heart failure appears inevitable. Cadaver donors (hearts taken from a person who has expired recently) from near-by cities/locations are preferred as the heart can be kept in good condition for 4-6 hours maximum, after removal from the donor’s body. The recipient is prepared for the surgery with suitable care and the transplant is done.
The patient will be moved to an ICU immediately after the surgery and would wake up there. Machines at the ICU shall monitor all the vitals. An endotracheal tube connected to a respirator shall help the person breathe. Drainage tubes connected to the chest help drain out fluids that accumulate around the heart and lungs. An IV line through the neck would be used to administer vital medications.
There may be pain. The new heart would be breathing faster than normal, initially. The medical and nursing staff would be monitoring the same. They would also teach the patient deep-breathing and coughing exercises that help cough out any secretions from the lungs. The patient would be helped to shift position from time to time.
There are a wide range of medicines to be taken following a heart transplant.
The incision in the chest area must be kept clean and dry at all times. After a few days of discharge, if the incision appears to be healing, the person can take a quick shower. The incision can be gently sprayed with soap water. However, the incision or the scabs must not be rubbed or, no dressings, lotions and ointments should be applied there. There will also be restriction on vehicle driving for 6-8 weeks after surgery. The person should not lift weights over 10-20 pounds for nearly 6 weeks after transplant surgery.
Because the person is taking immunosuppressant drugs now, he/she is vulnerable to a range of infections (called opportunistic infections).
The doctors will educate the patient about symptoms of these infections, so that in case they show up, the patient can seek urgent medical help.
In addition to Infections mentioned above, there are a whole lot of other complications. This includes first and foremost – rejection of the new heart by the body. Other complications are hypertension, kidney dysfunction, liver dysfunction, bone-marrow suppression, increased risk of cancers such as skin and lip, bone-loss and weakness, impotence, high potassium levels in the body, coronary artery disease and biopsy complications (due to repeated biopsy that check for rejection risk). All the follow-up medical care will look for signs and symptoms for any of these complications.
It is very important to eat a heart-healthy diet following transplant. This will require:
Some of the medication taken can affect the magnesium, potassium and phosphorus levels in the body. So, a qualified dietician or nutritionist shall advise the patient on potion size of each nutrient, what to eat, what to avoid etc.
The new heart must not be strained too much, but must also be gently exercised so that it begins to adjust to functioning under load. Further, the new heart is only 70 percent as efficient as a normal heart (healthy heart before transplant), so regular exercise is important to ensure the heart is working normally, for the rest of the life. So, a physiotherapist would advise the patient on dos and don’ts.
The patient will have regular follow-up visits to the doctor as per a given schedule:
A heart transplant can affect several aspects of one’s life including work, hobbies, sports, sexlife, social life, the finances, new schedules and restrictions that would require adjusting by family members, and dealing with emotions involved. A reputed hospital will offer counselling services that would make this transition and adjusting to the new life easy. The hospital may also connect the patient with other transplant patients or support groups where a lot of information, tips, tricks and hacks would be shared on a daily basis. Further, cardiac care is a highly sophisticated specialty today. Doctors are aware of all the challenges that transplant patients go through and would provide leads or inputs on how to make the journey easy.
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1. What medications are typically prescribed after a heart transplant?
Following a heart transplant, patients take immunosuppressant medications to prevent rejection, anti-hypertensive to manage blood pressure, cholesterol-lowering medications, anti-infective agents to fight infections, and medications to prevent ulcers.
2. How often are follow-up appointments needed after a heart transplant?
Follow-up appointments are frequent in the beginning, with visits every 2 weeks for the first 2 months. Gradually, these become less frequent, happening monthly between 3-6 months, and every 2 months between 7-12 months.
3. What are the signs and symptoms of infection after a heart transplant?
Due to suppressed immunity, transplant patients are more susceptible to infections. Be aware of fever, chills, fatigue, pain, cough, shortness of breath, urinary issues, or unusual vaginal discharge.
4. What dietary recommendations are followed after a heart transplant?
A heart-healthy diet is crucial post-transplant. This means limiting salt, sugar, and fat while consuming lean proteins, complex carbohydrates from whole grains, and plenty of fruits and vegetables.
5. What types of exercise are recommended after a heart transplant?
Gentle exercise is encouraged to help the new heart adjust. Light activities like walking, swimming, or light gym workouts are suitable. A physiotherapist can guide you on a safe exercise plan.
6. How can I emotionally adjust to life after a heart transplant?
A heart transplant can be emotionally challenging. Reputable hospitals offer counselling services to help patients navigate this transition and connect with support groups for shared experiences and emotional well-being.
Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals
NOTE: Take medications only when prescribed by your doctors, self-medication must be avoided under any circumstances.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801
