How is the heart procured from the donor?
Organs are removed for donation only from people whom doctors have declared, after careful testing, to be "brain dead." (By law, these doctors cannot be involved in the organ transplantation process.) Brain death means that blood flow to the brain has ceased and cannot be restored, and the brain and brain stem have completely stopped working. Brain death is absolutely irreversible; there is no way to bring a brain dead person back to life. Other parts of the body including the heart can be kept functioning by medical technology, but once that technology is removed the rest of the body will inevitably follow the brain in death. This allows organs to be removed in a healthy state after the donor's life has ended.
What happens in heart transplant surgery?
Heart transplantation is one of medicine's most remarkable procedures. One team of surgeons opens the recipient's chest in the manner of any open-heart surgery. The patient is connected to artificial heart and lung equipment that keeps the blood circulating and the lungs working while the operation is going on. Then the patient's diseased heart is surgically removed.
Meanwhile, at the donor's hospital (which may be many miles away), other surgeons remove the donor's heart and store it in a cold chemical solution to keep the tissue healthy. (Other surgeons may be removing other organs for other recipients.) The donor heart is then brought as quickly as possible to the recipient's bedside, often by helicopter. There, surgeons sew the heart into place and connect it with the recipient's blood vessels. As blood begins to flow, the heart warms up and begins to beat, sometimes with the aid of an electrical shock. The connections are checked for leaks. If all is well, the heart-lung machine is removed.
The transplant operation takes anywhere from two to six hours. The more previous operations the patient has had, the longer the procedure is likely to take.
Will I be in a lot of pain following surgery?
The only discomfort would be around the surgical incision. Effective pain medication would always be available.
How long will I be in the hospital?
The average hospital stay after a heart transplant is fifteen days. Regular check-ups with your doctors will follow.
Will I need cardiac rehabilitation?
Patients begin a cardiac rehabilitation program during their hospital stay and continue as an outpatient afterward. The program, available at several Henry Ford Health System sites around metropolitan Detroit, helps patients with heart-healthy techniques in exercise, diet and stress reduction. Henry Ford staff members who are trained in exercise physiology, nutrition, and stress management teach it. They work hand in hand with Henry Ford physicians. Staff members carefully tailor exercises to the needs of individual patients, keeping each patient's medical condition in mind. No one is asked to do more than what is medically appropriate. Studies show that cardiac rehabilitation, when its principles are followed carefully over a period of years, substantially reduces the risk of death from heart disease. Patients also report better general health and fitness, more energy, and higher levels of physical activity.
What is it like to live with a transplanted heart?
The recipient of a heart transplant has a wonderful second chance at life. In many cases, one's quality of life improves dramatically. But recipients must take care of the new heart by strict compliance with doctors' orders regarding medication, diet and exercise. Otherwise, the second chance may be quickly wasted.
What medications will I need to take?
The recipient of a heart transplant has a wonderful second chance at life. In many cases, one's quality of life improves dramatically. But he or she must take care of the new heart by strict compliance with doctors' orders regarding medication, diet and exercise. Otherwise, the second chance may be quickly wasted.
Will I need to change my diet?
A low-fat, low-salt diet is recommended.
Will I be able to exercise?
Yes. In fact, moderate exercise is strongly recommended.
How long before I can resume sexual activity?
Sexual activity can resume after you leave the hospital.
Can I have children?
Many women have enjoyed normal pregnancies and normal births after heart transplants. But anti-rejection drugs pose some risk to fetuses.
How long before I can return to work?
Patients are advised to stay off work for at least three months.
Will I be able to meet other heart transplant recipients?
Yes. A thriving support group at Henry Ford has helped many heart recipients cope with the challenges of living a new life with a transplanted heart. The group, which is entirely voluntary, welcomes anyone who has received a transplant or is awaiting a transplant and any family members and friends who wish to attend. Those awaiting transplants find it very helpful to speak with people who have already gone through the transplant process.
The group meets once a week at Henry Ford Hospital. Once a month, one of our physicians visits the group to discuss topics of mutual interest. Group members may attend whenever they wish.
How long will I live after a heart transplant?
The lifespan of heart transplant recipients vary widely, depending largely on how sick the patient was before the transplant. Naturally, younger, healthier patients can expect to live longer than patients who are over 65, or who have other problems such as high pressure in the blood vessels of their lungs do.
Heart transplant survival rates at Henry Ford Health System are significantly higher than national norms. About 90 percent of our transplant recipients live for at least one year after transplant. About 75 percent live for at least five years. And about 60 percent live for ten years or longer.
Who pays for a heart transplant?
Transplantation requires a careful evaluation to confirm that your medical insurance program will cover the costs. Most patients have insurance that will cover all costs associated with a heart transplant, including diagnosis, surgery, post-operative care and medications.
Henry Ford Health System accepts all insurance plans. We have transplanted patients covered by all major commercial insurance carriers, HMOs (including Health Alliance Plan and Selectcare), and Medicare and Medicaid. We are one of only two health systems in Michigan to be designated a transplant Center of Excellence by Blue Cross Blue Shield of Michigan, one of many commercial insurers that cover all costs of a heart transplant.
