Diagnosis & Testing
How Are Organ Donors Found for Heart Transplants?
Donors for heart transplants are individuals who may have recently died or become brain dead, which means that although their body is being kept alive by machines, the brain has no sign of life. Many times, these donors died as a result of a car accident, severe head injury, or a gunshot wound.
Donors give their permission for organ donation before their death; the donor’s family must also give consent for organ donation at the time of the donor’s death.
Donor organs are located through the United Network for Organ Sharing (UNOS) computerized national waiting list. This waiting list assures equal access and fair distribution of organs when they become available. When a heart becomes available for transplantation, it is given to the best possible match, based on blood type, body size, UNOS status (based on the recipient’s medical condition), and the length of time the recipient has been waiting. The race and gender of the donor have no bearing on the match. All donors are screened for Hepatitis B and C and for human immunodeficiency virus (HIV).
Unfortunately, not enough hearts are available for transplant. At any given time, almost 3,500 to 4,000 people are waiting for a heart or heart-lung transplant. A person may wait months for a transplant and more than 25% do not live long enough to get one.
Many people who are waiting for transplantation have mixed feelings because they are aware that someone must die before an organ becomes available. It may help to know that many donor families feel a sense of peace knowing that some good has come from their loved one’s death.
What Happens During a Heart Transplant?
Once a donor heart becomes available, a surgeon from the transplant center goes to harvest the donor heart. The heart is cooled and stored in a special solution while being taken to the recipient. The surgeon will make sure the donor heart is in good condition before beginning the transplant surgery. The transplant surgery will take place as soon as possible after the donor heart becomes available.
During the operation, the patient is placed on a heart-lung machine. This machine allows the body to receive vital oxygen and nutrients from the blood even though the heart is being operated on.
Surgeons then remove the patient’s heart except for the back walls of the atria, the heart’s upper chambers. The backs of the atria on the new heart are opened and the heart is sewn into place.
Surgeons then connect the blood vessels, allowing blood to flow through the heart and lungs. As the heart warms up, it begins beating. Surgeons check all the connected blood vessels and heart chambers for leaks before removing the patient from the heart-lung machine.
It is a complicated operation that lasts from four to 10 hours.
Most patients are up and around within a few days after surgery, and if there are no signs of the body immediately rejecting the organ, patients are allowed to go home within seven to 16 days.
What Are the Risks Associated With Heart Transplants?
The most common causes of death following a transplant are infection and rejection. Patients on drugs to prevent transplant rejection are at risk for developing kidney damage, high blood pressure, osteoporosis (a severe thinning of the bones, which can cause fractures), and lymphoma (a type of cancer that affects cells of the immune system).
Coronary artery disease develops in almost half the patients who receive transplants. And many of them have no symptoms, such as angina, because they have no sensations in their new hearts.
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