Heart Transplantation Health Article

Definition

Heart transplantation, also called cardiac transplantation, is the replacement of a patient's diseased or injured heart with a healthy donor heart.

Purpose

Heart transplantation is performed on patients with end-stage heart failure or some other life-threatening heart disease. Before a doctor recommends heart transplantation for a patient, all other possible treatments for his or her disease must have been attempted. The purpose of heart transplantation is to extend and improve the life of a person who would otherwise die from heart failure. Most patients who have received a new heart were so sick before transplantation that they could not live a normal life. Replacing a patient's diseased heart with a healthy, functioning donor heart often allows the recipient to return to normal daily activities.

Demographics

Patients are not limited by age, sex, race, or ethnicity. In 1999, the primary diagnoses of adult patients receiving cardiac transplantation include coronary artery disease, cardiomyopathy, congenital diseases, and re-transplantation associated with organ rejection. Characteristics of patient presentation include cardiomegaly, severe dyspnea, and peripheral edema.

Adults with end-stage heart failure account for 90% of heart transplant recipients. Pediatric patients make up the remaining 10%, with 50% of those going to patients under the age of five. In the United States, patients that receive heart transplant are 73% male, 77% are white, 19% are ages 35–49, and 51% are ages 50–64.

Because healthy donor hearts are in short supply, strict rules dictate criteria for heart transplant recipients. Patients who may be too sick to survive the surgery or the side effects of immunosuppressive therapy would not be good transplant candidates.

These conditions are contraindications for heart transplantation:

• active infection
• pulmonary hypertension
• chronic lung disease with loss of more than 40% of lung function
• untreatable liver or kidney disease
• diabetes that has caused serious damage to vital organs
• disease of the blood vessels in the brain, such as a stroke
• serious disease of the arteries
• mental illness or any condition that would make a patient unable to take the necessary medicines on schedule
• continuing alcohol or drug abuse