Type of Surgery
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Last updated: 11/24/2009
The most common and dangerous complications of heart transplant surgery are organ rejection and infection. Immunosuppressive drugs are given to prevent rejection of the heart. Most heart transplant patients have a rejection episode soon after transplantation....
Rapid diagnosis ensures quick treatment, and when the response is quick, drug therapy is most successful. Rejection is treated with combinations of immunosuppressive drugs given in higher doses than immunosuppressive maintenance. Most of these rejection situations are successfully treated.
Infection can result from the surgery, but most infections are a side effect of the immunosuppressive drugs. Immunosuppressive drugs keep the immune system from attacking the foreign cells of the donor heart. However, the suppressed immune cells are then unable to adequately fight bacteria, viruses, and other microorganisms. Microorganisms that normally do not affect persons with healthy immune systems can cause dangerous infections in transplant patients taking immunosuppressive drugs.
Patients are given antibiotics during surgery to prevent bacterial infection. They may also be given an antiviral drug to prevent virus infections. Patients who develop infections may need to have their immunosuppressive drugs changed or the dose adjusted. Infections are treated with antibiotics or other drugs, depending on the type of infection.
Other complications that can happen immediately after surgery are:
- bleeding
- pressure on the heart caused by fluid in the space surrounding the heart (pericardial tamponade)
- irregular heart beats
- reduced cardiac output
- increased amount of blood in the circulatory system
- decreased amount of blood in the circulatory system
About half of all heart transplant patients develop coronary artery disease one to five years after the transplant. The coronary arteries supply blood to the heart. Patients with this problem develop chest pains called angina. Other names for this complication are coronary allograft vascular disease and chronic rejection.
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This 3D animation explains how the heart muscle contracts to pump blood throughout the body. The action of cells at the microscopic level affects the function of the entire cardiovascular system, as the video explains.
For a heart transplantation, the area around the heart is exposed through a chest incision (A). The blood vessels leading to the heart are clamped, and the heart function is replaced by a heart-lung machine. The diseased heart is removed (B). The donor heart is placed in the chest, and the left atrium is attached (C). The right atrium is connected (D), and the aorta and pulmonary artery are finally attached (E). (Illustration by GGS Inc.)
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Heart transplantation or cardiac transplantation, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease. The most common procedure is to take a working heart from a recently deceased organ donor (allograft) and implant it into the patient. The patient's own heart may either be removed (orthotopic procedure) or, less commonly, left in to support the donor heart (heterotopic procedure). It is also possible to take a heart from another species (xenograft), or implant a man-made artificial one, although the outcome of these two procedures has been less successful in comparison to the far more commonly performed Bold textallografts.
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They've become more prevalent since the heart surgery.
-Skip Rutherford
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