A heart transplant is recommended for a patient with a failing heart and mostly when the patient’s diseased heart can not be helped by advanced heart failure medications. The patient’s diseased heart is replaced by a healthier, often younger donor heart. Heart transplant is a major operation but patient survival is very good provided regular medications and follow-up can be assured.
We perform heart transplants when the patient’s own diseased heart cannot maintain adequate body functions. Heart failure is frequently caused by the following illnesses:
- Weakness of heart muscle called Cardiomyopathy or Dilated Cardiomyopathy (DCM/ DCMP)
- Coronary Artery Disease (mostly after multiple heart attacks the heart becomes too weak to support function)
- Heart Valve Disease (many patients come to seek treatment only in the terminal stages of heart valve disease)
- Others like dangerous arrhythmia, HOCM, congenital heart disease, or a previous heart transplant
As a standard, we take a few days to assess a heart failure patient. We check medical records, treatments undertaken, other medical/surgical conditions that might forbid transplantation (like advanced age, cancer, active infections, serious kidney or liver failure, alcohol abuser unwilling to stop alcohol) and we also undertake a full biochemical screening to try and identify potentially treatable causes for heart failure. Once it is clear that a patient will improve only by a heart transplant, the patient is placed on an active transplant waitlist for allocation of a donor organ.
The past few years have seen rapid progress in the medical management of heart failure, which has gone hand in hand with advances in device treatments of heart failure. Modern ventricular assist devices are handy, durable, and more or less trouble-free. However, their costs remain prohibitive. Heart transplantation provides a durable result at a fraction of the cost and unsurpassable quality of life. Cardiac transplantation was initiated half a century ago. Most early failures came from rejection, a process by which the patient’s body identifies a new heart as foreign and launches an immune battle to kill it. New immune treatments have led to immense improvement in early and late post-transplant survival.
Organs are now allocated by NOTTO the national organ and tissue transplantation organisation as per a waitlist kept by the central and state offices