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About The Transplant

The hardest working muscle of our body, the heart beats 100000 times a day, 24x7 supplying essential nutrients and life-giving oxygen throughout the body. The heart pumps blood, which shuttles carbon dioxide to the lungs from where it is removed from the body. Hence, for life to sustain, the heart has to continue beating effectively, and it is for this very reason that the heart has to be taken care of.

But today, cardiovascular disease has become the leading cause of death globally. More than 17.3 million deaths annually can be attributed to this disease, and by 2030, the number is expected to grow more than 23.6 million. Earlier, factors which were non-modifiable like gender, age and family history accounted for heart diseases. But today, heart disease is determined by controllable risk factors such as physical inactivity, diet, and stress and has become one of the major diseases affected by lifestyle with the disease escalating in the younger generation due to their poor lifestyle.

Diabetes and hypertension have also increased the risks of heart diseases. Heart disease can also be attributed to high blood pressure and the increase in hypertension prevalence has been steady over the last fifty years. Certain other factors like high cholesterol and obesity also play important roles in the risks of developing heart diseases.

But due to prolonged exposure to these conditions, heart suffers from irreparable damage, and this leads to end-stage Heart failure, which can only be cured by Heart Transplant.  Following conditions result in development of end-stage heart disease: -

  • Viral infections
  • Damaged heart valves and muscles.
  • Coronary heart disease
  • Hereditary conditions.


Indications for a Cardiac Transplant
Heart Transplant is performed on cardiac patients who have less than a year to survive and all other medical, and non-medical therapies have been ineffective in curing the condition. Specific indications for a heart transplant are:

  • End Stage Congestive Heart Failure (CHF) - A heart transplant may be required for several reasons the most common being the inability of one or both ventricles to function properly. Heart transplantation is indicated for patients who have end-stage congestive heart failure (CHF) and for whom conventional medical therapy has failed, and the patients are not expected to survive more than a year without the transplantation. Their poor heart condition does not permit them other surgical options. Specific indicators that call for heart transplantation include:
     
  • Coronary Artery Disease (CAD)- Cardiovascular disease in medical terms is known as Coronary Artery Disease. This is a condition in which fats like cholesterol and calcium get accumulated, harden and form a plaque in the arteries that are supplying blood to the heart. The plaque results in the narrowing of the arteries and blocking or interrupting the flow of blood to the heart. As a result, the heart muscle lacks oxygen and the affected person experiences angina or chest pain.
     
  • Restrictive cardiomyopathy or severe hypertrophic cardiomyopathy where the walls of the heart thicken, become stiff or have stretched.
  • Congenital heart disease is a birth defect which affects the normal working of the heart thereby affecting the normal life of a person.

  • Intractable angina or malignant cardiac arrhythmias where conventional therapy has failed


Contraindications to Cardiac Transplantation
While people with end-stage heart disease may be in dire need of a new heart, not all of them qualify for the same. Some patients may not be suitable for heart transplant surgery, and certain conditions may increase the chances of complications. Conditions or ailments that suggest against the heart transplantation may be either absolute or relative.

  • Absolute Contraindications
    Advanced lung, kidney or liver disease
    Active cancer which may threaten the survival of the patient
    Vascular diseases of the arteries of the leg and the neck
    Fixed pulmonary vascular resistance which is greater than 4 wood units
    Life-threatening diseases which are unrelated to heart failure which includes acute infection or systemic diseases like sarcoidosis, systemic lupus erythematosus, sickle cell disease or amyloidosis
  • Relative contraindications
    Insulin-dependent diabetes with severe dysfunction of organ
    Recent thromboembolism such as a stroke
    Severe obesity
    Patients whose age is greater than 65 years

    Ongoing history of substance abuse such as alcohol, recreational drugs or smoking tobacco which  increases the risk of lung disease
    Psychosocial instability
    The inability to comply with the prescribed medical follow-up care.

 

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