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    Heart Failure and Heart Transplants

    What Happens During a Heart Transplant? continued...

    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 of a Heart Transplant?

    The most common causes of death following a heart transplant are infection and rejection. Patients on drugs to prevent rejection of the new heart 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).

    Atherosclerosis of the heart's arteries or coronary artery disease develops in almost half the patients who receive transplants. And many of them have no symptoms, such as angina (chest pain), because they have no sensations in their new hearts.

    What Is Organ Rejection?

    Normally, the body's immune system protects the body from infection. This occurs when cells of the immune system move around the body, checking for anything that looks foreign or different from the body's own cells.

    Rejection occurs when the body's immune cells recognize the transplanted heart as different from the rest of the body and attempt to destroy it. If left alone, the immune system would damage the cells of a new heart and eventually destroy it.

    To prevent rejection, patients receive several drugs called immunosuppressants. These drugs suppress the immune system so that the new heart is not damaged. Because rejection can occur anytime after a transplant, immunosuppressive drugs are given to patients the day before their transplant and thereafter for the rest of their lives.

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