The main indications for heart transplantation are the terminal stage of chronic ischemic heart disease, dilated cardiomyopathy with severe heart failure, severe heart defects combined in the decompensation stage, much less - other diseases of the heart.
Turning to the method of treatment, the doctor must be sure that the transplant - it's the only way to save the patient, the possibility that other methods of treatment ineffective.
Contraindications to heart transplantation are:
systemic diseases (such as insulin-dependent diabetes mellitus,
mental disorders, active infection in the body);
increased pressure in the pulmonary artery (pulmonary hypertension)
alcoholism or drug addiction.
The donor heart must be a man, who had no lifetime of cardio - vascular system, possibly younger than 60 years, with clinically pronounced dead brain. Blood group of donor and recipient must match.
End-stage heart failure affects the activity of all organs and systems of the body and creates a number of issues that may affect the early and late graft survival.
Heart transplantation is carried out only in specialized cardiac units possessing experience of extracorporeal circulation, where there is adequate equipment and highly trained staff.
Long-term results of operations do not depend on the age of the recipients and nature of preoperative heart disease. The main factor limiting long-term survival of patients after heart transplantation, is tissue incompatibility between recipient and donor.
Modern methods of resuscitation, including mechanical support, can provide adequate functional adaptation of the transplanted heart in the majority of recipients. However, the proportion of severe graft dysfunction is still significant. Soon after transplantation, high risk to life is lack of the right ventricle.
In the next 2-3 weeks after surgery the patient is in hospital under close medical supervision, are selected schemes of immunosuppressive therapy, prophylactic measures to prevent the rejection of transplanted hearts and infections.
After about a week (depending on the condition of the graft) patients are allowed to start walking and if there are no serious complications in 2-3 weeks the patient discharged.
