HEART TRANSPLANTATION


Heart transplantation has dramatically changed since Dr. Christian Barnard performed the world's first heart transplant on December 3, 1967 in Cape Town, South Africa. Anti-rejection drugs and other advances during the 1980s have made heart transplantation an effective therapy for carefully selected patients with advanced heart disease. In India Dr. Venugopal of All India Institute of Medical Sciences, New Delhi transplanted Cadaver Heart in the years 1994 after the HOT A passed.

How does the heart work?

The heart is a hollow organ with tough, muscular walls located under the breast bone (sternum). The heart is about the size of a fist and contracts rhythmically to pump blood to the lungs and to the rest of the body. The heart is divided into two sides by a vertical wall (septum). Each side of the heart again divides into upper and lower chambers. Valves inside these chambers prevent blood from flowing backwards. The right side of the heart receives deoxygenated blood from all parts of the body and pumps this blood to the lungs. Here, the lungs supply the blood with oxygen. The left side of the heart receives this oxygen-rich blood and pumps it back to the body through the aorta (the largest blood vessel leaving the left side of the heart). Because the heart is a muscle doing continuous work, it needs its own oxygen-rich blood supply. This blood is supplied by the coronary arteries which branch off from the aorta.

Who needs a heart transplant?

Patients who need heart transplants have one common characteristic-they are suffering from heart failure as a result of advanced heart disease. For these patients, transplantation is the only hope for survival as medical therapy or conventional heart surgery is no longer helpful. Without a heart transplant, survival will be limited to one or two years. Transplantation is performed for many heart conditions, but the two most common heart diseases leading to transplantation are coronary artery disease (narrowing or hardening of the coronary arteries) and cardiomyopathy (weakening of the heart muscle). Other disorders, such as heart valve diseases, congenital defects, and viral infections, can also weaken the heart and may lead to transplantation.

Results:

As of April 2000, there are 55,359 heart transplant patients worldwide according to the registry of the International Society for Heart and Lung Transplantation. Many heart transplant recipients are alive more than 10 years later. Sometimes, coronary artery disease may develop after a transplant and some patients eventually need a second transplant. Worldwide, the longest-living heart transplant recipient is still well 23 years later. Most heart transplant recipients return to normal, active lives and report that they are satisfied with the quality of their lives.