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Scifed Cardiology conference-2018
HEART TRANSPLANTATION
The modern day lifestyle makes
everyone susceptible to heart problems with advancing age. Regular check-ups
help to detect problems early and to seek effective treatment. Ignoring your
cardiac health and avoiding regular check-ups could lead to delay in the
identification of any underlying heart conditions resulting in advanced stages
of cardiac diseases.
Heart transplantation is the procedure by which the
failing heart is replaced with another heart from a suitable donor. It
is generally reserved for patients with end-stage Heart Failure, who are
estimated to have less than 1 year to live without the transplant and who are
not candidates for or have not been helped by conventional medical therapy. In
addition, most candidates are excluded from other surgical options because of
the poor condition of the heart.
Heart transplants are performed when other
treatments for heart problems haven't worked, leading to heart failure.
In adults, heart failure can be caused by several
conditions, including: A weakening of the heart muscle (cardiomyopathy),
Coronary artery disease, Heart valve disease, A heart problem you're born with
(congenital heart defect), Dangerous recurring abnormal heart rhythms
(ventricular arrhythmias) not controlled by other treatments, Amyloidosis,
Failure of a previous heart transplant.
In children, heart failure is most
often caused by either a congenital heart defect or a cardiomyopathy.
Another organ transplant may be
performed at the same time as a heart transplant (multi-organ transplant) in
people with certain conditions at select medical centers. Multi-organ
transplants include:
Heart-kidney
Transplant: This procedure
may be an option for some people with kidney failure in addition to heart
failure.
Heart-liver
Transplant: This procedure
may be an option for people with certain liver and heart conditions.
Heart-lung
Transplant: Rarely, doctors
may suggest this procedure for some people with severe lung and heart diseases,
if the conditions aren't able to be treated by only a heart transplant or lung
transplant.
Factors that may affect the eligibility for Heart Transplant:
A heart transplant isn't the right treatment for
everyone. Certain factors may mean you're not a good candidate for a heart
transplant. While each case is considered individually by a transplant center,
a heart transplant may not be appropriate if you: Are an advanced age that
would interfere with the ability to recover from transplant surgery; Have
another medical condition that could shorten your life, regardless of receiving
a donor heart, such as a serious kidney, liver or lung disease; Have an active
infection; Have a recent personal medical history of cancer; Are unwilling or
unable to make lifestyle changes necessary to keep your donor heart healthy,
such as not drinking alcohol or not smoking.
Complications of surgery:
Heart transplant surgery requires open heart
surgery, which carries the risk of many complications, including: Bleeding,
Infection, Blood clots, Heart attack, Stroke, Death.
Risks of having a heart transplant:
Although receiving a donor heart
can save your life, having a heart transplant has many risks. Risks include:
Rejection
of the donor heart: One of the
most significant risks after a heart transplant is your body rejecting the
donor heart.
Your
immune system will see your donor heart as a foreign object that's not supposed
to be in your body. Your immune system will try to attack your donor heart.
Usually
the rejection is without any symptoms and requires only an adjustment of
medications. If you miss doses of medications, however, the rejection can be
severe and very serious. It's important that you follow the instructions as
explained by your doctors.
To
determine whether your body is rejecting the new heart, you'll have frequent
heart biopsies to test your heart tissue during the first year after your
transplant. After the first year, the number of biopsies is significantly
reduced.
Problems
with your coronary arteries: After
your transplant, it's possible the walls of the arteries in your heart
(coronary arteries) could thicken and harden, leading to cardiac allograft
vasculopathy (CAV). This can make blood circulation through your heart
difficult and can cause a heart attack, heart failure, abnormal heart rhythms
(arrhythmias) or sudden cardiac death.
Your
doctor may recommend annual tests after your transplant to monitor your
coronary arteries for CAV.
Medication
side effects: The
immunosuppressants you'll need to take for the rest of your life may cause
kidney damage and other problems. Other complications of these medications can
include high blood pressure, high cholesterol, diabetes and a condition in
which your bones become thin and weak (osteoporosis).
Cancer: Immunosuppressants can also increase your
cancer risk. Taking these medications can put you at a greater risk of skin
cancer, non-Hodgkin's lymphoma and other solid tumors. Regular checkups are
necessary to detect the development of cancer.
Infection: Immunosuppressants decrease your ability to
fight infection. Some heart transplant recipients may develop an infection that
requires them to be admitted to the hospital during the first year after their
transplant. The risk of infection decreases over time as the amount of
immunosuppressant medication is decreased.
What if your new heart fails?
Heart transplants aren't successful for everyone.
Your new heart may fail because of organ rejection or because of the
development of heart valve disease or coronary artery disease. Should this
happen, your doctor may recommend adjusting your medications or in more serious
cases, another heart transplant.
In some cases, additional treatment options are
limited, and you may choose to stop treatment. Discussions with your heart
transplant team, doctor and family should generally address your expectations
and preferences for treatment, emergency care and end-of-life care.
Diet and nutrition:
After your heart transplant, you may need to adjust
your diet to keep your heart healthy and functioning well. Maintaining a healthy
weight through diet and exercise can help you avoid complications such as high
blood pressure, heart disease and diabetes.
Your
dietitian's recommendations may include: Eating plenty of fruits and vegetables
each day; Eating whole-grain breads, cereals and other grains; Drinking low-fat
or fat-free milk or eating other low-fat or fat-free dairy products, to help
maintain enough calcium in your body; Eating lean meats, such as fish or
poultry; Maintaining a low-salt diet; Avoiding unhealthy fats, such as saturated
fats or trans fats; Avoiding grapefruit and grapefruit juice due to its effect
on a group of immunosuppressant medications (calcineurin inhibitors); Avoiding
excessive alcohol; Staying hydrated by drinking adequate water and other fluids
each day; Following food safety guidelines to reduce the risk of infection.
Scientific
Federation providing excellent
opportunity for the people related to Heart
Transplantation to share their Research ideas at 2nd International Congress and Expo on Cardiology
(cardiology-2018) which is going to be held at Toronto, Canada during
September 20-21, 2018. Please use this occasion to share your scientific
excellences and be a part of this esteemed congress.
For more details, please go through the Conference Website mentioned
below.
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