A variety of heart conditions can lead to a transplant — including genetic or viral diseases of the heart muscle, abnormal protein build-up, and damage after a massive heart attack.
Heart transplants are usually reserved for patients with advanced heart failure that is not treatable with other medical therapies.
How Does a Person Know When They Need a Heart Transplant?
David Kaczorowski, MD, is surgical director of the UPMC Advanced Heart Failure Center. He says the first line of treatment for heart failure is medical therapy. “But as patients get worse, medical therapy can become less effective,” he says. “When it gets to that point, we have to consider other therapies for heart failure and transplant is one of them.”
Severe heart issues that can lead to the need for transplant surgery include:
- Advanced heart failure: The heart cannot pump enough blood to support the body’s needs.
- Arrhythmia: An irregular heartbeat.
- Cardiomyopathy: The heart muscle is diseased, enlarged, or rigid and does not pump blood effectively.
- Congenital heart disease: A heart defect present at birth.
- Coronary artery disease: Blood vessels that supply blood and nutrients to the heart are narrowed.
- Heart valve disease: One or more of the 4 heart valves is not working correctly.
Individuals eligible for heart transplants are generally age 70 or younger and are at risk of dying within the next year if the procedure isn’t performed.
Dr. Kaczorowski advises patients with heart failure to discuss the possibility of heart transplantation with their cardiologist.
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Getting on the Waiting List
People with advanced heart failure often are referred UPMC Advanced Heart Failure Center. They are seen by a team of experts that includes cardiologists, surgeons, and other doctors.
The team reviews the case and decides if a transplant will be beneficial. Then a decision is made about placing the patient on the transplant waiting list.
Anyone on the waiting list must stay in Pittsburgh or near UPMC so they can get to the hospital quickly once a donor heart is ready. It’s important for patients to stay as healthy as possible while on the waiting list.
For those who need to wait longer for a donor heart, a ventricular assist device (VAD) can serve as a bridge to a transplant.
What Happens During Heart Transplant Surgery?
- When a suitable donor organ becomes available, a patient on the waiting list is contacted, comes to the hospital, and goes to the operating room.
- After the suitability of the organ is confirmed, the operation begins under general anesthesia.
- The surgeon makes an incision in the chest and the patient is placed on a heart-lung bypass machine. The old heart is removed, and the new heart is placed into the patient’s chest.
- When the new heart begins to function, the patient is taken off he bypass machine, the chest is closed, and the recovery process begins.
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The Recovery Process
Heart transplant recipients remain in the hospital for a few weeks after surgery. Once recovered, many patients report a much better quality of life.
Heart Transplants During COVID-19
Dr. Kaczorowski and his colleagues believe that caring for your heart should be a priority even during the COVID-19 pandemic. Each patient should discuss transplantation with their doctor before deciding to proceed based on their medical history.
Why Choose the UPMC Heart Transplant Program?
A multidisciplinary team of experts in the UPMC Heart Transplant Program help patients decide if a heart transplant is right for them.
UPMC is one of the few programs with some heart transplant recipients who have lived 30 or more years after procedure. The work of UPMC experts has led to new breakthroughs in the field of transplantation.
For more information about heart transplants or to make an appointment for an evaluation, visit the UPMC Heart Transplant Program website, call 412-648-6202, or email cttransplant@UPMC.edu.
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.