Amazing Heart Transplant
Heart Transplant Making History
This month a heart from a deceased donor was actually revived after that patient’s death. The surgeons used an artificial circulatory mechanism and were able to get the heart beating.
The Duke University surgeons then transplanted the heart into a military veteran on the transplant list. The surgeons were able to revive the donor’s heart before surgically implanting it into the patient. In the past heart donations came have come from a live patient that may be brain dead or not able to recover from an illness or accident.
An average of 3,500 heart transplants are performed worldwide every year and about one half are performed in the US. About 200 heart and heart-lung transplants are performed in the UK due to severe heart failure.
History of Heart Transplants
In the late 1960’s, the first heart transplant was performed on a chimpanzee by Keith Reemtsma, MD. Tulane University then revolutionized organ transplantation, which helped people with organ failure around the world.
South African cardiac surgeon, Dr. Christian Barnard, performed the first human to human heart transplant in 1967. The surgeon used the techniques that had been developed by American surgeons, Norman Sumway and Richard Lower. Unfortunately, the patient died 18 days after the transplant.
The first pediatric transplant was performed in 1967, as well. Dr. Adrain Kantrowitz performed the surgery at Maimonides Hospital in Brooklyn, New York. Again, the child’s heart stopped beating after 7 hours.
On January 6, 1968, Dr. Norman Shumway and Dr. Donald Ross performed a heart transplant at Stanford University Hospital with success. For about a decade, Stanford University Hospital stood alone as they were the only hospital pioneering this operation. They withstood the controversy over the economic and legal issues. However, in 1968, there were 100 heart transplants performed by various doctors worldwide, but only one third of them lived longer than 3 months.
Brain death has been the only allowed ethical standard for a heart donation. The recent donation of the heart that was not beating came was the first adult DCD, which stands for donation after circulatory death in the USA. The new technique used for this heart used warm perfusion, which circulates the blood, oxygen and electrolytes through the heart. This technique was first used in 2015, in the U.K. at Royal Papworth Hospital.
Medical Criteria for a Heart Transplant
If a patient is suitable for transplant they will be put on the transplant list. If a patient is potentially suitable they are reevaluated on a regular basis. The donor heart must be the correct size, it must match the patient’s blood and tissue type. A heart should be transplanted within 4 hours, so the patient has to be available with little notice.
When all other treatments for heart problems has failed and has heart failure the patient is eligible for the transplant list. Children who have a congenital heart defect or cardiomyopathy are candidates for a heart transplant.
For adults heart transplants occur for the following reasons:
- Coronary artery disease
- Heart valve disease
- Severely weakened heart muscle (cardiomyopathy)
- Recurrent and dangerous heart arrhythmias (especially ventricular arrhythmias)
- Failure of a previous heart transplant
Multi-organ transplants are performed when necessary in select hospitals in addition to a heart transplant, and they include:
- Heart and liver transplant
- Heart and kidney transplant
- Heart and lung transplant (rarely done)
A heart transplant is not done on someone of advanced age, when they have another medical condition that can shorten their life, when they have an active infection or a recent history of cancer. Also, if they are unwilling to make the necessary lifestyle changes to keep their donor heart healthy, such as quitting smoking or drinking alcohol as your body might reject the donor heart they are not eligible.
Experience a Heart Transplant in 360°
Problems Causing Rejection or Failure of Donor Heart
Rejection of the donor heart is the most serious factor. Immunosuppressants taken to prevent rejection can sometimes cause kidney damage.
Other potential problems include:
- Primary graft failure - most frequent cause of death in the first few months following the transplant
- Artery problems - the walls of the arteries in the heart may thicken and harden, which may make the circulation of blood through the heart compromised, which may cause a heart attack, heart arrhythmias, heart failure or sudden cardiac death
- The immunosuppressants may cause an increased risk for developing cancer (non-Hodgkin’s lymphoma), and there is an increased risk of skin and lip tumors
- Immunosuppressants also decrease the body’s ability to fight infections.
The patient is monitored for signs of symptoms of rejection. It is imperative that the transplant team is notified for rejection signs, which include new shortness of breath,fatigue, fever, less amount of urine or weight gain.
Advancing Technology
The intra-aortic balloon pump was successfully used starting in the 1970s. This is a machine that takes over some of the work of the heart while someone is waiting for the right donor heart match. Dr. Ross has headed the research for immunosuppressant medications and mechanical assist devices. His program performs 100 heart transplant surgeries annually.
Pediatric Heart Transplant at Seattle Children's
Heart Transplant Survival Rates
Survival rates are based on numerous factors. The U.S. rate is 88% initially but after 5 years it drops to 75%. Most transplant patients are able to return to work and a fairly normal life. Physical activity should be a part of life as well. Managing medications, therapy and a life-long plan of care if vital for a full life.
References
- https://columbiasurgery.org/brief-history-transplantation-nypcolumbia
- https://surgery.duke.edu/news/doctors-duke-university-hospital-perform-first-dcd-heart-transplant-us
- https://www.srtr.org/transplant-centers/duke-university-hospital-ncdu/?organ=heart&recipientType=adult&donorType=
- https://www.dukehealth.org/locations/duke-cardiac-transplant-clinic-clinic-2f2g
- https://www.ncbi.nlm.nih.gov/pubmed/16704154
- https://en.wikipedia.org/wiki/Heart_transplantation
- https://www.mayoclinic.org › heart-transplant › about › pac-20384750
- https://www.bhf.org.uk/informationsupport/treatments/heart-transplant
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2019 Pamela Oglesby
Comments
Pamela Oglesby (author) from Sunny Florida on March 17, 2020:
Thank you Cong Dong.
Cộng Đồng TopnList Việt Nam from Ho Chi Minh, Viet Nam on March 17, 2020:
like
Pamela Oglesby (author) from Sunny Florida on February 12, 2020:
Hi Peggy, I had no idea you were a nurse or that you saw Dr. DeBakey perform surgery. I think the surgery has probably advanced even more now. It is fantastic that they can do transplants for those who need one.
Thank you so much for your comments.
Peggy Woods from Houston, Texas on February 12, 2020:
It is lovely that they keep making advances with regard to transplants of all kinds. I remember watching a heart transplant from a room above the operating room when Dr. DeBakey was performing one back in the 1970s. It was amazing to see! I was an OR nurse at the time working at Methodist Hospital in Houston's Texas Medical Center.
Pamela Oglesby (author) from Sunny Florida on December 29, 2019:
Hi MG Singh, I think age should probably impact the decision to get a heart transplant. For instance, if you are a teenager or even in your 20s, a heart transplant to save your life is probably worth the risk.
I think if the surgery goes well and if the patient's body does not try to reject the organ, then I think someone lives a good life. All the questions you asked are probably the same questions that a person in heart failure asks themselves. A decision for one may not be the right decision for another person. You really asked some interesting questions. Thank you for your comments.
MG Singh emge from Singapore on December 29, 2019:
I sometimes wonder how effective Heart transplanting is? Does the patient recover up to at least 90% of his active life or he remains an inert living being? Lastly is it worth it ? to go in for a heart transplant. After all, nobody is immortal. I am distinguishing heart transplants from open-heart surgery. Nice article and very stimulating.
Pamela Oglesby (author) from Sunny Florida on December 11, 2019:
Hi Lora, It does sound like science fiction but it is real. I find it fascination also. I am glad you found the article informative. Thanks for commentings.
Lora Hollings on December 10, 2019:
This is a fascinating article, Pamela! It is simply amazing what they can do now with heart surgery. Implanting a heart from a deceased donor almost sounds like science fiction. I really enjoyed your article and learned much from reading it.
Pamela Oglesby (author) from Sunny Florida on December 10, 2019:
Hi Umesh, Thank you so much for your very nice comments.
Pamela Oglesby (author) from Sunny Florida on December 10, 2019:
Hi MG Singh, I am glad this article was infomative for you. Thank you for your comments.
MG Singh emge from Singapore on December 10, 2019:
A very informative article. I didn't know so many things. Thank you, Pamela.
Umesh Chandra Bhatt from Kharghar, Navi Mumbai, India on December 10, 2019:
Elaborate and well explained. Thanks.
Pamela Oglesby (author) from Sunny Florida on December 09, 2019:
Hi Alyssa, You are definitely busy reading today and it is much appreciate. The heart transplants are fascinating to me as they save the life of someone who is otherwise dying. The history keeps expanding.
Alyssa from Ohio on December 09, 2019:
This is amazing! It's always exciting to hear about medical advancements. Thank you for sharing this and giving some background on the history of heart transplants. :)
Pamela Oglesby (author) from Sunny Florida on December 09, 2019:
Hi Chuck, You bring up some concerns that many of us have considered as it is expensive to get a heartg transplant. I appreciate your generous comments. I remember Dr. Christian Barnard's first success also. He had previously transplanted a heart into an ape.
Thank you so much for your very nice comment.s
Chuck Nugent from Tucson, Arizona on December 09, 2019:
This is a great Hub with a lot of good information. I remember the headlines when Dr. Christian Barnard performed the first successful human heart transplant. A couple of years later in a graduate economics course we were discussing monopolists and economic limits on a monopolist's profit potential The instructor insisted that there were real world limits (not laws or government regulations) that a monopolist could charge. After a few minutes of back and forth debate with the instructor successfully rebutting each example we came up with one of my fellow students came up with heart transplants citing the fact that, at that time Dr. Christian Barnard was the only person in the world who had successfully done heart transplants so, in the absence of laws or regulations, he could theoretically get a person dying of heart disease to pay any amount he wanted. All of us agreed and thought we had won the argument until the professor responded saying that the death was an alternative choice to extending one's life for an unknown amount of time by driving the person and their family deeply into a debt that the person and family could never get out from under. He made the point that we always have a choice although the choice can be between bad and worse as well as good or bad. Good work, great Hub.
Pamela Oglesby (author) from Sunny Florida on December 09, 2019:
Hi Ms Dora, I agree that the medical advances do give us hope. Thank you for your comments. Have a nice week.
Dora Weithers from The Caribbean on December 08, 2019:
Medical advances, especially in the area of heart transplants, give us hope. Thanks so much for sharing this information.
Pamela Oglesby (author) from Sunny Florida on December 08, 2019:
Hi Audrey, I remember that astonsihing news also. Your comments are appreciated.
Audrey Hunt from Pahrump NV on December 08, 2019:
I remember when the first heart transplant was performed on a chimpanzee. This was astonishing news back then. Thanks for sharing this informative update about heart transplant..
Pamela Oglesby (author) from Sunny Florida on December 08, 2019:
Hi John, I am glad you found this article interesting. Thanks for your comments John.
Pamela Oglesby (author) from Sunny Florida on December 08, 2019:
Hi Devika, I'm glad you learned some new facts from this hub. People sure can live longer. I appreciate your comments.
Devika Primić from Dubrovnik, Croatia on December 08, 2019:
Interesting and useful to everyone. I learned a lot from this hub. This is new to me glad you wrote about it. People can live longer with new medicine techniques.
John Hansen from Australia (Gondwana Land) on December 07, 2019:
That is a wonderful new advancement. Thank you for researching and sharing this interesting article, Pamela.
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Maria, If i understood the article correctly this is the first time that term has been used. I found the information very interesting as everything seems to advance so quickly.
I appreciate your comments, as always. Love and hugs to you.
Maria Jordan from Jeffersonville PA on December 07, 2019:
"Donation after Circulatory Death" (DCD) is a new concept for me, Pamela.
Thanks for this interesting and informative update on heart transplants - truly fascinating.
Love and hugs, Maria
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Bill, I remember Barnard's surgery as well. It is truly amazing. Thanks for your comments.
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Lorelei, The advances are wonderful and saving lives. Thank you so much for your comments. I live your 100 year comments.
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Ruby, I agree that heart transplants are amazing. I very much appreciate your very nice comments.
Ruby Jean Richert from Southern Illinois on December 07, 2019:
I find heart transplants amazing. We have developed techniques that were impossible a few years ago. Your research is also amazing. It was interesting to learn the statistics involving the heart, Well done!
Lorelei Cohen from Canada on December 07, 2019:
It truly is amazing the advances in medicine that are now allowing us to extend our life. Here's to a happy 100 years for each of us to enjoy (or so I am hoping).
Bill Holland from Olympia, WA on December 07, 2019:
I remember Barnard's one in 1967. I thought it to be one of the most amazing advancements in medicine. It still blows me away that they do that, and do it often.
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Chris, I remember the first one too as a child. I was always fascinated with medical advances and that may be why I became a nurse. I very much appreciate your wonderful comments.
Chris Mills from Traverse City, MI on December 07, 2019:
I remember hearing about the first heart transplants. Even as a child, I was amazed by the technology. I am a laboratory technician. I appreciate the research you put into this article. Very well done.
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Rebecca, I appreciate your very nice comments.
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Clive, Thanks for your comments.
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Flourish, I think the time factor will improve, and more hearts will be available also. Thanks for commenting.
Pamela Oglesby (author) from Sunny Florida on December 07, 2019:
Hi Liz, The advancements are amazing. As a nurse I have taken care of numerous people who had open heart surgery, but they do so much more now. I appreciate your comments, Liz.
Liz Westwood from UK on December 06, 2019:
In my life time heart transplants have really taken off. I have vague memories of Dr. Christian Barnard. It is amazing how much the techniques and skills around heart transplants have been improved. I even hear of double heart and lung transplants sometimes. Similarly, but in a totally different branch of medicine, IVF has been developed from early trials to become quite commonplace.
Elaina Baker from USA on December 06, 2019:
I heard about this but you explain it well here. I understand this could revolutionize heart transplants because of the availability factor — the window of time to prepare the heart for transfer will allow time for greater travel if needed and thus more people can be potentially served.
Clive Williams from Jamaica on December 06, 2019:
Thats magnificent. Great work
Rebecca Mealey from Northeastern Georgia, USA on December 06, 2019:
I've heard a lot about heart transplants and new technology lately. Interesting! Great article!
Pamela Oglesby (author) from Sunny Florida on December 06, 2019:
Hi Eric, I am sorry to hear about your heart. I guess the study helps others but it sounds a little sad. I always want the best for you Eric. I appreciate your sharing.
Eric Dierker from Spring Valley, CA. U.S.A. on December 06, 2019:
Well knock me down and cover me with fool's gold. Now I possess a bad heart. Oh it ticks like a clock which doctors are confounded about. My bad heart stems from bad things I have done. They want my body for study and not for transplant.It is gifted to U of A, medical department.
We must give what we can and sometimes that is our lives.