If a heart muscle has been badly damaged and does not respond to treatment, a person may need a heart transplant. In a transplant, the diseased heart is surgically removed and replaced with a healthy heart from a donor who has suffered brain death. Cardiomyopathy is the term used to describe a weakened heart muscle. People can develop cardiomyopathy for many reasons. The most common is that the heart has been damaged by a heart attack(s) and has lost its ability to function normally. Hearts can also be damaged by viruses, abnormalities of the heart valves, congenital structural abnormalities, and alcohol or drug abuse. Sometimes women can develop cardiomyopathy during or after pregnancy and sometimes it just happens for no clear reason.
When a heart transplant is determined to be necessary, the patient is put on the UNOS (United Network for Organ Sharing) waiting list. When a donor heart becomes available information about the donor is matched with potential recipients by the UNOS computer. UNOS identifies the recipients that have a compatible blood type and body size and then ranks them by how ill they are and how long they have been on the waiting list.
Having a strong support system, such as family and friends, is necessary for a successful transplant and post-operative course. The evaluation and waiting period are often very difficult and stressful. Sometimes a patient’s heart failure worsens causing frequent or prolonged hospital stays and in some cases a patient may need a heart pump to “buy time” until a donor heart becomes available. Patients often cannot work due to their illness. Family and financial stress is very common for all these reasons.
After heart transplant surgery, patients typically are in the hospital 1-2 weeks. After discharge they are followed with lab work, doctor visits, echocardiograms, and heart biopsies. Follow-up after a heart transplant lasts for the rest of the patient's life. The follow-up is most intense for the first several months and then gradually becomes less frequent. Patients must take medicine to prevent rejection as well as other medicines. Rejection medicines can be very hard on the patient’s kidneys and are associated with many side effects. Rejection medicines also make transplant patients more prone to infections and certain kinds of cancer than the average person. After surgery, patients must follow a healthy diet, not smoke, and should get regular exercise.
Heart transplants help many people who would otherwise die. Transplants cannot happen without donors. If you would like to be an organ donor in the event of your death, it is important to talk about it with your family NOW. Let them know your wishes to be a donor. You can also register to be a donor at www.IowaDonorNetwork.org.