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Heart transplant or cardiac transplant is a surgical condition which involves replacing dysfunctional heart with healthy heart .It is not considered to be a cure for heart disease, but a life-saving treatment. It is adviced when there is end stage heart failure and medical treatments are not helping. The patient's heart is removed and replaced with the donor, occasionally the diseased heart is left in place to support the donor heart .
Indications for Heart Transplant
Conditions that may eventually require a heart transplant include:
- Congestive Heart Failure - as the heart muscle gets weaken so it fails to pump blood efficiently.
- Coronary heart disease – a build-up of fatty substances in the arteries supplying the heart, which block or interrupt blood flow to the heart
- Cardiomyopathy – where the walls of the heart have become stretched, thickened or stiff
- Congenital heart disease – birth defects that affect the normal workings of the heart
- Cardiologist determines the eligibility for heart transplant whether you are suitable for one, also your Psychological and social evaluation
- Based on your assessment, you may be considered suitable for a transplant and then you will be put onto the transplant waiting list.
- Blood test- this will help to determine a good donor match.
- Diagnostic test- it will help to access the overall health of the recipient.
- Test such as x-ray, ultrasound, CT scan, pulmonary function test and dental examination.
- Others- several immunizations to prevent infections.
- A heart transplant operation usually takes between 4-6 hours
- Once a donor heart becomes available, a surgeon surgically removes the heart from the donor's body. The heart is stored in a special solution. The transplant surgery is performed at the earliest, after the donor heart becomes available.
- The procedure is performed under general anaesthesia
- During the surgery, the patient is placed on a heart-lung machine
- The surgeon makes incision in sternum to get access to heart.
- Diseased heart is removed, the donor’s heart is placed in the patient’s body and blood vessels connected.
- When the transplant procedure is completed , the heart will be restarted .
- When heart begins to take over pumping and condition is stable, the heart-lung machine will be turned off.
- Tube will be attached to drain fluid from the heart.
- The sternum will be joined and sutured together with wires.
- After the operation you will be moved to the intensive care unit .
- Ventilator attached so that breathing will be assisted.
- Blood samples will be taken frequently to check the status of the new heart.
- Immunosuppressant medicine will be given and monitored closely.
- You will have a wound along sternum
- Important to keep the surgical area dry and clean.
- Advised to avoid strenuous activities until sternum is fully healed, which can take up to three or four months.
- There will be follow- up after the surgery which may include blood test, X-Ray other tests
- Attend all your appointments – this allows doctors to monitor your health and alter medications if needed.
- Take your prescribed medication.
- Adviced to make lifestyle changes -Don’t smoke – this will help to keep your heart healthy, Do regular physical activity , Eat a healthy, balanced diet, control cholesterol and blood pressure, maintain healthy weight.
- Maintain personal and food hygiene to avoid infection.
A heart transplant is a complex and risky procedure. Possible complications include:
- Rejection by immune system
- Graft failure -the donated heart fails to work properly
- narrowing of the arteries supplying the heart
- Side effects from the immunosuppressant medication
- Bleeding after the surgery
- Blood clot that can cause heart attack, stroke or lung problem
- Breathing problem
- Kidney failure
For those people who are fortunate enough to receive a transplant, the long-term outlook is good . 75% are alive after five years.Quality of life is usually good.
Factors Affecting Cost of Heart transplant
Following are the factors which will affect the treatment cost:
- The hospital patient is opting for.
- Operating room, recovery room charges
- Fee for the team of doctors (Cardiologists, Anaesthetist, etc )
- Medicines and sterile dressings
- Standard test and diagnostic procedures
- Cost of follow up care