What Is a Heart Transplant?
The procedure involves removing the sick heart from the patient and replacing it with a donor heart that is in good health.
In certain cases, a child’s heart cannot function properly and he or she cannot survive without a transplant. The condition is sometimes referred to as heart failure or pediatric heart disease at its end-stage. Medicine, surgery, or other procedures are usually first used to treat heart failure. A child can require a heart transplant if those methods do not work. [1]
When people die, their organs will be donated by organ donors who agreed (or whose guardians agreed) to do so. To help someone who is sick, they choose to donate their organs.
After undergoing heart transplant surgery, many kids lead healthy and normal lives. To prevent their bodies from rejecting their heart, they will be taking medicines for the rest of their lives. When the newly constructed heart is rejected, the body’s immune cells attack it because it is foreign to them.
Related: Congenital heart disease in children
What Happens Before a Heart Transplant?
Doctors will recommend a heart transplant center to you if your child needs one. A transplant team usually consists of the following members:
- surgeons
- Transplant coordinators
- cardiologists (heart doctors)
- nurses
- psychologists
- dietitians
- social workers
As part of the health care team, your child will be examined to ensure that he or she is healthy enough to have surgery and take the necessary medications. Tests such as these will be conducted by the team:
- Blood tests: determining blood type.
- An echocardiogram: an imaging test that uses sound waves to produce images of the heart.
- Electrocardiogram (ECG, EKG): measures the electrical activity of the heart and indicates if the heart is arrhythmic or if the heart muscle is injured.
- Cardiac catheterization: This medical procedure entails the insertion of a thin, plastic tube into a blood vessel and connecting it to the heart so doctors can examine the organ from there. [2]
In addition, your doctor might perform a biopsy, which involves the removal of a small fragment of heart tissue for examination under a microscope.
As much as possible about your child is learned through the transplant evaluation. As well as information about what your child will experience before, during, and after the transplant, this is a time for you to learn about your child’s body. Information and support are provided by the transplant team. When you are unsure about something, be sure to ask.
The next step is finding a heart for your child if the transplant team determines that he or she is a good candidate. On the organ waiting list is the name of your child. The list below contains the names of all the people who are waiting for an organ.
There is a possibility that your child may have to wait to be matched with a suitable heart. It can take a long time to fill the gap between the number of hearts needed and the number of hearts donated.
You will be in close contact with the health care team and your doctors. Continually stay in touch. The sooner you act, the better your chances are of finding a heart. Have a bag on hand and be prepared to go to the transplant hospital immediately.
Make sure that your child remains as healthy as possible while you await a transplant. If the time comes for a transplant, he or she is prepared to undergo it. Here are some helpful tips for you:
- Make healthy food choices
- Follow the directions on all medications
- Remain in contact with your doctors
Any changes in your child’s health should be reported to your doctor as soon as possible.
During heart transplant surgery, what happens?
Your child will be prepared for surgery by the transplant team when you arrive at the hospital. Testing may be conducted to determine if the new heart is the right one. An operating room is next on your child’s agenda.
Your child will be put under anesthesia in the operating room so that he or she can sleep through the procedure. A chest incision (cut) is made by the surgeon and the sick heart is removed. By sewing the new heart’s blood vessels to your child’s blood vessels, the surgeon attaches the new heart to the chest area. A doctor might not close the incision right away to check the heart’s function.
It takes between 4 and 6 hours for a heart transplant to be completed. While you wait for the surgery to begin, you will receive regular updates from the transplant team.
What Happens After Heart Transplant Surgery?
The cardiac intensive care unit (CICU) would be the place your child would go every night after heart transplant surgery. There is the possibility of visiting your child briefly. Pain medicine will be given to your child. Once the doctors are confident the new heart is working properly, the patient will be placed on a ventilator while on a breathing tube. Some time may be needed for this.
Depending on your child’s condition, ICU stays can last anywhere from 24 hours to a few weeks. A typical stay lasts between seven and ten days. You will need to transfer your child to the general cardiac unit when your child is ready. In addition to caring for your child, the transplant team will closely monitor him or her.
After surgery, children typically spend at least 3 to 4 weeks in the hospital. A new heart is taught to kids and their families during this time. Your child needs to carefully follow the instructions provided by the doctor.
You will likely return to the hospital multiple times in the weeks after your child goes home so the doctors can make sure that everything is okay.
What Problems Can Happen?
After a transplant, rejection is a common problem. This occurs because the body does not recognize the new heart and does not realize its usefulness. Therefore, the immune system attacks it.
A medication (also known as an immunosuppressant or anti-rejection medicine) can control this reaction. A new heart is tricked into being accepted by the body in a way. In the days following surgery, they can increase the likelihood of infection for your child. Make sure your child does not come into contact with sick people and wash hands well and often at home.
In the first few weeks following transplant surgery, the risk of rejection is greatest. A new heart is never completely accepted by the body. Therefore, anti-rejection medicines need to be taken perpetually.
After the body becomes used to the new heart, immunosuppressants are usually reduced in amount. A new transplant is needed only rarely when the body rejects the new organ.
Future Perspectives
Heart transplant recipients often live healthy lives after recovery. Several people report feeling better than they have ever done.
Maintaining the health of your child’s new heart is very important to you as well. Don’t forget to encourage your child to take his or her medicines as directed, rest well, and exercise frequently.
Keeping an eye out for inflammation and/or rejection can help you detect your child’s illness.
- tiredness
- weight gain
- fever
- trouble breathing
- vomiting
- poor appetite
Any of these problems should be discussed with your doctor immediately.
You will have regular doctor’s checkups so problems can be caught early. This might happen once a week at first. It will get easier as time goes on. One or two annual checkups might eventually suffice.
What can I do to help my child?
Kids who have serious health issues may find it difficult to cope. Stress can be exacerbated by surgery and immunosuppressant therapy. How you will incorporate these changes into your daily routine should be discussed with your child. Take time to do fun things with friends and family.
The use of immunosuppressive drugs can be challenging for teens. You may experience:
- more acne
- weight gain
Teens at risk for not taking medicines after transplants are frequently affected by side effects from these drugs. A rejection of the new heart is possible. So make sure you tell them how important it is to take their medications as prescribed.
To help:
- Whenever your child needs to talk to you, be there for him or her.
- A therapist or counselor can provide the additional support your child needs.
- Support groups can be found online. Kids and teens can use these groups to relieve stress and make connections with others going through similar difficulties. The Transplant Living website provides online resources.
- Make sure you get support as well. Being able to express yourself with people who understand what you’re feeling can be a great relief. If you have questions about family support groups, ask your transplant care team.