A heart transplant is an operation wherein the doctor replaces an individual’s failing heart with a healthier donor heart. Typically, the surgery is for people whose condition does not improve with other surgeries or treatments, such as end-stage heart failure or severe coronary artery disease. Even though a heart transplant is one of the complex procedures, the survival chances and recovery is good with adequate follow-up care, proper nutrition, and lifestyle changes.

Why is it done?
Doctors suggest a heart transplant when other treatments do not work and there is a risk of heart failure. Typically, heart valve disease, coronary artery disease, weakening of heart muscle, congenital heart defect, failure of previous transplant, and ventricular arrhythmias are some of the reasons for heart failure. Children usually suffer from heart failure by a cardiomyopathy or a congenital heart defect. However, a heart transplant is not for everyone. One may not be the ideal candidate for a heart transplant if:

They have an active infection
They are at an advancing age
They have a possibly life-threatening condition
They are unable or unwilling to make necessary lifestyle changes
They have a recent history of cancer

Procedure
A heart transplant is one of the most intense and complex procedures. It has three phases:

Before the transplant
Several steps are required to prepare the patient for the transplant. Here is a basic guide to the course of action taken once an individual is referred to a transplant program.

The doctors administer a transplantation evaluation.

First, the candidate will undergo different tests to assess their overall health and study their kidney function, immune system tolerance, and blood composition.
The doctor will perform diagnostic tests to check the working of the patient’s heart and circulatory and respiratory systems.
Imaging and blood tests are the next step.
Healthcare providers will check the candidate for specific diseases like HIV, hepatitis C and B, tuberculosis, varicella-zoster virus, toxoplasmosis, and herpes simplex virus.
An infectious disease specialist will ensure the candidate’s vaccines are up-to-date.
The patient will undergo neurological and psychological evaluation and testing because maintaining a healthy transplant is challenging and stressful.
The doctor will assess oral health, especially the condition of the candidate’s teeth, as infections from cavities can spread to the heart.
As one of the most intensive and challenging procedures, the healthcare team will ensure patients have a solid support system to help with recovery.
They will talk the candidate through the resources needed in the process.
Once all these steps are done, the candidate will be put on the waitlist.
There will be a bridge treatment – an ongoing treatment as one waits for the transplant or support with a mechanical device till a suitable donor is found.

During the transplant
As stated, a heart transplant is an extremely challenging procedure with several possible risks. So, the care team will undertake the following steps:

Administer anesthesia
Patients will receive general anesthesia to put them into deep sleep.

Put you on a ventilator
The doctor will insert a tube down the patient’s throat and annex the tube’s end outside the body to the ventilator. It will help them breathe despite the anesthesia.

Add blood thinners
They will add blood thinners to the blood to lower the risk of clots and allow the blood to flow through the heart-lung bypass machine.

Connect the candidate to a cardiopulmonary bypass machine
This is done to take over the heart and lungs’ working during the surgery. It helps adds oxygen to the blood, removes carbon dioxide, and ensures the blood circulates to other tissues and organs.

Remove the heart
The surgeon will remove the patient’s heart to accommodate the donor’s heart. It involves clamping the blood vessels that connect to the heart and disconnecting the organ from them.

Implanting the new heart
Finally, the surgeon will attach the donor’s heart to the blood vessels and begin restarting and warming the donor’s heart. One may need an electrical pacing device for the new heart to start breathing, but it is only a temporary implantation.

After the transplant – The care and recovery phase
Once the transplant is over, patients need to undertake the following steps:

Hospital recovery
Depending on the situation, patients will stay in the hospital for one to three weeks. For the first part of the recovery, they will be in the intensive care unit, where doctors will monitor them 24/7. A team of doctors will scrutinize the patient’s vital signs and watch for any symptoms of the body rejecting the donor’s heart.

Care plan
Before leaving the hospital, the doctor will suggest a care plan that must be followed as one recovers at home.

Cardiac rehab
Patients may be asked to join a cardiac rehab program to improve their heart function, endurance, and strength.

Cost
An average transplant cost is about $1,664,800. It comprises expenses from pre-and-post transplant care, doctor fees, hospital charges, organ procurement, and therapies.