The heart transplant process is a nerve-wracking journey of extraordinary technical and medical expertise working against the steady ticking of time. Here’s an unvarnished look at how a typical heart transplant happens and the many intricate steps involved.
The Cardiac Recovery Team
When a potential donor heart is located, a team of very experienced cardiac surgeons is sent via chartered jet to check on the condition of the heart, carefully matching it for a variety of factors, including size, shape, age, and blood type, comparing those factors against those of the intended recipient.
Cardiac transplant surgeons make the call on whether or not to accept the heart, as they are the only ones who can visualize where and how to strategically remove a donor heart from its body of origin to match the specifications of the intended recipient. No other organ transplant requires this.
Once the procurement resource planning surgical team accepts the donated heart on behalf of the patient, and the intended heart recipient and Operating Room (OR) transplant team are notified and begin their preparations.
The value of this gift of life is not taken lightly. There is often a moment of silence to acknowledge the heart donor for his or her gift of life.
Now the “surgical dissection” maneuvers begin, carefully uncoupling the heart from its attached vascular system and removing it from the donor’s body.
The viability ‘window’ of a recovered heart is extremely limited. Both recovery and donor teams must be ‘synchronized’ and in continuous communication. This is where highly-coordinated medical logistics between OR teams truly begins.
The donor heart is carefully removed, cleaned, cooled in a special saline solution, and flown to the transplant destination in the shortest amount of time possible, often across many states.
Barring no unexpected delays, the Cardiac Transplant team of surgeons and OR nursing staff should have a fairly good understanding of when to place the recipient patient under anesthesia.
The Cardiac Transplant Team
With thorough ongoing logistics communication, the two cardiac teams work together to assure that the patient recipient will be prepped by the implant surgery team and ready to go — when the donor heart arrives.
Once the donor heart arrives in the OR, the double and triple checking of blood type and heart statistics begins. If everything checks out – and sometimes, even this late in the game, it does not, and the surgery is called off – the arduous multi-hour transplant process begins.
An incision is made into the transplant recipient’s chest, and a surgeon opens the rib cage so that he or she can safely operate on the heart. The patient is now attached to a heart-lung bypass machine, which ensures that the patient continues to receive oxygen-rich blood to sustain body functions during the hours of surgery to come.
Now, the attention turns back to the donor heart. It is specially cleaned and re-examined on a separate table and brought over to the
recipient where it is placed appropriately into the chest cavity. Now the highly specialized and intricately intense sequence of surgical attachment begins. All major blood vessels must be perfectly fitteded to the recipient heart.
Once the implantation surgery is successfully accomplished, the arterial clamp is removed, and the blood from the recipient can flow through its new heart. After a few tension-filled seconds, the heart begins to beat (or is shocked via a specialized AED to get it to beat on its own). The heart recipient is now carefully removed from the heart lung machine.
A ventilator helps the patient breathe, while tubes in the chest remain to drain fluids from around the lungs and heart. The incision sites are checked repeatedly for bleeds. Finally, the chest cavity opener is removed, and the chest is sutured.
OR nurses will tell you that the most important work of the transplant process begins after surgery is complete. Heart transplants require extensive after care.
The patient is likely to remain in the ICU for a few days before being moved to a regular hospital room. Heart transplant patients often stay in the hospital for a week or two. The time varies from person to person, depending on any complications.
Heart transplant patients may take immunosuppressants to decrease the activity of their immune systems and to prevent it from attacking their donated heart. Some of these drugs will be taken by the patient for the rest of their life. Over time, the risk of heart rejection decreases.
Here is a link to a 5-minute 360-degree video of the heart transplant process.
MediGo is honored to be a valued organ transplant partner in medical logistics. Our Organ Delivery Management system involves high-tech communication and time-sensitive tracking in real time. When everyone involved in the transplant process knows – minute by minute — exactly where the organ is, OR and patient prep can be orchestrated right down to the second.