T.C. Sağlık Bakanlığı
İstanbul Sağlık Bilimleri Üniversitesi
Mehmet Akif Ersoy Göğüs Kalp Ve Damar Cerrahisi
Eğitim Ve Araştırma Hastanesi

Cardiac Transplant


Cardiac Transplant

What is cardiac transplant?

Cardiac transplantation is the process of replacing the patient's heart with a healthy human heart. When a healthy person who has donated an organ is killed, organs such as kidney, liver, heart, lung are prepared and transferred to a patient who has previously received organ transplants. All organ donation organization, the Republic of Turkey Ministry of Health, National and Regional Coordination Centers will be made by employees on site.

 

Investigations made before and after Cardiac transplantation

The tests performed before and after cardiac transplantation in our center can be listed as follows. Additional tests are also carried out when deemed necessary.

  • Electrocardiography (ECG); is the device in which the electrical activity of the cardiac (rhythm, frequency) is recorded.
  • Echocardiography (ECO); The function of the cardiac pump is to determine the movements of the cardiac wall, the function of the caps, and the dimensions of the cardiac chambers.
  • Laboratory tests
  • Blood group identification
  • The presence of infections such as hepatitis, HIV
  • Kidney, liver diseases, anemia, bleeding problems are tested.
  • Cardiac catheterization and angiography; This test, which is performed by introducing the coronary artery through the artery and giving the cardiac opaque substance, shows the obstructions in the coronary vessels feeding the heart, the pressures of the cardiac  chambers can be measured and the cardiac functions can be determined.
  • Peripheral doppler test; With this method, obstructions in the veins, stenosis can be detected.
  • Carotid doppler test; Examination of the carotid artery by ultrasound.
  • Abdominal ultrasonics; It is checked whether there is a problem in the organs in the abdomen.
  • Lung film; It is used to check for any problems in the lungs.
  • Lung function tests; It measures the function of the lungs and the aeration capacity.
  • Cardiac biopsy; is a method used to investigate post-transplant tissue rejection. The cardiac  is reached with the help of a wire sent into the vein passing through the inguinal or the neck and samples are taken from the cardiac tissue. Acquired tissue samples are sent to the pathology to determine if the tissue is rejected, if any. Cardiac biopsy is performed on the 15th post-transplant for the first time. It can be applied 4-6 times on the average within the first year after transplantation. Over the years, the biopsy frequency is reduced.

 

What is cardiac failure?

 

Heart; is a vital organ that provides blood circulation in the body.

Poor oxygenated blood returning from the body is sent to the lungs by the right ventricle of the cardiac. The blood that is oxygenated in the lungs returns to the left ventricle of the cardiac, and from there it is pumped to the whole body.

Cardiac failure occurs when the right, left, or both tines of the heart are unable to function.

Cardiac failure is a progressive disease, and the strength of the heart gradually decreases over time. The cardiac becomes unable to pump blood in the amount needed by the body. As a result, nutrients and oxygen can not reach as much as tissue and cells. Therefore, various problems begin to appear in the organs.

Cardiac failure can be seen at any age, depending on the underlying cause. However, studies show that the incidence is higher in people over 65 years of age (cardiac failure, 2.5% of people over 45 years old and about 10% of people over 65 years of age).

Cardiac failure; is the leading cause of hospitalization and death in our country and all over the world. More than half of patients with end stage cardiac failure are lost within 1 year after diagnosis.

How is cardiac failure treatment done?

In the treatment of heart failure, remedies for drugs, diet, rehabilitation, rhythm disturbance remedies and disease causing heart failure can be applied.

However, when heart failure progresses to the last stage, none of these treatments will be able to get enough response. The most effective methods for the treatment of heart failure at this stage are; heart transplantation and artificial heart support devices.

Disease Symptoms

  • Horny breathing
  • Heart pain

What are the diseases that lead to cardiac failure?

Ischemic Cardiomyopathy: Coronary Artery Disease is the most common cardiac disease. Coronary vessels are the cardiac-feeding veins. These vessels become narrowed and / or blocked because the cardiac does not go to enough nutrients and oxygen. This causes the cardiac muscle to be damaged or even die (myocardial infarction). The damage to the cardiac muscle is caused by a decrease in the cardiac contraction force, which is called ischemic cardiomyopathy. As the force of contraction of the cardiac decreases, cardiac failure symptoms begin to emerge and the severity of symptoms increases with time.

Dilate Cardiomyopathy: A disease that causes cardiac failure due to enlargement and expansion of the cardiac due to insufficient contractility due to congenital structural disorder of the cardiac muscles. In people born with Dilate Cardiomyopathy, cardiac failure can occur in infancy or childhood, or it may not be noticed until you are symptomatic in adulthood.

Complex Heart Valve Disease: Congenital or acquired aortic and / or mitral valve deficits increase cardiac workload and can lead to cardiac failure resulting in cardiac failure.

Myocarditis: A virus infection is a disease that results from the loss of muscle contraction power. Disturbance of the calvainous contraction may become completely permanent after the virus infection has passed, and it may become permanent and result in cardiac failure.

Congenital Cardiac Diseases: Disruptions in the development of the cardiac or cardiac-related vessels during the embryological development process that occurs in the mother's womb lead to the fact that the hearts of the born babies are not in normal structure. These congenital cardiac diseases, which can be very diverse, can be repaired by surgery or interventional techniques when diagnosed on time. However, despite this repair, cardiac failure may occur early or late.

Who Can Benefit From Cardiac Transplantation?

Cardiac patients under 65 years of age who are in the last phase of cardiac failure (Stage-D) and who are expecting less than 1 year of life, regardless of what cause (ischemic cardiomyopathy, dilate cardiomyopathy, valve diseases, myocarditis, congenital diseases, heart tumors etc.) They can be candidates for.

In addition, although there is no end-stage cardiac failure, treatment of some rhythm disorders (eg, ventricular fibrillation) resistant to all kinds of medications and rhythm regulatory treatment, resistant and life-threatening, can also be done by cardiac transplantation.

Elderly patients (65-72 years) may be eligible for appropriate treatment when their physical characteristics are carefully assessed.

In addition to all these, it is important for patients who will become cardiac transplant candidates to have full compliance with treatment, lack of drug / substance abuse, and, if possible, family and social support.

The success of surgery after cardiac transplantation, and any other medical problems that may adversely affect the quality of life of the patient, are also carefully examined and evaluated.

It is the practice of the patients to take a programa after the above mentioned medical, psychological and social characteristics of the patients are evaluated by the experts in the cardiac transplant team.