Heart Transplant (cont.)
Who needs a heart transplant?
Every year in the United States there are about 4,000 people who could benefit
from a heart transplant. Unfortunately, there are only about 2,000 donor hearts
available. Therefore, there is a careful selection process in place to assure
that hearts are distributed fairly and to those who will benefit most from the
donor heart. The heart is just a pump, although a complicated pump. Most
patients require a transplant because their hearts can no longer pump well
enough to supply blood with oxygen and nutrients to the organs of the body. A
smaller number of patients have a good pump, but a bad "electrical conduction
system" of the heart. This electrical system determines the rate, rhythm and
sequence of contraction of the heart muscle. There are all kinds of problems
that can occur with the conduction system, including complete interruption of
cardiac function causing sudden cardiac death.
While there are many people with "end-stage" heart disease with inadequate
function of the heart, not all qualify for a heart transplant. All the other
important organs in the body must be in pretty good shape. Transplants cannot be
performed in patients with active infection,
cancer, or bad diabetes mellitus;
patients who smoke or
abuse alcohol are also not good candidates. It's not easy
to be a transplant recipient. These patients need to change their lifestyle and
take numerous medications (commonly more than 30 different medications). Hence,
all potential transplants patients must undergo psychological testing to
identify social and behavioral factors that could interfere with recovery,
compliance with medications, and lifestyle changes required after
transplantation.
Moreover, needing a heart and being a suitable candidate are not enough. The potential
donor heart must be compatible with the recipient's immune system to decrease
the chance of problems with rejection. Finally, this precious resource, the
donor organ, must be distributed fairly. The United Network for Organ Sharing
(UNOS) is in charge of a system that is in place to assure equitable allocation
of organs to individuals who will benefit the most from transplantation. These
are usually the sickest patients.
Next: What are the results of a heart transplant? »
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