There’s a reason the heart is considered a vital organ. It pumps blood throughout our bodies. That blood, in turn, carries a constant supply of oxygen and nutrients to sustain our other organs and takes unwanted waste products away. Keeping the heart healthy is of utmost importance given its many crucial roles.
There are many conditions that can cause heart problems—and even lead to the need for a transplant. For example, congestive heart failure occurs when the heart’s capacity to pump blood does not meet the body’s needs. The most common cause of congestive heart failure—which affects 6 million Americans—is coronary artery disease. High cholesterol, high blood pressure, poor diet, a sedentary lifestyle, diabetes, being overweight, smoking, and stress are risk factors for coronary artery disease.
Heart failure may also be caused by other conditions, including heart valve disease, irregular heartbeat (arrhythmia), and structural heart disease. For advanced heart failure, mechanical solutions may be an option. For instance, a ventricular assist device (VAD) is a small mechanical pump implanted inside the chest to help keep the heart pumping. VADs are often called a “bridge to transplant” because they can improve a patient’s quality of life while they await a heart transplant.
When you need a heart transplant
Some individuals spend months or years on the waiting list. At Yale, before anyone is added to the heart transplant list, they meet with a team that includes a social worker, pharmacist, nutritionist, and surgeon to plan for care before and after the transplant. Potential transplant recipients must also undergo medical tests to determine if the transplant will benefit them.
“With this multidisciplinary approach, we have many experts coming together and discussing fairly openly what we think the likelihood is that the person will do well after the operation,” says Arnar Geirsson, MD, division chief of Cardiac Surgery.
Transplant surgery is a complex procedure and may take three to 12 hours. Recipients recover in the intensive care unit and can usually walk around within a few days.
“As long as everything goes well, we start education pretty quickly. We give patients a good idea of what life after transplant is like, as far as the nuances of medications, dietary changes, and other aspects of their care they need to think about,” says Kelsey Siegel, RN, Heart and Vascular Center transplant coordinator at Yale New Haven Hospital.
Immunosuppressant medications make transplantation possible, says Mabel Wai, a Heart and Vascular Center transplant pharmacist at Yale New Haven Hospital.
“These are medications that lower the responsiveness of your immune system at the time of transplant because of how the body reacts to—or rejects—foreign objects, such as a transplanted heart,” says Wai.
However, this “lowered” immune system puts patients at risk for infections, especially during the first year after transplantation. That’s why it’s important for transplant recipients to maintain lifelong relationships with their care team.
“For 10, 15, or even 20 years out, we see our patients twice a year to ensure they stay healthy. We commit to our patients by being their support team and giving them the resources they need post-transplant,” Siegel says.