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WHAT YOU SHOULD KNOW:
- A heart transplant is a surgery done to replace your failing heart with a donor heart. The donor is another person who has chosen to give their organs to others when they die. Your heart looks like an upside-down pear and is found in your chest between your lungs. Your heart is connected to large blood vessels such as the aorta and vena cava. Your heart has four chambers (spaces) including two upper atria and two lower ventricles. The chamber walls are muscle tissue that beat (tighten and relax) constantly. With each beat, blood, oxygen, and nutrients are pumped to other tissue and organs in your body.
- Conditions such as heart failure, coronary artery disease, or congenital (born with) heart disease weaken and damage your heart. A weak or damaged heart may not pump enough blood to the rest of your body. Tissue and other organs will not have enough oxygen and nutrients to function properly. Heart disease may be controlled for a long time with medicines and other treatments. If your heart failure becomes severe (very bad), you may need a heart transplant. When you are in need of a heart transplant, you will be placed on a transplant list. You may need to wait for a long period of time before a donor heart is found. When a donor heart is found and ready, you will be called to the hospital.
- During surgery, your caregiver will cut open your chest down to your heart. Your failing heart will be removed and the donor heart will be secured in its place. When your new heart is in place and beating, your caregiver will close your chest. You may be watched closely in the hospital for a few weeks after your surgery. With a heart transplant, your symptoms such as shortness of breath and chest pain may resolve. A heart transplant may improve your ability to function without tiring so easily. You may be able to begin doing activities you enjoy again.
Take your medicine as directed:
Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
- Antibiotics: This medicine is given to fight or prevent infection caused by bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
- Antifungals: This medicine helps kill fungus that can cause infection and illness. Antifungal medicine may be taken orally or used as an ointment or cream on your surgery site.
- Antirejection medicine: Your body tries to attack your new organ like it would attack an infection. These medicines are given to help your body accept your new organ and to keep your body from rejecting it. You may need to take this medicine for the rest of your life.
- Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.
- Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.
- Pain medicine: You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
- Statins: These medicines are used to decrease the amount of fat in your blood.
Ask your caregiver when to return for a follow-up visit:
- You will need to have regular, lifelong follow-up visits with your caregiver after your transplant. Your blood or urine may be tested often to check the level of antirejection medicine in your body. You may need an endomyocardial biopsy done a week after surgery, and as suggested by your caregiver. During the biopsy, a small sample of tissue from your new heart is collected. Your caregiver will get the tissue sample through a small cut made in your chest. The sample tissue is sent to a lab to check if your body is accepting the donor heart.
- An intravascular ultrasound (IVUS) may be used to check how your new heart is working. An IVUS may also be used to look for signs of early rejection after your surgery. You may need repeat ECGs, an echocardiogram, cardiac catheterization, and magnetic resonance imaging of your heart. Ask your caregiver when to come back to have your stitches or chest drains removed. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.
During photopheresis, a machine is used to treat samples of your blood with ultraviolet (UV) light. This is done to remove cells that may cause your body to reject the donor heart. The treated blood will be returned to your body through an IV.
Cardiac rehabilitation, or cardiac rehab, is a program that helps you feel better after your heart transplant. Cardiac rehab may also decrease your risk of having heart problems in the future. During cardiac rehab, you learn how to live a more heart-healthy lifestyle. You may also learn how to exercise safely to strengthen your muscles and heart.
After your heart transplant, you may have feelings of sadness and guilt. You may have trouble thinking about how the heart in your chest came from someone who has died. You and those close to you may be anxious and scared during your recovery. These feelings are normal. You may choose to see a special caregiver to talk about your feelings. Your family and friends may also be a part of these meetings. Talking with a caregiver may help everyone understand your condition, surgery, or care better.
Deep breathing and coughing:
Deep breathing and coughing helps keep you from getting a lung infection after surgery. Deep breathing opens the airways going to your lungs. Coughing helps to bring up sputum (mucus) from your lungs for you to spit out.
- Hold a pillow tightly against your wound when you cough to help decrease the pain. Take a deep breath and hold the breath as long as you can. Then push the air out of your lungs with a deep, strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while you are awake. Remember to follow each deep breath with a cough.
- You may be asked to use an incentive spirometer. This helps you take deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Hold your breath as long as you can. Then let out your breath. Use your spirometer every hour while you are awake.
Diet and drinking liquids:
- Eat a variety of healthy foods every day. Your diet should include fruits, vegetables, breads, dairy products, and protein (such as chicken, fish, and beans). Eating healthy foods may help you feel better and have more energy. You may be told to eat foods that are low in fat or cholesterol. You may also be told to limit the amount of salt you eat. Special cookbooks can make it easier to plan low-fat and low-salt meals. Ask your caregiver if you should be on a special diet.
- Follow your caregiver's advice about how much liquid you should drink each day. For most people, good liquids to drink are water, juices, and milk. Try to drink enough liquid each day, and not just when you feel thirsty.
If you smoked before your heart transplant, do not start again. Smoking harms the lungs, blood, and your heart. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking.
CONTACT A CAREGIVER IF:
- One or both of your ankles are swelling.
- You are dizzy and feel like you are going to faint (pass out).
- You fall when trying to get up and walk.
- You feel anxious and can't think clearly.
- You have a cough, sore throat, or a cold sore.
- You have pain in your surgery site that does not get better after taking medicine.
- Your stitches or staples are loose or coming out.
- You have questions or concerns about your condition, medicine, or care.
SEEK CARE IMMEDIATELY IF:
- You have signs of a heart attack:
- You have chest pain or trouble breathing that is getting worse over time.
- Chest pain or discomfort that spreads to your arms, jaw, or back.
- Unusual, sudden back pain.
- Nausea (sick to your stomach).
- Trouble breathing.
- Lips or nailbeds that turn blue or white in color.
- This is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!
- Your surgery site is swollen, red, or has pus coming from it.
- You have a fever (high body temperature).
- Your bandage begins to soak with blood.
- You are urinating less than usual or not at all.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
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