After spending 20 months on a waiting list, former Vice-President Dick Cheney underwent a heart transplant on Saturday, March 24, 2012. A long-time cardiac patient, Cheney suffered his fist heart attack at age 37.
In 2010, he was diagnosed with end stage heart failure. To help his heart to continue to pump adequate supplies of blood, a left ventricular assist device was implanted.
Heart transplants are the treatment of last resort for those with end-stage heart failure. Heart failure is a life-threatening condition where the heart has become so diseased or damaged that it can no longer do its job and supply the body with enough blood.
End-stage heart failure can be caused by numerous conditions including hereditary heart conditions, viral infections of the heart, heart disease, and heart damaged heart valves or muscles. As the name implies, end-stage heart failure occurs when all other treatment options have been tried without success.
Once a determination is made that no other treatment options exist, a heart transplant may be recommended. Not every person with end-stage heart failure is a candidate for a heart transplant. Determining who is eligible for a heart transplant can be a delicate balancing act.
All patients with end-stage heart failure are obviously extremely ill and have exhausted normal treatment options. However, not all end-stage heart failure patients are well enough to survive a heart transplant.
Heart transplant candidates are evaluated by a team of doctors and other professionals, including a psychiatrist, social worker, transplant coordinator, dietician, cardiologist, and a cardiovascular surgeon. The transplant team evaluates the candidate on a number of different criteria, including age and blood circulation.
In addition, other conditions such as history of cancer, high blood pressure, infections, diabetes, and a history of diseases affecting the kidneys, lungs, or liver are also considerations in determining suitability for a heart transplant.
The mental state of the candidate is also important because heart transplant recipients will have to make lifelong lifestyle changes after the transplant. People who engage in unhealthy lifestyle habits, such as drug or alcohol abuse are generally not candidates for a heart transplant.
Once approved by the evaluation team, the heart transplant candidate is placed on a national transplant waiting list. All organ transplants are administered by the Organ Procurement and Transplant Network (OPTN).
When a donor heart becomes available, the OPTN selects a recipient based on the factors such as location of the recipient, urgency, blood type, and size of donor.
In the United States alone, there are approximately 3000 people waiting on a heart transplant at any given time. Unfortunately, there are generally fewer donors available than recipients.
While heart transplants are the treatment of last resort, those lucky enough to receive a new heart can expect a much-improved survival prognosis. Most recipients, 88 percent, survive the first year with 75 percent surviving for an additional five years.
More than half of all transplant recipients, 56 percent, survive for an additional 10 years. Most transplant recipients are able to resume a normal life.
Sources:
What is a Heart Transplant? National Heart Lung and Blood Institute. 03 Jan 2012. http://www.nhlbi.nih.gov/health/health-topics/topics/ht
Peter Nicholas. Cheney Undergoes Heart-Transplant Surgery The Wall Street Journal. 24 Mar 2012. http://online.wsj.com/article/SB10001424052702304724404577302181063114506.html
Updated by Shabir Bhimji, MD, PHD. Heart Transplant. MedlinePlus, a service of the U.S. National Library of Medicine, National Institutes of Health. 04 May 2011. http://www.nlm.nih.gov/medlineplus/ency/article/003003.htm
Reviewed March 26, 2012
by Michele Blacksberg RN
Edited by Jody Smith