Heart transplant, when is it necessary?

The history of heart transplants in Spain dates back almost four decades, since which date more than 9,000 have been performed. In recent years, the number of patients who have undergone this intervention has remained around 300 per year, even during the most complicated times of the pandemic, since 278 procedures were performed throughout 2020 . Thanks to these interventions, more and more patients have been able to survive, most of them with a good quality of life.

But, when does this option arise? As explained by Dr. Nicolás Manito Lorite, from the Bellvitge University Hospital Cardiology Service, in this video from #intheheartofthehospital , heart transplantation is indicated for diseases of the myocardium -the heart muscle- when they are in a very advanced stage . In patients with end-stage heart disease, transplantation may be the option with the best guarantee of success. In fact, the prognosis is very favorable if we take into account what the patient’s life expectancy would be if they had not undergone the transplant, since many of them would die if they did not undergo a transplant within a year after being diagnosed with severe heart failure.

Regarding these survival expectations, Dr. Francisco González Vílchez, a cardiologist at the Marqués de Valdecilla University Hospital, explained in this press release that the first year after transplantation is the one with the highest mortality. However, despite this, more than 80% of heart transplant recipients survive this period . “In these cases, the median survival is up to 18 years,” he noted.

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The procedure consists of replacing the heart of a patient with terminal heart muscle disease with the healthy heart of a deceased person. When health professionals verify that the transplant is the best alternative for the patient, they must undergo a series of tests in order to be placed on the waiting list . With them, the blood group, the immunological suitability and also that the patient does not have any pathology that could limit their life expectancy, be they systemic diseases, cancer or other pathologies that put the patient at risk, are checked.


Once the intervention has been completed, it is important that transplant patients follow these five recommendations recalled by Dr. Lorenzo Silva, a cardiologist at the Puerta de Hierro University Hospital in Majadahonda (Madrid), in this # telodigodecorazón video :

– follow the indicated pharmacological treatment, taking immunosuppressant medication.

– Avoid as far as possible situations that increase the chances that the patient may suffer an infection.

– exercise regularly and maintain a healthy diet, trying to cook food well and not eating raw meat.

– Go to the revisions of the calendar indicated by the specialist, in which endomyocardial biopsies and catheterizations are included from time to time.

– follow the recommendations of the healthcare professionals who treat you.


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