Why Do Heart Transplants Only Last 10 Years?

Why Do Heart Transplants Only Last 10 Years
While transplanted organs can last the rest of your life, many don’t. Some of the reasons may be beyond your control: low-grade inflammation from the transplant could wear on the organ, or a persisting disease or condition could do to the new organ what it did to the previous one.

Can a heart transplant last 20 years?

Characteristics of Patients With Survival Longer Than 20 Years Following Heart Transplantation | Revista Española de Cardiología Introduction and objectives The number of heart-transplant recipients exceeding 20 years of follow-up is steadily increasing. However, little is known about their functional status, comorbidities, and mortality. Identifying the predictors of prolonged survival could guide the selection of candidates for the low number of available donors. Methods Functional status, morbidities, and mortality of heart-transplant patients between 1984 and 1992 were analyzed. To identify predictors of 20-year survival, a logistic regression model was constructed using the covariates associated with survival in the univariate analysis. Results A total of 39 patients who survived 20 years (26% of patients transplanted before 1992) were compared to 90 recipients from the same period who died between 1 and 20 years post-transplantation. Major complications were hypertension, renal dysfunction, infections, and cancer. After a mean follow-up of 30 months, 6 survivors had died, yielding a mortality rate of 6% per year ( vs 2.5%-3% in years 1-19). Causes of mortality were infection (50%), malignancy (33%), and allograft vasculopathy (17%). Long-term survivors were younger and leaner, and had nonischemic cardiomyopathy and lower ischemic time. Logistic regression identified recipient age <45 years (odds ratio=3.9; 95% confidence interval, 1.6-9.7; P =.002) and idiopathic cardiomyopathy (odds ratio=3; 95% confidence interval, 1.4-7.8; P =.012) as independent predictors for 20-year survival. Conclusions One fourth of all heart-transplant patients in our series survived >20 years with the same graft, and most enjoy independent lives despite significant comorbidities. Recipient age <45 years and idiopathic cardiomyopathy were associated with survival beyond 2 decades. These data may help decide donor allocation. Introducción y objetivos Los receptores de trasplante cardiaco que sobreviven más de 20 años están aumentando. Poco se conoce de su seguimiento, sus comorbilidades y su mortalidad. Identificar predictores de larga supervivencia puede guiar la selección de candidatos para los donantes disponibles. Métodos Se revisó la información sobre la clase funcional, las comorbilidades y la mortalidad de pacientes trasplantados antes de 1992. Para identificar los predictores de supervivencia > 20 años, se construyó un modelo de regresión logística utilizando las variables asociadas a supervivencia en el análisis univariable. Resultados Se comparó a 39 supervivientes con seguimiento > 20 años (el 26% del total) con 90 pacientes que sobrevivieron entre 1 y 20 años. Las principales complicaciones fueron hipertensión, disfunción renal, infecciones y neoplasias. Tras 30 meses de seguimiento, 6 murieron, lo que implica una mortalidad del 6%/año (frente a un 2,5-3% en los años 1 a 19). Las principales causas de muerte fueron infección (50%), cáncer (33%) y vasculopatía del injerto (17%). Los supervivientes eran más jóvenes y delgados, y tenían cardiopatía no isquémica y menos isquemia en cirugía. La regresión logística identificó la edad del receptor < 45 años ( odds ratio = 3,9; intervalo de confianza del 95%, 1,6-9,7; p = 0,002) y la miocardiopatía idiopática ( odds ratio = 3; intervalo de confianza del 95%, 1,4-7,8; p = 0,012) como predictores independientes de supervivencia > 20 años. Conclusiones En nuestra serie, más del 25% sobrevive más de 20 años con el mismo injerto y lleva vida independiente a pesar de las comorbilidades. La edad del receptor < 45 años y la miocardiopatía idiopática se asociaron a larga supervivencia. Estos datos pueden ayudar a la asignación de donantes. INTRODUCTION Advances in the medical and surgical treatment of heart failure in recent decades include the use of new drugs, cardiac resynchronization therapy-defibrillators, and ventricular assist devices; however, heart transplantation continues to be the treatment of choice for refractory cases. The enthusiasm shown when the first transplantation was performed by Christiaan Barnard in 1967 rapidly waned because of the common postoperative complications and the high early mortality associated with rejection and infection. The introduction of cyclosporin and other advances in the 1980s radically improved the prognosis of these patients and led to prolonged survival and widespread use of the technique. International and Spanish registries show that the median survival of transplanted patients is currently somewhat higher at 10 years, and about 14 years for those who survive the first year, which is the year with the highest incidence of complications. In the oldest transplantation programs, the group of transplanted patients with follow-up exceeding 20 years is now becoming numerous. However, no large series to date have described any transplantation recipients with more than 20 years of follow-up. There is only a small cohort, and therefore the clinical characteristics associated with prolonged survival are not well understood. Functional status, quality of life, comorbidities, and the incidence and causes of death in this period are also not well known, even though these are important aspects in patients who have received immunosuppressant medication for 20 years. This patient subgroup was the objective of our study. METHODS A retrospective review was carried out using the databases, medical histories, and anatomic pathology reports related to patients who received a heart transplant at our hospital from September 1984 to May 2012. For parameters related to the follow-up of these patients, the patient's current status was confirmed by phone. The patients in our study received transplants between September 1984 and May 1992. For this study, survival was defined as time to death or retransplantation due to graft failure. Our study excluded any patients who received a simultaneous heart and lung transplant as well as patients with heart retransplantation, shown in other studies to have a significantly different morbidity and mortality from that of de novo heart transplantation. All patients were classified into 3 groups according to clinical progress: patients who died within 1 year (group A), usually due to causes related to surgery and acute rejection or infectious complications, patients who survived the first year but did not survive 20 years (group B), and patients who survived more than 20 years with no need for retransplantation (group C). The last group was the subject of our study, and its characteristics are described in detail. A comparison with group B was established to identify the characteristics associated with long-term survival. The comparison group for patients from group A did not include patients who died in the early post-transplantation stage because the factors associated with early mortality have been investigated in numerous studies and are not of interest in identifying the factors associated with very long survival in surgical survivors. Immunosuppressive therapy in all patients started as triple therapy with cyclosporin, azathioprine, and prednisone. Most patients received induction therapy with muromonab (OKT3), 2 weeks initially and 1 week after 1987. Routine protocols for the withdrawal of steroids or other immunosuppressants were not used at our hospital, although a low threshold for the withdrawal of drugs causing significant adverse effects was maintained after the first year. We analyzed 62 variables related to the recipients, donors, procedures, and events during follow-up, which are the same variables used in the Spanish registry. Statistical Analysis In the descriptive analysis of the variables, parameters with a normal distribution were described as the mean standard deviation and those with a non-normal distribution were described as the median (range). For the comparisons of quantitative variables, the Student t test was used in variables with normal distribution, and nonparametric tests if otherwise. All qualitative variables were compared by the χ 2 test, and all survival rates were described using Kaplan-Meier curves. In order to identify the characteristics associated with survival>20 years, a bivariate analysis that included characteristics of the recipient, donor, and surgery was performed. All variables associated with survival >20 years with a significance level of P P Results From the first heart transplantation in 1984 until May 2012 at our hospital, 761 heart transplantations have been carried out in 736 patients, including 25 retransplantations and 30 heart-lung transplants. A total of 706 patients were included in the de novo heart transplantation survival curve at our hospital. The overall survival curve of our series is shown in, The actuarial survival rates were 75% at 1 year, 64% at 5 years, 53% at 10 years, 40% at 15 years, and 26% at 20 years. Of 183 transplants performed before May 1992, 39 patients survived and are the main focus of our study (). The general characteristics are shown in and are compared to those of the control group, which included 90 patients who survived the first year but died before they completed 20 years of follow-up. In the comparison of the two groups, the following variables showed a statistically significant association with survival >20 years: lower age and lower body mass index of the recipient, dilated cardiomyopathy as pretransplantation diagnosis, history of extracorporeal circulation, and lower time of ischemia during surgery. The following variables showed some trends but did not achieve statistical significance: weight disproportion>20% (if the donor was younger than the recipient) and mechanical ventilation. Other variables that were included, such as older donor age, history of diabetes mellitus, risk of cytomegalovirus (negative recipient and positive donor), and number of rejections in the first year post-transplantation were not associated with lower survival in our series. Variables with P Table 2). Specifically, the model identified 2 variables: recipient age During a mean follow-up of 30 months, 6 of 39 recipients with very long survival died, which represents a survival of 84% and an average annual mortality of 6%. Only 1 patient was lost to follow-up. The actuarial survival curve at 20 years post-transplantation is shown in, Of the deaths, 3 were due to infectious complications (pneumonia, septic shock due to peritonitis secondary to colon perforation, and sepsis of unknown origin), 2 to neoplasms (lung and tongue cancer), and 1 to heart failure associated with allograft vasculopathy. In the case of patient autonomy to perform daily activities, most (82%) of the 33 patients who survived at the time of the study were completely autonomous, whereas 6% were partially dependent and 12% were completely dependent. The functional limitations were attributed to osteomuscular diseases in half the cases, whereas the others were due to vascular and neurologic causes. The incidence of common complications in transplanted patients was recorded during follow-up. In terms of infectious complications, 8 patients (20%) had hospitalizations for bacterial infections during the follow-up period, mainly respiratory, urinary, and soft tissues, and another 10 (26%) experienced major viral infections (4 due to cytomegalovirus, 1 herpetic encephalitis caused by herpes simplex virus 2, 3 cases of chicken pox zoster, 1 hepatitis B infection, and 2 hepatitis C infections, of which 1 had cirrhosis of the liver as a complication that required liver transplantation, which was successful). In all, 38% of the survivors have had some kind of malignancy, mainly benign skin tumors (60%), followed by solid-organ neoplasms (tongue, lung, and liver), and only 1 presented a blood cancer. After 20 years of transplantation, most (84%) patients presented with chronic kidney disease, with a mean estimated glomerular filtration rate of 59 mL/min. A total of 36% had stage 2 renal insufficiency, 48% had stage 3, and 15% had stage 4. At the time of writing, none had required definitive renal replacement therapy. Cardiovascular risk factors were very prevalent: 94% had hypertension, 87% had hyperlipidemia, and 15% had diabetes mellitus. Patients underwent coronary angiography every 3 years according to our local protocol for the detection of allograft vasculopathy; this was often accompanied by intravascular ultrasound. A total of 35 (89%) patients presented some degree of allograft vasculopathy, although most (72%) had no significant coronary lesions. In the case of patients with an intravascular ultrasound study, 27% were classified as Stanford class II, 11% as Stanford class III, and 58% as Stanford class IV. To date, 3 of these recipients have required percutaneous revascularization (which failed in 1 case). Two of them had systolic graft dysfunction, with 40% left ventricular ejection fraction. Nine patients presented significant arrhythmias. One of them required ablation for ventricular tachycardia, and 8 (20%) required pacemaker implantation for symptomatic bradyarrhythmia at some time during the course of their clinical progress. shows the prevalence of the main complications in the long-term survival group. In terms of immunosuppression, 1 or more components of the initial triple therapy had been withdrawn in most patients, such that 76% were being treated with 2 drugs at the time of the study. The most common combination was cyclosporin and corticosteroid (13 patients ), followed by cyclosporin and azathioprine (5 patients ), cyclosporin and mycophenolate mofetil (3 patients ), cyclosporin plus everolimus (2 patients ), and everolimus plus prednisone (3 patients ). One patient received a combination of tacrolimus and mycophenolate and another, everolimus with mycophenolate. Cyclosporin was usually switched due to renal dysfunction, azathioprine because of blood count abnormalities (leukocytopenia), and corticosteroids because of recurrent infections or metabolic disorders such as hard-to-control diabetes mellitus or osteoporosis. Patients with rare infections or malignancies with considerable repercussions eventually were switched to monotherapy. DISCUSSION Advances implemented in recent decades in the management and follow-up of patients with heart transplantation have allowed prolonged survival rates to be obtained. At present, 20-year survival rates in the national and international registries are >20%, similar to the 26% reported in our series. As in the case of international registries, the initial mortality observed in our curve is high for the current standards due to the relative weight of the procedures carried out at the start of the series in the 1980s and early 1990s, but decreases when only recent surgical patients are taken into account. This is influenced not only by the learning curve, but also by advances in immunosuppression, prophylaxis of infectious diseases, and monitoring and management of the various types of rejection. From the quantitative point of view, mortality after the first year becomes more stable and the mortality rate remains steady. Annual mortality was 2.5% in our series, 2.6% in the Spanish Heart Transplantation Registry, and 3.5% in the Registry of the International Society for Heart and Lung Transplantation (ISHLT). In comparison, the mortality of the general population between 55 and 60 years of age in Spain is approximately 0.5%. In comparison to these figures, recipients who have reached 20 years post-transplantation in our series showed a mortality rate of 6% per year of follow-up; however, this figure should be viewed with caution, due to the low numbers of patients and of deaths during follow-up. Although several articles on the long-term follow-up of transplant patients have been published in recent years, most of these studies had a follow-up period of the first 15 years and only a few lasted as long as 20 years. In various studies, particularly in those published more recently, the factors associated with longer survival were consistent with those identified in our series. These included low recipient age, lower body mass index at the time of transplantation, nonischemic diagnosis prior to transplantation, and lower graft ischemia time. In contrast, other factors identified in these series, such as low donor age, serologic group at risk of cytomegalovirus infection, smoking, and history of diabetes mellitus, which have been found to be predictors, were not associated with survival>20 years in our series. Several reasons that might explain this discrepancy in our series include donor age, which was much lower in all cases, in keeping with the practice at that time. Nonetheless, the low percentage of patients with acknowledged smoking, diabetes mellitus, and serologic group at risk of cytomegalovirus infection in our series prevented an appropriate assessment of their influence in our study. An analysis of the late causes of death after heart transplantation show that allograft vasculopathy and neoplasms predominate after the first year. In patients who survive the first decade, when allograft vasculopathy is more prevalent, cancer appears to be the main cause of death. Large series with 15 years of follow-up report malignancies as the leading cause of death (35.8%), followed by allograft vasculopathy (24.7%) and infections caused by microorganisms other than cytomegalovirus (8.6%). In our patients, there were few deaths. However, the same causes of death, with slightly different prevalences, were observed after 20 years of the transplantation; predominance of infections was observed, followed by neoplasms, and allograft vasculopathy in 1 case. The progress of these patients is characterized by the usual complications associated with transplantation and chronic immunosuppression, such as recurrent bacterial and viral infections, chronic kidney disease, hypertension, diabetes mellitus, hyperlipidemia, and neoplasms. In our series, most patients (84%) presented some degree of renal dysfunction after 20 years of transplantation, a figure that appears to be consistent with the rate of kidney disease (65%) reported by the ISHLT registry at 10 years of follow-up; it is very likely that prolonging follow-up in these patients to 20 years would show figures highly consistent with ours. In the ISHLT registry, 4% of patients were receiving renal replacement therapy at 10 years post-transplantation. None of our 39 patients are in the dialysis program, although 15% presented creatinine clearance<30 mL/min, which means that, over time, some might require replacement therapy. Similar to international experience, in our hospital's cohort of transplant patients before 1992 who died within 20 years, 4% required hemodialysis before they died. In terms of the prevalence of cardiovascular risk factors, we have no data beyond 5 years in the ISHLT registry for comparison. However, the figures from this registry seem consistent with ours, as most patients already present hypertension and hyperlipidemia at 5 years, similar to the patients in our series. Among osteomuscular complications, osteoporosis is the most common and is associated with significant functional limitation in many cases. This frequency is probably due to prolonged exposure to corticosteroids, and was the cause of corticosteroid discontinuation in many cases. Despite all these complications, the quality of life of patients in our series appears to very acceptable, as 82% of subjects were independent for activities of daily living. In international registries, this parameter has been similarly assessed, but data are only shown for the first 5 years of follow-up, with figures for complete autonomy of around 90%. This is the first time the parameter has been assessed after more than 2 decades of immunosuppression. In series that evaluated the early progress of transplantation, acute rejection has been described as a major cause of mortality. Over the years, however, it becomes less common and even though most patients at 20 years receive significantly lower immunosuppression, in our series there were virtually no events that could be related to acute cellular rejection. We cannot rule out that this privileged subgroup of recipients may have some degree of immunologic tolerance of their respective grafts. Therefore, in our case we preferred to decrease the immunosuppressive burden considerably. Limitations This study has several limitations. First, it is a retrospective study conducted at a single center, and therefore we cannot rule out the presence of local factors that could have affected the outcomes and/or follow-up. The relatively low number of patients in the survivor group after 20 years post-transplantation, although obviously justifiable, means that the conclusions of the statistical analysis should be viewed with caution. Second, the quality of life data were assessed and collected by the cardiologist who performed the follow-up at the outpatient clinic, rather than by a standardized tool such as a validated questionnaire. CONCLUSIONS

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One fourth of all heart-transplant patients from the start of our experience achieved survival >20 years with the same graft. Predictors of this favorable outcome included recipient age New studies to identify recipient and donor characteristics that predict very long-term survival in large series may contribute to better allocation of the few donors currently available.

CONFLICTS OF INTEREST None declared. Copyright © 2013. Sociedad Española de Cardiología : Characteristics of Patients With Survival Longer Than 20 Years Following Heart Transplantation | Revista Española de Cardiología

What is the average life expectancy of a heart transplant patient?

The Newark Beth Israel Heart Transplant team notes that a heart transplant is considered the gold standard treatment option for end-stage heart failure. It is only recommended when conservative treatment options fail. The worldwide heart transplant survival rate is greater than 85 percent after one year and 69 percent after 5 years for adults, which is excellent when compared to the natural course of end-stage heart failure.

The first year after surgery is the most important in regards to heart transplant survival rate. The annual death rate after the first year is only 4 percent. Recent improvements to the heart transplant survival rate can be attributed to an increased rate of survival after the first year, and specifically to improvements seen with immunosuppressant medications.

Immunosuppressant medications suppress the immune system, thereby decreasing its ability to attack foreign invaders. These medications are given to heart transplant patients to prevent the immune system from attacking the new donor heart. Immunosuppressant therapy is now tailored to the individual patient.

What is the longest surviving heart transplant patient?

After Cheri Latzke Lemmer’s heart transplant in 1981, at age 24, she figured she’d be lucky to make it to 30. “It was scary back then—the survival rate wasn’t very good,” Lemmer recalls. “You had a good chance of making it one year, but your odds of making it five years weren’t very high.” Lemmer was heart transplant patient No.8 at what was then called University of Minnesota Hospitals.

  • The team had performed its first heart transplant three years earlier.
  • In May 2020, this pioneering heart transplant program celebrated a major milestone: its 1,000th transplant.
  • The team also celebrates the fact that its average patient survival is 13.6 years posttransplant, three years beyond the national average—with many heart recipients living decades beyond that.
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Lemmer, 64, had a second successful heart transplant a year ago at M Health Fairview University of Minnesota Medical Center, The Le Sueur, Minnesota, woman is grateful to be the longest-surviving heart transplant recipient in the world.

Why cant you live as long after a heart transplant?

DEAR MAYO CLINIC: My dad is 66 and was just put on the waitlist for a heart transplant due to coronary artery disease. How soon after the transplant would we know that he’s out of the woods and his body didn’t reject the new heart? Are there other complications he might face? What is the life expectancy for someone who’s had a heart transplant if all goes well? ANSWER: Although rejection can happen at any time, the first year after a transplant is the most critical.

People who have a heart transplant are closely monitored by a transplant care team for rejection, as well as infection — a common complication after a transplant — and other health concerns. Life expectancy varies considerably, but once a patient gets past the first year after a transplant without significant complications, life expectancy tends to rise.

A heart transplant is a surgery in which a failing or diseased heart is replaced with a healthier donor heart. A heart transplant is a major operation that has significant risks. One of the most serious is rejection. Rejection happens when the body’s immune system sees a new organ as something foreign, or unknown, and tries to destroy it.

  • The risk for rejection is highest immediately following transplant surgery.
  • That risk then slowly declines throughout the first year after a transplant.
  • To help prevent rejection, people who have a transplant need to take anti-rejection medications for the rest of their lives.
  • These medications keep the body’s immune system from attacking the transplanted heart.

Because they suppress the body’s immune system, anti-rejection medications put transplant patients at high risk for infections. To catch rejection, infection and other possible complications as quickly as possible, transplant patients have frequent follow-up appointments with their care team.

Along with a physical exam, those appointments include blood tests to check for infections and track how well the anti-rejection medications are working. Heart transplant recipients also need heart biopsies regularly after a transplant to check for rejection. The procedure involves removing a tiny piece of tissue from the heart for testing.

Heart biopsies are done frequently in the months following surgery. They are needed less often as time goes by. After three years, routine biopsies typically are not necessary. Beyond rejection and infection, another possible complication of a heart transplant that can occur as time goes on is coronary artery disease,

Coronary arteries are the blood vessels that supply blood, oxygen and nutrients to the heart. After a transplant, the walls of the arteries in the transplanted heart could thicken and harden. This can make blood circulation through the heart difficult and lead to other heart problems. You mention that your father needs a transplant due to coronary artery disease.

That diagnosis won’t affect his risk for the disease after a transplant. The risk of coronary artery disease in a transplanted heart is similar for all patients. Life expectancy after a heart transplant depends a great deal on a person’s medical condition and age.

In general, though, statistics show that among all people who have a heart transplant, half are alive 11 years after transplant surgery. Of those who survive the first year, half are alive 13.5 years after a transplant. Getting regular follow-up care, seeking prompt medical attention for any symptoms or other concerns, and taking all medications exactly as prescribed can help decrease the risk of complications after a heart transplant.

As he waits, your father also can increase the likelihood of a successful transplant by following a healthy lifestyle, including eating well, not smoking, staying active and reducing stress. If he has questions or concerns, encourage him to talk with his transplant team.

What is the quality of life after a heart transplant?

Life after heart transplantation can look very different, especially in the months following your surgery. Symptoms from heart diseases such as end-stage heart failure should improve dramatically. And many can perform the same level of physical activity and have the same quality of life as those who have not had a heart transplant.

Can you drink alcohol after heart transplant?

Smoking and alcohol – Smoking can be very harmful, so you’ll usually have to stop smoking before you can be considered for a transplant. Get more advice and information about stopping smoking You can still drink alcohol after a heart transplant, although you should avoid drinking excessive amounts. Try to avoid regularly drinking more than 14 units of alcohol a week.

Can you fully recover from a heart transplant?

How long does it take to fully recover? – It generally takes three to six months to fully recover from heart transplant surgery. However, age and previous medical problems may cause a longer recovery period.

What age do heart transplants stop?

Who might not be suitable for a heart transplant – Not everyone who could benefit from a heart transplant will be suitable for one. This is because the operation places a major strain on the body and may mean the risks outweigh the potential benefits. For example, you may be considered unsuitable for a heart transplant if you:

have irreversible damage to other organs, such as your kidneys have an active infection – this will need to be treated first, if possible have cancer – treatment to bring it under control (known as being in remission) will usually be needed before a transplant is considered have damaged blood vessels as a result of diabetes are obese – you may need to lose weight before a transplant is considered drink alcohol excessively or smoke – you may need to stop before a transplant is considered

Age is not a factor in determining whether a heart transplant is suitable, although they’re rarely performed in people over the age of 65 because they often have other health problems that mean a transplant is too risky.

Is 70 too old for a heart transplant?

Journal of the American Geriatrics Society Research Summary A new study published in the Journal of the American Geriatrics Society suggests that survival rates after heart transplant surgery are similar in adults ages 18 to 69 and adults ages 70 and older.

Only 1 in 50 people who are considered for heart transplant surgery and 1 in 50 people who receive a heart transplant are ages 70 or older. For older adults in the study, the likelihood of surviving one or five years after a heart transplant was about the same as for younger adults. Having a stroke after heart transplant surgery was more common in older adults, but the risk in both age groups was low. Older patients were more likely to receive hearts from higher-risk donors, who are older and more likely to have diabetes and high blood pressure. Advanced age alone should not prevent people from being considered as candidates for heart transplants.

Why We May Need Heart Transplants as We Age Heart failure develops when your heart can no longer pump enough blood to provide your body with the oxygen and nutrients it needs. It is usually caused by other chronic conditions that become more common as we age and is the leading cause of hospitalizations in people over 65.

When heart failure can no longer be treated with medication or medical devices, a heart transplant may be necessary. Because the supply of donor hearts is limited, healthcare professionals must make decisions about who they think has the most potential for a good recovery and long-term survival. Until recently, many believed that people aged 70 or older were only good candidates for the operation if they: (a) were strong enough; (b) were able to take all the medications needed to prevent their bodies from rejecting their new heart; (c) had strong support from family and friends; (d) did not drink alcohol or smoke; and (e) did not have other serious chronic diseases or infections.

That opinion is changing as the population of older adults increases in the U.S. and a growing number of older patients receive heart transplants with positive results. Because of improvements in patient screening and care after surgery, heart transplant surgery has become an option for people with heart failure who are expected to live five years or less.

  • What the Researchers Learned Researchers at the Hartford Hospital in Connecticut included 57,285 adult patients (aged 18 and older) listed as candidates for heart transplant surgery in the U.S.
  • Between January 2000 and August 2018 in their study.
  • They found that only one in 50 of these patients was 70 years old or older.

Of the 37,135 patients who had heart surgery over the 18-year period, about the same proportion was at least 70 years old, but the number of older patients receiving a heart transplant each year has increased from 30 in 2000 to 132 in 2017. The researchers looked at the difference between the percentage of patients ages 18-69 and patients aged 70 or older who died (the mortality rate) within one year and five years after heart transplant surgery.

  • There was no significant difference between groups for the mortality rate in the first year after surgery, even though the older patients were more likely to receive hearts from older donors with chronic diseases like diabetes and blood pressure.
  • The difference between the mortality rate for the older and younger patients within five years of heart transplant surgery disappeared when researchers took into consideration factors like patients’ body mass index (BMI) and the time patients spent on the transplant waitlist.

Having a stroke after heart transplant surgery was more common for older patients, but the risk was still very low (3.5 percent). In older patients, most strokes occurred during year three of the follow-up period. Study Limitations This study’s researchers looked at information collected in the past and observed the differences between the older and younger groups.

  • This means they were unable to identify specific causes for their findings.
  • What’s more, the number of older patients was very small, making it hard to draw definite conclusions from.
  • Finally, most of the older patients who received heart transplants were white, not frail, and did not have other chronic diseases besides heart failure.

The researchers noted that this group of older heart transplant recipients does not represent most older adults who have heart failure. What This Study Means for You If you’re 70 or older and have heart failure, heart transplant surgery might be a life-extending option for you.

  • Consider asking your heart failure doctor whether you could be a candidate for a heart transplant.
  • This summary is from ” Clinical Outcomes of Older Adults Listed for Heart Transplantation in The United States,” It appears online ahead of print in the Journal of the American Geriatrics Society,
  • The study authors are Abhishek Jaiswal, MD; Naga Vaishnavi Gadel, MBBS; David Baran, MD; Kathir Balakumaran, MD; Andrew Scatola, MD; Joseph Radojevi, MD; Jason Gluck, MD; Sabeena Arora, MD; Jonathan Hammond, MD; Ayyaz Ali, MD; Douglas L.
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Jennings, PharmD; and William L. Baker, PharmD. https://www.mayoclinic.org/tests-procedures/heart-transplant/about/pac-20384750 ← Previous Next →

How many heart transplants can a person have?

4. People can have multiple organ transplants – Yale Medicine doctors have performed almost 10 heart–kidney transplants in the past two years, which is significant for almost any center, says Dr. Sen. “Many patients who have heart failure over time also develop kidney dysfunction,” he says.

  1. Sometimes that can be a limiting factor in terms of being able to get a heart transplant.
  2. But we’ve tried to think ‘outside the box’ and be open to multi-organ transplant for certain cases.” Surgeons perform the heart transplant first and the kidney transplant a day or more later.
  3. The kidney surgeon must have expertise in performing kidney transplants in patients who are not stable, Dr.

Ahmad says, explaining that heart transplant patients who have been in the intensive care unit have more complex needs than those who have been on dialysis and are otherwise healthy. Heart transplant doctors work closely with Yale Medicine’s kidney transplant specialists on these patients.

Does the heart store memories?

in Article, Opinion November 11th, 2014 Do you ever think about your childhood or replay an event in your head that happened 15 years ago but its so vivid that it seems like it happened yesterday? Do you ever hear something and think it sounds like your favorite song and then start singing that song? These are memories that were formed in your brain that are replayed as a result of a specific stimulus.

For a long time scientists believed that memories were formed, processed, and sent to different destinations in the brain. Dr. Wilder Penfield was one of the first to accidentally discover this. In the 40s he electrically stimulated different areas of his patients’ brains while they were under local anesthesia and found that the region he stimulated would elicit specific memories in the patient’s life (see video below).

For example, in one of his patients he stimulated her temporal lobe (auditory cortex) and she started to hum her favorite song out loud. This suggested that the memory of this song was stored in the place where it was processed or originated (i.e. the auditory cortex processed the first time she listened to the song).

  • Penfield concluded that the cortex (the outer layers of the brain) stored the “complete record of the stream of consciousness; all those things in which a man was aware at any time” Until recently, scientists have believed this phenomenon.
  • The theory of cellular memories states that memories, as well as personality traits, are not only stored in the brain but may also be stored in organs such as the heart.

In 2009 Harvard Medical School defined cellular memories as “a sustained cellular response to a transient stimulus.” Basically, when a cell is introduced to a specific stimulus it will react in a certain way and every time it is given this stimulus it will have the same response.

The best way to understand cellular memories is studying cases of organ transplants. One of the more famous cases includes a woman named Claire Sylvia. In the 70s this woman received a heart and lung transplant from an 18-year- old boy who died in a motorcycle accident. After her surgery Sylvia had cravings she never had before like beer and burgers.

After some time, she contacted the family of her donor and was in shock that he enjoyed the same foods (She wrote a book on her experience!- link below). Another extreme case was an 8-year-old girl who received a 10-year-old girls heart. After her operation she began to have nightmares of a man trying to kill her.

  1. Her dreams were so vivid that she went to a psychiatrist who actually believed they were real.
  2. It was found that the donor was murdered and the recipient who had the nightmares described the man in such detail that the police were able to find the killer and he was convicted of murder.
  3. There are a few different theories on how cellular memories might work but there is no strong scientific evidence on the process of cellular memories.

A lot of research is being done today not only with interaction of the brain and the bodies organs but also with quantum physics and how atoms interact. It is still a mystery today but its something interesting to keep in the back of your head or heart.

Are people different after a heart transplant?

Abstract – Heart transplantation is not simply a question of replacing an organ that no longer functions. The heart is often seen as source of love, emotions, and focus of personality traits. To gain insight into the problem of whether transplant patients themselves feel a change in personality after having received a donor heart, 47 patients who were transplanted over a period of 2 years in Vienna, Austria, were asked for an interview.

  • Three groups of patients could be identified: 79% stated that their personality had not changed at all postoperatively.
  • In this group, patients showed massive defense and denial reactions, mainly by rapidly changing the subject or making the question ridiculous.
  • Fifteen per cent stated that their personality had indeed changed, but not because of the donor organ, but due to the life-threatening event.

Six per cent (three patients) reported a distinct change of personality due to their new hearts. These incorporation fantasies forced them to change feelings and reactions and accept those of the donor. Verbatim statements of these heart transplant recipients show that there seem to be severe problems regarding graft incorporation, which are based on the age-old idea of the heart as a centre that houses feelings and forms the personality.

Is the old heart removed during a heart transplant?

Heart transplant surgery involves removing most of your diseased heart and inserting one from a person who has died. You will be called to come to the hospital immediately once you have been assigned a donor heart. Upon arrival, you will go the Coronary Care Unit for a physical exam and more tests, including blood and urine samples.

  • You will be prepared for surgery, which includes the insertion of intravenous lines and a catheter in your neck to measure the pressure in your heart.
  • You will be given anesthesia so that you will sleep through the surgery.
  • You also will receive immunosuppressive drugs before and during the procedure to prevent your body from rejecting the new heart.

The surgery involves:

A major incision down your chest. Your breastbone is split in half. Your main arteries are connected to a heart lung bypass machine to pump your blood and a ventilator will help you breathe. Most heart transplants are done with a method called orthotopic surgery, where most of your heart is removed but the back half of both upper chambers, called atria, are left in place. Then the front half of the donor heart is sewn to the back half of the old heart. The donor’s aorta and pulmonary arteries are connected to yours. The bypass machine is disconnected and your new heart begins the work of pumping blood. Your incisions are closed.

This surgery is considered less complicated than most heart bypass surgeries, including coronary artery bypass graft (CABG).

Can you drink coffee after a heart transplant?

For all the Starbucks fans out there needing heart valve surgery, I have some difficult news to share with you. Brace yourself Here it is: “Coffee is not recommended right after any form of cardiac surgery, including heart valve surgery.” Yes, I know. That’s a tough one. I can personally relate to what you might be going through right now. I remember thinking, “WHAT? NO COFFEE!” as I was discharged from USC Medical Center after my aortic valve surgery. (Actually, it wasn’t that dramatic.) FYI, I typically start everyday with some form of hot caffeine drink – coffee or chai tea.

Did you know 90% of adults in North America drink at least one caffeine-enhanced drink every day? And, did you know that caffeine was discovered by a German chemist in 1819?) Anyways, after cardiac surgery it is highly advisable to let your central nervous system (and heart rate) not react to artificial stimulants, like the caffeine in coffee.

Don’t worry though It’s not permanent. My cardiologist gave me the green-light to start drinking coffee a few weeks after my aortic valve replacement. Keep on tickin! Adam Adam Pick is a heart valve patient and author of The Patient’s Guide To Heart Valve Surgery,

  • In 2006, Adam founded HeartValveSurgery.com to educate and empower patients.
  • This award-winning website has helped over 10 million people fight heart valve disease.
  • Adam has been featured by the American Heart Association and Medical News Today.
  • Adam Pick is a heart valve patient and author of The Patient’s Guide To Heart Valve Surgery,

In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Do people feel weird after heart transplant?

Another article by Bunzel e tal, which looked at 47 people who had a heart transplant, said 79 per cent of the patients reported no change in their personality at all.

What age do heart transplants stop?

Who might not be suitable for a heart transplant – Not everyone who could benefit from a heart transplant will be suitable for one. This is because the operation places a major strain on the body and may mean the risks outweigh the potential benefits. For example, you may be considered unsuitable for a heart transplant if you:

have irreversible damage to other organs, such as your kidneys have an active infection – this will need to be treated first, if possible have cancer – treatment to bring it under control (known as being in remission) will usually be needed before a transplant is considered have damaged blood vessels as a result of diabetes are obese – you may need to lose weight before a transplant is considered drink alcohol excessively or smoke – you may need to stop before a transplant is considered

Age is not a factor in determining whether a heart transplant is suitable, although they’re rarely performed in people over the age of 65 because they often have other health problems that mean a transplant is too risky.