Perhaps the most drastic measure taken with regard to heart health is the heart transplant. When a heart has been damaged by long-term heart disease or infection and can no longer work adequately, the last resort is often a heart transplant. This process involves replacing the diseased heart with the healthy heart of a donor. Due to prevalence of heart disease in the United States and an overall decrease in heart health, there is an increasing need for donor hearts, as transplant rates are increasing every year. There were 2,154 heart transplants performed in the United States in 2002.
To perform a heart transplant, an incision is made in the sternum and the blood is routed to a heart-lung bypass machine to keep oxygen circulating through the body. The diseased heart is removed, and the donor heart is put in its place.
Heart transplants are recommended for patients who have suffered heart failure caused by a variety of issues, typically coronary artery disease, congestive heart failure, congenital heart disease and arrhythmias that do not respond to other treatments. Transplants are usually not given to patients who have kidney, liver or lung disease, or to diabetics.
Heart transplants are a risky surgery. Drugs must be given to prevent rejection of the donor organ, and there is great risk of infection and bleeding. However, if the transplant is successful, 80% of heart transplant patients live two years after it completion. If rejection is avoided, a patient can live more than 10 years after receiving a transplant, and after a six-week recovery period, patients can lead fairly normal lives, though vigorous physical activity should be avoided.
Aside from the technical risks, finding a donor heart is a difficult process. The heart must be taken from a fresh cadaver, and it is difficult to keep the donor heart alive while transporting it to the recipient. Artificial hearts can be used to keep those waiting for transplants alive for short periods of time, but they are not viable for long periods of time and are not viable replacements for healthy donor hearts.
Procedural improvements are constantly being made to the transplant process, and artificial heart research may lead to better and more viable mechanical replacements for human organs. However, for now, transplants remain risky and are only attempted when all other treatments have been unsuccessfully exhausted.