Heart Transplant: Patients Who Need Them, Risks & Statistics

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  • 0:01 Pump Replacement
  • 0:51 Heart Replacement
  • 3:06 The Risk Involved
  • 4:38 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

Heart transplants are really tricky things. This lesson explores the two main reasons for a heart transplant along with the biggest problem that may arise as a result of the procedure itself.

Pump Replacement

I remember a few occasions in my life when my home's basement flooded. This usually occurred when there was a ton of rain outside for days on end. The water pump in the basement would give out, and that would eventually cause the basement to flood. I'm sure many of you can relate to a similar scenario. Then you'd call the plumber, get the pump replaced, and start cleaning up the gigantic and often stinky mess the flood had created.

In an analogous fashion, the pump inside of our body, our heart, may fail for one reason or another, and our body actually begins to flood inside just like a basement would. Heart replacement surgery must occur not only to help remove the excess fluid out of the body but to more obviously save a person's life.

Heart Replacement

Heart transplantation refers to the surgical process where a failing heart is replaced by a heart from a suitable donor. There are two main conditions where heart replacement surgery is most often indicated. One of these problems is called dilated cardiomyopathy (DCM). This is a condition where the heart's left ventricle becomes enlarged and dysfunctional, meaning the left ventricle that is supposed to pump oxygenated blood from the lungs and into the body becomes large, flabby, and weak. This leads to the heart's inability to pump blood efficiently around the body.

Think of the basement pump all of a sudden ballooning out. Instead of having strong walls that help it pump the water out of the house, the walls become very weak as a result of the ballooning out of the inner chamber. These weak and flabby walls are then unable to contract properly and, therefore, the water cannot be pumped out very well. DCM is the third most common cause of heart failure and is the number one reason for heart replacement therapy.

The other major reason for a heart transplant is ischemic cardiomyopathy. This refers to a condition where inadequate oxygen delivery to the heart leads to cardiac muscle weakness and dysfunction. The most common cause of ischemic cardiomyopathy is coronary artery disease, which is the most common cause of heart disease and the most common cause of death throughout the world. Over time, ischemic cardiomyopathy can result in dilated cardiomyopathy as the muscle cells die off due to a lack of oxygen.

That's because the oxygen delivered to your pump, the heart, is an important part of energy production. Without oxygen, energetic processes stop, and the heart muscle cells function improperly. Imagine turning off the electricity, the energy, to the pump in your basement. It won't work and will not be able to pump at all, leading to the flooding of the basement yet again. Infants, by the way, can also undergo a heart transplant. For infants, the most common reason for a heart transplant is a congenital heart defect that cannot be fixed by other surgical means.

The Risks Involved

One of the biggest risks involved in the transplantation of the heart is known as heart transplant rejection. Although the doctors performing the operation are trying to do a world of good for the patient receiving the heart transplant, the patient's body may not be so kind. The problem is that the heart being transplanted is someone else's.

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