Any medical types on the flist...

[kellifer]

So, I have a couple of questions for a fic and I'm sure I could google or wiki it but...

- What kind of complications could arise from a heart transplant?

- What are the considerations? Do blood types have to match etc...?

- What's the recovery like?

Basically I'm going to be using "science-fiction" rather than science - alien technology, but there are some things that would still work the same...

This is for my second sweet charity fic so any help would be appreciated... I've completely changed what I'm writing... again... *bites fingernails*

Comments

[crazedturkey.livejournal.com]

Complications of any surgery =

a) infection
b) bleeding
c) anaesthetic risks
i)airway difficulties which range from getting your teeth chipped to not being able to get an airway and killing the patient
ii) anaphylaxis to the drugs used
iii) depression of respiration due to the drugs used
iv) cardiac arrest due to the drugs used.

Specific to cardiac transplantation:
a) cardiac arrest (you take out the heart, you put the new one in, and it don't start/ you start to take the old one out and it gives up the goat before you get there - generally people who get a transplant have been on the list a LONG time and are pretty sick by the time they get the transplant)

b) complications from being on cardiac bypass which involves a degree of hypoxia. Leave someone on too long and you ruin their brain.

c) INFECTION - in order to not reject a transplant you have to have your own immune system suppressed for the rest of your life.

d)Rejection. Which if it happens early is devastating.

there's more than that but this isn't really my field.

Tissue matching is not based on blood type. It is based on HLA typing (blood typing is important for blood transfusions :D).

HLA = Human leucocyte antigens. These are little complexes that we all have sitting on the outside of our cells. Basically they operate to provide us with immunity. If a virus gets into your cell, or cancer, or something else that shouldn't be there the cell alerts your immune system by displaying it in a HLA. THe immune system can then act by destroying the cell or creating antibodies against the foreign agent. There's great variety amongst HLA types for the obvious reason that good varied immmunity allows greater resistance for the human race against new and improved viruses.

Unfortunately because the immune system is designed to contact these HLAs, if they see a HLA they aren't used to (i.e in donated tissue) they'll be primed to make antibodies. Which is why its so important to get a match.

There are three types of HLAs on chromosome 6. Because you get two different ones from your mum and Dad, you have six different HLAs. THe interesting thing about them is that they are inherited as a 'haplotype' so the three that sit on the one chromosome will all be passed down as a group together. So in theory three of your HLAs will also be found in your mother, and in one of her parents. (or your father etc.) That means that siblings are usually uniquely placed to be good donors. (Unless you are vastly unlucky and they got the exact opposite chromosomes to you).

I'm not up with the latest research, but last I heard there was some studies now saying that with good immunosuppression you might be able to match donors with only 5/6 match.

But yeah, even with a 6/6 match, our testing methods aren't as good as mother natures and the immune system will eventually detect that the tissue is slightly foreign and therefore must be destroyed.

Which brings me to the issue of recovery. People with donated organs generally do brilliantly immediately post surgery. They look and feel awesome. Mostly because like I said before, by the time they get to surgery, because the transplant lists are so damn long, they're generally pretty sick. And then they get a new organ that actually works, and its frikking amazing.

Unfortunately, mother nature is always going to kick our arses. The thing with foreign donations is that graft rejection is not something that might happen. It WILL happen eventually. Everything we do is just an attempt to stave it off.

You may be interested to know that the five year survival post-transplant is between 60 and 70%. Most people don't get longer than aout 15 years. (I think the record is 29).

There you go. Hope that helps :D