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

[stir-of-echoes.livejournal.com]

complications:

The body will attack anything that’s not its own. When someone is given a donor organ, the cells of the immune system realise that it is foreign and attack it. When the immune cells attack a new organ there’s the risk of rejection so there’s a need for anti-rejection medication. Rejection is most common in the first six weeks but can occur at any time. The dosage of anti-rejection medication is usually decreased over time but transplant patients remain on anti-rejection medication for the rest of their life.

Regular heart biopses will also be performed to check for any signs of rejection.

The anti-rejection medications used to suppress the immune system can cause diabetes. If someone had diabetes before the transplant, the control of blood sugar may be more difficult and will be monitiored strictly. Medication can also cause blood cholesterol to go up and will also be monitored.

Infection is also a risk because the anti-rejection drugs that prevent immune cells from attacking and killing new organs are immunosuppressive drugs which also prevent immune cells from attacking other foreign objects in the body. Because they block the ability of immune cells to attack foreign objects in the body the drugs cause a risk of developing infections caused by foreign bodies like viruses and bacteria.

Infection is more a risk if someone is being medicated with a high dose of immunosuppressive drugs. Someone will be on high doses of the drugs immediately after transplant surgery and during times of rejection. As the doses of immunosuppressive drugs are lowered the chances of getting an infection are also lowered but the risk never goes away.

Blood pressure should also be monitored after transplant as it is often a common problem and left unchecked could cause kindney problems, stroke and ultimately a heart attack.

There is also a risk of mood swings due to the high doses of steroids used in the early days after the transplant.

Considerations:

For blood transfusions a person need only match ABO type and Rh type. (blood type, like A-positive.)

For organs a much more strict match is needed. Blood will only be there for a few weeks; the organ will be there for the rest of your life. For that, every attempt to match the Major Histocompatibility Complex (MHC) which is basically a cluster of genes essential to the immune system. Tests will be conducted to obtain a close match as the body will be very allergic to the proteins produced by somebody else’s MHC, and the body will attack what it sees as a foreign object.

Also, the heart of the donor, where possible is preferred to be close enough to the recipient’s heart's size, so the donor is preferred to be within 20 percent of the weight of the recipient.

Recovery:

Recovery is usually around six weeks taking into account that there were no complications during or post surgery, longer than other serious operations due to the immune system being suppressed but most people are usually released from the hospital within ten to fifteen days.

The first year is considered critical with frequent scheduled heart tests (endomyocardial biopsies) performed to watch for early signs of organ rejection and usually a cardiac rehabilitation program will have been instituted during the hospital stay which will continue upon discharge including supervised physiotherapy. Within a few weeks of the operation most people will be able to do quite vigorous exercise. The rehabilitation programme also offers advice about how to have a healthier lifestyle, and psychological support for patient and partner.

Regular exercise is encouraged, always started with warm up period as new hearts respond slowly to the demand of exercise as it is without nerve supply in the first year but most people are soon able to take in part in a full range of activities and exercise.

Quality of life is usually good, especially if the side effects of the immunosuppressant drugs can be kept to a minimum. People are able to return to work, education and many heart transplant patients have no major problems with sporting activities.

Usually within six to eight weeks after the operation life pretty much returns to something like normal.

Hope that helps a little :)