After cardiothoracic surgeon Hiroo Takayama, MD, PhD, NewYork-Presbyterian/Columbia University Medical Center, was featured on the television documentary series NY Med recently, audience members tweeted several follow up questions. Dr. Tayakama answers these questions, regarding a heart transplant, below.
Question: What was that icy looking liquid on the container that carried the donor heart?
Answer: It is preservation solution. The heart is soaked in this solution in a sterile bag, which is surrounded with ice cubes.
Q.: Why was the donor heart yellow and not red as it was taken out of the transport container?
A.: It was the yellow layer of fat that covers and protects the heart.
Q.: How long can a heart be stored?
A.: Only four to six hours.
Q.: How is the “new” heart started after transplantation?
A.: Once sewn in and perfused with blood, most hearts resume a regular beat and contraction on their own, although the new heart usually requires support with medication for a while.
Q.: What is the life expectancy of a heart transplant recipient?
A.: Approximately half of heart transplant recipients are alive at 10 years post transplant.
Q.: What would disqualify someone from being a heart donor?
A.: The absence of the following conditions are the suggested criteria for cardiac donors:
- prolonged cardiac arrest
- prolonged severe hypotension
- preexisting cardiac disease
- intracardiac drug injection
- severe chest trauma with evidence of cardiac injury
- septicemia
- extracerebral malignancy
- positive serologies for HIV, hepatitis B or hepatitis C
Q.: How old must you be to donate a heart?
A.: You must be younger than 55 years old although there are exceptions.
Q.: Does blood type factor into the donor/recipient process?
A.: Yes. ABO blood type has to be compatible.
Q.: Will we ever be able to grow or print new hearts from stem cells or cultured tissue?
A.: Researchers have been trying this with some promising findings. Although growth of complete new hearts is still on the horizon, current studies are using stem cells to regenerate myocardial cells and help damaged hearts with or without the additional aid of implantable LVAD.
Q.: When was the first heart transplant performed and where?
A.: South African Christiaan Barnard surprised the world when he performed the first human-to-human heart transplant on December 3, 1967.
Q.: How common is a heart transplant? How many are performed on a yearly basis?
A.: Approximately 3,700 to 3,800 heart transplants are performed worldwide. In the U.S., approximately 2,200 are performed every year.
Q.: How many hospitals in the U.S. transplant hearts? In the world at large?
A.: Over 140 centers perform heart transplantation in the U.S. Over 250 centers report to the International Society for Heart and Lung Transplantation as heart transplant center worldwide.
Q.: Since organ donation is limited or restricted in Japan, how many patients travel to other countries for a heart transplant? Is the organ donation/transplant process in Japan changing?
A.: Because of extremely limited number of donors in Japan, every year several patients with end stage heart failure, especially pediatric patients, travel to other countries such as the U.S. and Germany. In the U.S., the number of donor hearts that can be allocated to foreign recipients is restricted to fewer than five.