Heart transplant

When the heart is beyond repair, damaged by heart attacks, infection or other disease, the only answer may be to replace it with a heart from a person who has donated theirs on death.

A heart transplant may be offered for a number of reasons, when certain provisos are met:

• the heart muscle has become weakened (cardiomyopathy)
• the heart's blood vessels are blocked and the heart muscle is damaged
• apart from heart problems, the individual is in good health
• other treatments have been tried or excluded
• the individual is under 60 (in most cases)
• the individual is able and willing to stick to lifestyle changes necessary after the transplant

In the past, heart transplants sometimes failed because the person's immune system rejected the transplanted heart. But as techniques have improved and new immunosuppressive drugs have been introduced to prevent rejection, so heart transplants have become more successful. The majority of people who have a heart transplant can now expect to live for five years or more.

Even so, transplant remains an 'end-of-the-line' treatment when all else has failed and the patient is likely to die or have a poor quality of life unless it's done. Unfortunately, a shortage of donors means that a significant number of people who are waiting for a heart transplant die before one is found.

After a transplant, the individual will need to take immunosuppressive drugs for the rest of their life, to stop their body rejecting the transplant, as well as other drugs to help their body fight infections. The new heart will be monitored at regular intervals for any signs of rejection.