New Hearts Add Decades to Patient Lives

Heart failure patients may extend life by 20 years or more with a heart transplant

(RxWiki News) Thirty years ago, it was rare for a heart transplant patient to live more than a year. Today, with improved medication and techniques, transplants can lengthen lives by more than 20 years.

With heart failure, the heart is weakened and cannot pump enough blood to meet the body’s needs. Although the condition may often be treated by limiting fluid and salt intake, taking medication, and possibly surgery, heart transplantation may be the only option for some patients who have more severe heart failure.

A new study finds that heart transplantation success rates have been improving and life spans can increase by decades after such an operation.

"Talk to your doctor about the benefits of heart transplantation."

Hector Rodriguez Cetina Biefer, MD, and Markus J. Wilhelm, MD, from the Clinic for Cardiovascular Surgery at the University Hospital Zurich in Switzerland, headed a research team that followed 133 patients who had heart transplantation at the hospital between 1985 and 1991.

The most common reason for a heart transplant is that both ventricles are failing to supply enough blood to the body and severe heart failure is detected, according to the American Heart Association. With severe end-stage heart failure, an individual is unable to carry out any physical activity without discomfort. Even at rest, patients experience fatigue, rapid or irregular heartbeat (palpitation), or shortness of breath.

More than half of these patients (55.6 percent) lived two decades or more following the operation. For those who extended their lives by 20 years, the average age at the time of the surgery was 43 and a half years.

Authors said that advances in “immunosuppressive management” have likely contributed to these survival rates. The body recognizes a transplanted heart as a foreign object, triggering the body’s immune system to attack it.  Immunosuppressive medication weakens the immune system, which in turn protects the transplanted organ from damage.

Transplant rejection (or graft rejection) is still a problem for many patients. Researchers discovered it to be the cause of 21 percent of deaths. Malignancy (or cancer) also accounted for about one in five deaths. An accelerated form of heart disease called cardiac allograft vasculopathy was cited as the cause of death in 14.5 percent of cases, and infections accounted for another 14.5 percent of deaths.

In related commentary, James Kirklin, MD, from the University of Alabama in Birmingham, stressed that the overall results of the study were positive.

“The fact that over half of patients were alive 20 years later should provide hope and the expectation that a new heart for most patients really is a ‘new lease on life,’” he said in a press release. “If patients take care of themselves, they can expect to have many years of good quality of life.”

As transplantations have become more successful, they have become more in demand. The demand for organs, however, outstrips supply in most countries, according to the World Health Organization.

The study was published in the February 2014 issue of The Annals of Thoracic Surgery.

Review Date: 
January 31, 2014