heart transplant: Orthotopic procedure...

1. HEART TRANSPLANTATION
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2. WHAT IS HEART??
• The human heart is an organ that pumps
blood
• supplying oxygen and nutrients to the tissues
• Normal heart 60 to 100 beats per minute.
• if the heart is not able to supply blood to the
organs and tissues, they'll die."
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3. HISTORY
• On 3 December 1967, South African doctor, Dr
Christiaan (Chris) Barnard,
• performed the world's first human to human
heart transplant
• On a patient with end-stage heart failure, using
another human heart
• He Received the transplant from Denise Darvall, a
25-year-woman who was fatally injured in a car
accident.
• Mr. Washkansky, had a good early recovery but
unluckily
• died of pneumonia 18 days later.
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4. Dr. Chris Barnard

5. CONT….
• The second heart transplant patient, Mr. Bleiberg
• Inadequate understanding of early post-operative
complications as
• Well as a lack of tools to address the problems of acute
rejection
• Mr. Bleiberg sadly died of a myocardial infarction 19
months after his heart transplantation.
• In 1984, the world's first successful pediatric heart
transplant was performed at Columbia on a four-year-old
boy. He received a second transplant in 1989 and lived until
he succumbed to other health issues in 2006.
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6. Why is it needed?
The reasons patients come to Sutter Heart
Transplant Services fall into two major categories:
• cardiomyopathy (68 percent)
• coronary heart disease (32 percent).
• Cardiomyopathy is a disease of the heart
muscle that involves a weakening or stiffening
of the muscle. When medications and
treatments fail, a heart transplant may be the
only option.
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7. CONT….
• Coronary heart disease
• in which a waxy substance called plaque builds
up inside the coronary arteries.
• Over time, plaque can harden or rupture (break
open). Hardened plaque narrows the coronary
arteries and reduces the flow of oxygen-rich
blood to the heart.
• When the patient's life is still in jeopardy in spite
of traditional treatments, a heart transplant may
be seen as the only option for extending life.
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9. How does the heart of a human
work?
• The heart has four chambers:
• The right atrium receives blood from the veins and
pumps it to the right ventricle.
• The right ventricle receives blood from the right
atrium and pumps it to the lungs, where it is
loaded with oxygen.
• The left atrium receives oxygenated blood from the
lungs and pumps it to the left ventricle.
• The left ventricle (the strongest chamber) pumps
oxygen-rich blood to the rest of the body. The left
ventricle’s vigorous contractions create our blood
pressure.
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11. Parameter list for assessment of
donor hearts
• Age<55 years old
• Negative serology(Hep B, C and HIV)
• blood pressure (normal)
• Diabetes
• Gestational diabetes (diabetes during pregnancy).
• Significant coronary arteries
• Polycystic kidney disease (B.P is high)
• Substance abuse (drug addiction)
• Psychiatric illness. mental health problems
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12. CONT….
• ABO blood group
• Body size compatibility (+-20% body weight)
• Recent cancer or a history of cancer that was
not completely treated.
• Protein in the urine > 300 mg per 24 hours (a
test of kidney function)
• History of blood clots
• Same sex (survival rate increased)
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13. SURGICAL TRANSPLANTATION
TEHNIQUES
• ORTHOTOPIC IMPLANTATION
• HERTOTOPIC IMPLANTATION
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14. ORTHOTOPIC IMPLANTATION
• If the donated organ is good, you will then be taken to
the operating room, put to sleep with an anesthetic
• exposing the chest cavity through a cut in the ribcage.
• Your main arteries are connected to a heart lung bypass
machine to pump your blood and a ventilator will help
you breathe.
• surgeon open the pericardium (a membrane that covers
the entire heart) in order to remove your diseased heart.
• The back part of your own left atrium will be left in place,
but the rest of the heart will be removed.
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15. CONT…
• Your new heart will be carefully trimmed and
sewn to fit the remaining parts of your old heart.
• This transplant method is called an "Orthotopic
procedure".
• This is the most common method used to
transplant hearts.
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21. WORLD BEST INSTITUTIONS FOR
HEART TRANSPLANTS
• University of Washington Medical Center
(Seattle)
• Mayo Clinic Hospital (Phoenix)
• Tufts Medical Center (Boston)
• Ohio State University Medical Center (Columbus)
• Spectrum Health (Grand Rapids, Mich.)
• Keck Hospital of USC (Los Angeles)
• Advocate Christ Medical Center (Oak Lawn, Ill.)
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22. Thank you..
By KAZIM TANVEER