Heart transplantation

"Our specialists are trained in international centers and we have extensive experience in performing cardiac surgical techniques".

DR. GREGORIO RÁBAGO JUAN-ARACIL
DIRECTOR. CARDIAC SURGERY DEPARTMENT

A heart transplant is the replacement of a heart with end-stage cardiomyopathy by the heart of a deceased person.

The results of the Clinic in the last 5 years show a survival at the year of 90% and at 5 years of 75%. Likewise, our hospital stays have been reduced to 7-10 days, with the consequent decrease in costs and post-operative complications.

If we take into account that if these patients had not been transplanted, 90% would have died during the first year, we can assure that heart transplantation is the therapy that shows the greatest difference between surgical treatment and the natural evolution of the disease.

The results must be evaluated not only in terms of survival but also in terms of quality of life. For the survivors, heart transplantation reaches the set goal. It provides the possibility of joining an active and normal life to patients who, without this treatment, had a life expectancy of less than one year, with complete physical disability. 

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When is a heart transplant indicated?

The indication for heart transplantation is made in patients with end-stage heart failure, poor quality of life, risk of sudden death, lack of response to maximum medical treatment or conventional surgery and with a life expectancy of less than one year.

Most indications are performed in patients with coronary disease who have suffered one or several extensive acute myocardial infarctions with severe dysfunction of left ventricular contraction.

Other less frequent indications are secondary myocardiopathies or heart valve diseases that have produced irreversible damage to the left ventricle and some congenital cardiopathies.

Most frequent indications for this treatment:

Do you have any of these diseases?

You may need a heart transplant

Learn more about heart transplantation

The clinical development of cardiac transplantation that requires the use of ischemically free grafts contributed to increase the interest in the concept of death based on neurological criteria. Usually, death is diagnosed by the cessation of cardiac activity, because the absence of blood supply in the brain produces its death.

However, in 1% of the deceased people the inverse way occurs, that is to say, first the cerebral death is produced by a cranioencephalic traumatism, a cerebral hemorrhage, etc., and secondly, after some hours or several days, the cardiac arrest is produced.

The donor is a deceased person, following neurological criteria, who maintains respiratory activity connected to a respirator, because the respiratory center is not active, and during the first hours or days, until cardiac arrest occurs, maintains the function of the other organs and systems.

The limited number of potential patients requires that every donor must be considered a multi-organ donor for kidneys, heart, lungs, liver, pancreas, corneas and bones.

Experimental studies of heart transplantation showed that in the heart, as in other solid organs, an immune reaction of the host occurs which, if not controlled, leads to the destruction of the graft. The immune response and the chances of rejection are greatest during the first few months.

We can consider rejection in:

  • Hyperacute. It is an uncommon complication that conditions the failure of the heart in the first minutes or hours after the transplant.
  • Acute. It is characterized by an inflammatory infiltration that, depending on the degree, can produce myocardial necrosis. Most of the transplanted patients suffer some acute rejection during the first months, despite the immunosuppressive treatment, but 95% of these acute rejections, if diagnosed early and treated properly, resolve without sequelae.
  • Chronic rejection, which affects the coronary arteries of the heart and is related to the arteriopathy of the graft. To prevent the appearance of acute rejection or that this rejection can be controlled and cured, it is necessary to administer immunosuppressive treatment.

The incorporation of cyclosporine A, the development of new immunosuppressive agents and the recovery of other drugs that had fallen into disuse, have provided a wide spectrum of immunosuppressive agents, which allow the development of individualized immunosuppression protocols for each patient.

Heart transplantation is the best treatment option for patients 
who have end-stage heart failure in order to improve their quality of life and survival.

It is essential that you follow the advice of heart surgeons and nurses in all matters relating to taking medication and practicing healthy living habits.

After a heart transplant, we advise our patients to lead a strictly normal life, with a series of care in diet, physical exercise and lifestyle habits.

Where do we do it?

IN NAVARRA AND MADRID

The Department of Cardiac Surgery
of the Clínica Universidad de Navarra

The Cardiac Surgery Department of the Clinic is backed by its extensive experience of more than 50 years. It is a pioneer in the introduction of the most complex procedures and the most avant-garde techniques.

Our surgeons are specialists trained in international reference centers, which combine the application of the latest techniques with personalized treatment to our patients.

We also have a team of highly specialized nurses, both in surgical and clinical aspects.

Treatments we perform

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Why at the Clinica?

  • Pioneers in advanced procedures and techniques.
  • Implantation of the first total artificial heart in Spain in 2016.
  • Specialists trained in international centers of reference at national level.

Safer than ever to continue taking care of you

We update safety protocols weekly with the latest scientific evidence and the knowledge of the best international centers with which we collaborate.