Heart transplant depends on donor compatible patient

The first heart transplant was made in 1967 in South Africa, and since then techniques to protect the recipient from the heart and the transport of the donated heart have evolved. Overcome of the receptors has increased and today the side effects of immunosuppressive drugs (which prevent the rejection of the organ received) are much smaller and allow a complete life.

Heart failure is a progressive disease, and even though it is now possible to park the symptoms or improve most patients, some develop into a serious condition, where shortness of breath happens even at rest. In these, treatment alternatives are the cardiac resynchronizer, the implantation of auxiliary "pumps" to the heart or the heart transplant.

Transplantation depends on the withdrawal of the heart from a person who died due to brain death. The heart can be transplanted as long as it is functioning and in good condition and is compatible with the recipient in diverse characteristics, from blood type to weight and height. When brain death is confirmed by clinical and imaging exams and there is no possibility of the brain working again, the physician triggers the organ-seeking team that attends the hospital. The organ procurement team, with highly trained professionals, monitors and verifies the examinations, evaluates the donor's clinical condition and, if considered eligible, talks with the family and understands their wishes about the fate of the deceased relative. If the family accepts, new tests are collected to detect prohibitive diseases. When exiting the results of the exams, the agency offers the State Transplant System (Transplant Center) to the team responsible for the recipient that occupies the first position more compatible with the offered donor. The transplantation team will then judge the acceptance, if so, the recipient is advised to attend the hospital, if not already hospitalized. In addition, the patient is instructed not to drink or eat anything else from the phone call.

The recipient should have transplant indication and no contraindication. Must be accredited in a transplant service registered in the Ministry of Health, live near the transplant center and pass the evaluation of the multiprofessional team. He receives a registration number and can follow his place in the queue.

Already in the queue, he must wait for the transplant team call. When a compatible donor is available, he must report to the hospital very quickly. There is a synchronized work between the collection and transplant staff, so that when the withdrawal team offers ok for transplant staff, the recipient should start the surgery as soon as possible, once the heart out of the body can be preserved for a maximum of four hours.

The main indications are severe heart failure (shortness of breath in small effort) that is unresponsive to treatment and ventricular arrhythmia without the possibility of treatment documented by clinical tests and laboratory tests (ergospirometric test and walk test of 6 minutes). Absolute contraindications are severe liver disease, severe lung disease, donor incompatibility, severe brain or peripheral disease and the possibility of not using immunosuppressive drugs (severe psychiatric illness or chemical dependency). Unfortunately for the few donors we have a queue that can months. When a person who is internal and unable to be discharged for heart failure, needs drugs to keep the heart beating, or some device only because of the heart without sufficient strength, it becomes a priority because of the imminent risk of death.Think about who's been waiting for a heart, a kidney, a liver or a cornea for years. Think it was you.

This text was the invaluable contribution of nurse Amanda Bezerra, who is one of the nurses of the Search and Rescue Service. Organs and Tissues of the Dante Pazzanese Institute of Cardiology.

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