Heart transplantation - wikipedia Heart transplantation This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. ( November 2011 ) Heart transplantation Diagram illustrating the placement of a donor heart in an orthotopic procedure. Notice how the back of the patient 's left atrium and great vessels are left in place. Specialty cardiology ICD - 9 - CM 37.51 MeSH D016027 MedlinePlus 003003 ( edit on Wikidata ) A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end - stage heart failure or severe coronary artery disease when other medical or surgical treatments have failed. As of 2016, the most common procedure is to take a functioning heart, with or without transplanting one or both lungs at the same time, from a recently deceased organ donor ( brain death is the standard ) and implanting it into the patient. The patient 's own heart is either removed and replaced with the donor heart ( orthotopic procedure ) or, much less commonly, the recipient 's diseased heart is left in place to support the donor heart ( heterotopic, or `` piggyback, '' transplant procedure ). Approximately 3500 heart transplants are performed every year in the world, more than half of which occur in the US. Post-operation survival periods average 15 years. Heart transplantation is not considered to be a cure for heart disease, but a life - saving treatment intended to improve the quality of life for recipients. Contents 1 History 2 Contraindications 3 Complications 4 Prognosis 5 See also 6 References 7 External links History One of the first mentions of the possibility of heart transplantation was by American medical researcher Simon Flexner, who declared in a reading of his paper on `` Tendencies in Pathology '' in the University of Chicago in 1907 that it would be possible in the then - future for diseased human organs substitution for healthy ones by surgery -- including arteries, stomach, kidneys and heart. Not having a human donor heart available, James D. Hardy of the University of Mississippi Medical Center transplanted the heart of a chimpanzee into the chest of a dying Boyd Rush in the early morning of Jan. 24, 1964. Hardy used a defibrillator to shock the heart to restart beating. This heart did beat in Rush 's chest for 60 to 90 minutes ( sources vary ), and then Rush died without regaining consciousness. Although Hardy was a respected surgeon who had performed the world 's first human - to - human lung transplant a year earlier, author Donald McRae states that Hardy could feel the `` icy disdain '' from fellow surgeons at the Sixth International Transplantation Conference several weeks after this attempt with the chimpanzee heart. Hardy had been inspired by the limited success of Keith Reemtsma at Tulane University in transplanting chimpanzee kidneys into human patients with kidney failure. The consent form Hardy asked Rush 's step sister to sign did not include the possibility that a chimpanzee heart might be used, although Hardy stated that he did include this in verbal discussions. A xenograft is the technical term for the transplant of an organ or tissue from one species to another. The world 's first human - to - human heart transplant was performed by South African cardiac surgeon Christiaan Barnard utilizing the techniques developed by Norman Shumway and Richard Lower. Patient Louis Washkansky received this transplant on December 3, 1967, at the Groote Schuur Hospital in Cape Town, South Africa. Washkansky, however, died 18 days later from pneumonia. On December 6, 1967, at Maimonides Hospital in Brooklyn, New York, Adrian Kantrowitz performed the world 's first pediatric heart transplant. The infant 's new heart stopped beating after 7 hours and could not be restarted. At a following press conference, Kantrowitz emphasized that he did not consider the operation a success. Norman Shumway performed the first adult heart transplant in the United States on January 6, 1968, at the Stanford University Hospital. A team led by Donald Ross performed the first heart transplant in the United Kingdom on May 3, 1968. An allograft is the technical term for a transplant from a non-genetically identical individual of the same species. Brain death is the current ethical standard for when a heart donation can be allowed. Worldwide, more than 100 transplants were performed by various doctors during 1968. Only a third of these patients lived longer than three months. The next big breakthrough came in 1983 when cyclosporine entered widespread usage. This drug enabled much smaller amounts of corticosteroids to be used to prevent many cases of rejection ( the `` corticosteroid - sparing '' effect of cyclosporine ). On 9 June 1984 `` JP '' Lovette IV of Denver became the world 's first successful pediatric heart transplant. Columbia - Presbyterian Medical Center surgeons transplanted the heart of 4 - year - old John Nathan Ford of Harlem into 4 - year - old JP a day after the Harlem child died of injuries received in a fall from a fire escape at his home. JP was born with multiple heart defects. The transplant was done by a surgical team led by Dr. Eric A. Rose, director of cardiac transplantation at NewYork -- Presbyterian Hospital. Drs. Keith Reemtsma and Fred Bowman also were members of the team for the six - hour operation. In 1988, the first `` domino '' heart transplant was performed, in which a patient in need of a lung transplant with a healthy heart will receive a heart - lung transplant, and their original heart will be transplanted into someone else. Worldwide, about 3,500 heart transplants are performed annually. The vast majority of these are performed in the United States ( 2,000 -- 2,300 annually ). Cedars - Sinai Medical Center in Los Angeles, California, currently is the largest heart transplant center in the world, having performed 132 adult transplants in 2015 alone. About 800,000 people have NYHA Class IV heart failure symptoms indicating advanced heart failure. The great disparity between the number of patients needing transplants and the number of procedures being performed spurred research into the transplantation of non-human hearts into humans after 1993. Xenografts from other species and artificial hearts are two less successful alternatives to allografts. The ability of medical teams to perform transplants continues to expand. For example, Sri Lanka 's first heart transplant was successfully performed at the Kandy General Hospital on July 7, 2017. During heart transplant, the vagus nerve is severed, thus removing parasympathetic influence over the myocardium. However, some limited return of sympathetic nerves has been demonstrated in humans. ( ( ( 1 ) ) ) Contraindications Some patients are less suitable for a heart transplant, especially if they suffer from other circulatory conditions related to their heart condition. The following conditions in a patient increase the chances of complications ; Absolute contraindications : Advanced kidney, lung, or liver disease Active cancer if it is likely to impact the survival of the patient Life - threatening diseases unrelated to heart failure including acute infection or systemic disease such as systemic lupus erythematosus, sarcoidosis, or amyloidosis Vascular disease of the neck and leg arteries. High pulmonary vascular resistance - over 5 or 6 Wood units. Relative contraindications : Insulin - dependent diabetes with severe organ dysfunction Recent thromboembolism such as stroke Severe obesity Age over 65 years ( some variation between centers ) - older patients are usually evaluated on an individual basis. Active substance abuse, such as alcohol, recreational drugs or tobacco smoking ( which increases the chance of lung disease ) Patients who are in need of a heart transplant but do not qualify, may be candidates for an artificial heart or a left ventricular assist device ( LVAD ). Complications Post-operative complications include infection, sepsis, organ rejection, as well as the side - effects of the immunosuppressive medication. Since the transplanted heart originates from another organism, the recipient 's immune system typically attempts to reject it. The risk of rejection never fully goes away, and the patient will be on immunosuppressive drugs for the rest of their life, but these may cause unwanted side effects, such as increased likelihood of infections or development of certain cancers. Recipients can acquire kidney disease from a heart transplant due to side effects of immunosuppressant medications. Many recent advances in reducing complications due to tissue rejection stem from mouse heart transplant procedures. Surgery death rate is 5 - 10 % in 2011. People who have had heart transplants are monitored in various ways to test for the development of rejection. Prognosis The prognosis for heart transplant patients following the orthotopic procedure has increased over the past 20 years, and as of June 5, 2009, the survival rates were : 1 year : 88.0 % ( males ), 86.2 % ( females ) 3 years : 79.3 % ( males ), 77.2 % ( females ) 5 years : 73.2 % ( males ), 69.0 % ( females ) In 2007, researchers from the Johns Hopkins University School of Medicine discovered that `` men receiving female hearts had a 15 % increase in the risk of adjusted cumulative mortality '' over five years compared to men receiving male hearts. Survival rates for women did not significantly differ based on male or female donors. See also Artificial heart Biological pacemaker Xenotransplantation References ^ Jump up to : Cook JA, Shah KB, Quader MA ; et al. ( 2015 ). `` The total artificial heart ''. Journal of Thoracic Disease. 7 ( 12 ) : 2172 -- 2180. doi : 10.3978 / j. issn. 2072 - 1439.2015. 10.70. CS1 maint : Explicit use of et al. ( link ) CS1 maint : Multiple names : authors list ( link ) ^ Jump up to : Till Lehmann ( director ) ( 2007 ). The Heart - Makers : The Future of Transplant Medicine ( documentary film ). Germany : LOOKS film and television. Jump up ^ Burch M. ; Aurora P. ( 2004 ). `` Current status of paediatric heart, lung, and heart - lung transplantation ''. Archives of Disease in Childhood. 89 ( 4 ) : 386 -- 389. doi : 10.1136 / adc. 2002.017186. PMC 1719883. PMID 15033856. Jump up ^ MAY TRANSPLANT THE HUMAN HEART (. PDF ), The New York Times, January 2, 1908. Jump up ^ Hardy James D., Chavez Carlos M., Kurrus Fred D., Neely William A., Eraslan Sadan, Turner M. Don, Fabian Leonard W., Labecki Thaddeus D. ( 1964 ). `` Heart Transplantation in Man ''. JAMA. 188. doi : 10.1001 / jama. 1964.03060390034008. CS1 maint : Multiple names : authors list ( link ) ^ Jump up to : Every Second Counts : The Race to Transplant the First Human Heart, Donald McRae, New York : Penguin ( Berkley / Putnam ), 2006, Ch. 7 `` Mississippi Gambling '', pages 123 - 127. This source states the heart beat for approximately one hour. Jump up ^ James D. Hardy, 84, Dies ; Paved Way for Transplants, Obituary, New York Times ( Associated Press ), Feb. 21, 2003. This source states the transplanted chimpanzee heart beat for 90 minutes. Jump up ^ Hardy James D ( 1963 ). `` Lung Homotransplantation in Man ''. JAMA. 186. doi : 10.1001 / jama. 1963.63710120001010. See also `` LUNG TRANSPLANTATION ''. JAMA. 186 : 1088. 1963. doi : 10.1001 / jama. 1963.03710120070015. in same issue. Jump up ^ Second Wind : Oral Histories of Lung Transplant Survivors, Mary Jo Festle, Palgrave MacMillan, 2012. Jump up ^ Every Second Counts, McRae, page 126, top. ^ Jump up to : Cooper DK. `` A brief history of cross-species organ transplantation ''. Proc ( Bayl Univ Med Cent ). 25 : 49 -- 57. PMC 3246856. PMID 22275786. '... the consent form for Hardy 's operation -- which, in view of the patient 's semicomatose condition, was signed by a close relative -- stipulated that no heart transplant had ever been performed, but made no mention of the fact that an animal heart might be used for the procedure. Such was the medicolegal situation at that time that this `` informed '' consent was not considered in any way inadequate... ' Jump up ^ Xenotransplantation : Law and Ethics, Sheila McLean, Laura Williamson, University of Glasgow, UK, Ashgate Publishing, 2005, page 50. ^ Jump up to : McRae, D. ( 2006 ). Every Second Counts : The Race to Transplant the First Human Heart, New York : Penguin ( Berkley / Putnam ). Jump up ^ Norman Shumway : Father of heart transplantation who also performed the world 's first heart - lung transplant, Obituary, The Independent ( UK ), 16 Feb. 2006. Jump up ^ `` Memories of the Heart ''. Doylestown, Pennsylvania : Daily Intelligencer. November 29, 1987. p. A -- 18. Jump up ^ `` Pneumonia Blamed in Transplant Patient 's Death ''. The New York Times. 1967 - 12 - 21. Retrieved 2018 - 01 - 08. Jump up ^ Lyons, Richard D. `` Heart Transplant Fails to Save 2 - Week - old Baby in Brooklyn ; Heart Transplant Fails to Save Baby Infants ' Surgery Harder Working Side by Side Gives Colleague Credit '', The New York Times, December 7, 1967. Accessed November 19, 2008. Jump up ^ Heart : An American Medical Odyssey, Dick Cheney, Richard B. Cheney, Jonathan Reiner, MD, with Liz Cheney, Scribner ( division of Simon & Schuster ), 2013. `` Three days later, on December 6, 1967, Dr. Adrian Kantrowitz... '' Jump up ^ Tilli Tansey ; Lois Reynolds, eds. ( 1999 ), Early heart transplant surgery in the UK, Wellcome Witnesses to Contemporary Medicine, History of Modern Biomedicine Research Group, ISBN 978 - 1 - 84129 - 007 - 2, Wikidata Q29581627 Jump up ^ MAJOR MEDICAL MILESTONES LEADING UP TO THE FIRST HUMAN HEART TRANSPLANTATION, Kate Elzinga, from Proceedings of the 18th Annual History of Medicine Days Conference 2009 : The University of Calgary Faculty of Medicine, Alberta, Canada, Cambridge Scholars Publishing, 2011. ``... following Barnard 's landmark heart transplantation on December 3, 1967, 107 human heart transplants were performed by 64 surgical teams in 24 countries in 1968... '' Jump up ^ The Adrian Kantrowitz Papers, Replacing Hearts : Left Ventricle Assist Devices and Transplants, 1960 -- 1970, National Institutes of Health, U.S. National Library of Medicine. Jump up ^ Transplantation of the heart : An overview of 40 years ' clinical and research experience at Groote Schuur Hospital and the University of Cape Town, South African Medical Journal, `` Part I. Surgical experience and clinical studies. '' J Hassoulas, Vol. 102, No. 6 ( 2012 ). Jump up ^ `` TALK ABOUT A GUY WITH A LOT OF HEART 1st kid to get new ticker wants to be doc '' NY Daily News, 13 April 2003 Jump up ^ Raffa, G.M. ; Pellegrini, C. ; Viganò, M. ( November 2010 ). `` Domino Heart Transplantation : Long - Term Outcome of Recipients and Their Living Donors : Single Center Experience ''. Transplantation Proceedings. 42 ( 9 ) : 3688 -- 3693. doi : 10.1016 / j. transproceed. 2010.09. 002. Jump up ^ `` SRTR -- Scientific Registry of Transplant Recipients ''. www.srtr.org. Archived from the original on 2016 - 10 - 25. Retrieved 2016 - 10 - 24. Jump up ^ Reiner Körfer ( interviewee ) ( 2007 ). The Heart - Makers : The Future of Transplant Medicine ( documentary film ). Germany : LOOKS film and television. Jump up ^ First ever heart transplant in Sri Lanka successful, Hiru News, Sunday, 09 July 2017. Jump up ^ Arrowood, James A. ; Minisi, Anthony J. ; Goudreau, Evelyne ; Davis, Annette B. ; King, Anne L. ( 1997 - 11 - 18 ). `` Absence of Parasympathetic Control of Heart Rate After Human Orthotopic Cardiac Transplantation ''. Circulation. 96 ( 10 ) : 3492 -- 3498. doi : 10.1161 / 01. CIR. 96.10. 3492. ISSN 0009 - 7322. PMID 9396446. Jump up ^ Mehra MR, Canter CE, Hannan MM, Semigran MJ, Uber PA, et al. The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation : A 10 - year update. J Heart Lung Transplant. 2016 Jan. 35 ( 1 ) : 1 - 23. Jump up ^ Bishay R ( 2011 ). `` The ' Mighty Mouse ' Model in Experimental Cardiac Transplantation ''. Hypothesis. 9 ( 1 ) : e5. doi : 10.5779 / hypothesis. v9i1. 205. Jump up ^ Jung SH, Kim JJ, Choo SJ, Yun TJ, Chung CH, Lee JW ( 2011 ). `` Long - term mortality in adult orthotopic heart transplant recipients ''. J. Korean Med. Sci. 26 : 599 -- 603. doi : 10.3346 / jkms. 2011.26. 5.599. PMC 3082109. PMID 21532848. Jump up ^ Costanzo, MR ; Costanzo, MR ; Dipchand, A ; Starling, R ; Anderson, A ; Chan, M ; Desai, S ; Fedson, S ; et al. ( 2010 ). `` The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients ''. The Journal of Heart and Lung Transplantation. 29 ( 8 ) : 914 -- 56. doi : 10.1016 / j. healun. 2010.05. 034. PMID 20643330. Jump up ^ Heart Disease and Stroke Statistics -- 2012 Update The American Heart Association. Retrieved 27 November 2012. Jump up ^ Weiss, E.S. ; Allen, J.G. ; Patel, N.D. ; Russell, S.D. ; Baumgartner, W.A. ; Shah, A.S. ; Conte, J.V. ( 2009 ). `` The Impact of Donor - Recipient Sex Matching on Survival After Orthotopic Heart Transplantation : Analysis of 18 000 Transplants in the Modern Era ''. Circulation : Heart Failure. 2 ( 5 ) : 401 -- 408. doi : 10.1161 / CIRCHEARTFAILURE. 108.844183. External links First U.S. Human - to - Human Heart Transplant at Wayne State University Library contains high - definition images from this procedure, performed by Dr. Adrian Kantrowitz. Fortis Centre for Heart Failure & Transplat in India Official Heart Transplant Museum - Heart Of Cape Town Photograph of first U.S. heart transplant Western Cape government ; South Africa ( 21 February 2005 ). `` Chris Barnard Performs World 's First Heart Transplant ''. Cape Gateway. Retrieved 2007 - 01 - 10. Department of Cardiothoracic Surgery. `` Patient 's Guide to Heart Transplant Surgery ''. University of Southern California. Retrieved 2007 - 01 - 10. Nancy Reid ( 22 September 2005 ). `` Heart transplant : How is it performed ? ''. Healthwise. Archived from the original on 1 May 2007. Retrieved 2007 - 01 - 10. The Adrian Kantrowitz Papers Profiles in Science from the National Library of Medicine for Adrian Kantrowitz, the first to perform a pediatric heart transplant Orthotopic heart transplantation : the bicaval technique ( 1 ) ( 2 ) Surgery and other procedures involving the heart ( ICD - 9 - CM V3 35 -- 37 + 89.4 + 99.6, ICD - 10 - PCS 02 ) Surgery and IC Heart valves and septa Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Percutaneous aortic valve replacement Mitral valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock -- Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of great vessels Jatene procedure Mustard procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock -- Taussig shunt SVC to the right PA Glenn procedure Cardiac vessels CHD Angioplasty Bypass / Coronary artery bypass MIDCAB Off - pump CAB TECAB Coronary stent Bare - metal stent Drug - eluting stent Bentall procedure Valve - sparing aortic root replacement Other Pericardium Pericardiocentesis Pericardial window Pericardiectomy Myocardium Cardiomyoplasty Dor procedure Septal myectomy Ventricular reduction Alcohol septal ablation Conduction system Maze procedure Cox maze and minimaze Catheter ablation Cryoablation Radiofrequency ablation Pacemaker insertion Left atrial appendage occlusion Cardiotomy Heart transplantation Diagnostic tests and procedures Electrophysiology Electrocardiography Vectorcardiography Holter monitor Implantable loop recorder Cardiac stress test Bruce protocol Electrophysiology study Cardiac imaging Angiocardiography Echocardiography TTE TEE Myocardial perfusion imaging Cardiovascular MRI Ventriculography Radionuclide ventriculography Cardiac catheterization / Coronary catheterization Cardiac CT Cardiac PET sound Phonocardiogram Function tests Impedance cardiography Ballistocardiography Cardiotocography Pacing Cardioversion Transcutaneous pacing Organ transplantation Types Allotransplantation ABOi Autotransplantation Xenotransplantation Organs and tissues Bone Bone marrow Brain Corneal Face Hand Head Heart Heart -- lung Intestine Kidney Liver Living donor Lung Pancreas Islet cell Penis Skin Spleen Testicle Thymus Uterus Vagina Medical grafting Bone grafting Skin grafting Vascular grafting Organ donation Non-heart - beating donation Organ harvesting Organ trade Complications Graft - versus - host disease Post-transplant lymphoproliferative disorder Transplant rejection Transplant networks and government departments Balttransplant BC Transplant Society Eurotransplant Gift of Life Marrow Registry Human Tissue Authority LifeSharers National Marrow Donor Program NOD - Lb National Transplant Organization NHS Blood and Transplant Scandiatransplant Trillium Gift of Life Network United Network for Organ Sharing Advocacy organizations Anthony Nolan DKMS Donate Life America Halachic Organ Donor Society Kidney Foundation of Canada National Kidney Foundation ORGANIZE Joint societies American Society of Nephrology American Society of Transplantation Canadian Society of Transplantation Countries Organ transplantation in different countries Organ transplantation in China Organ transplantation in Israel Organ transplantation in Japan Organ theft in Kosovo Gurgaon kidney scandal People Heart Christiaan Barnard James D. Hardy Adrian Kantrowitz Richard Lower Norman Shumway Kidney J. Hartwell Harrison John P. Merrill Joseph Murray Michael Woodruff Liver Fikri Alican James D. Hardy Thomas Starzl Lung Fikri Alican Joel D. Cooper Vladimir Demikhov James D. Hardy Pancreas Richard C. Lillehei Penis André van der Merwe Other Alexis Carrel Jean - Michel Dubernard Donna Mansell Bruce Reitz List of organ transplant donors and recipients Related topics Biomedical tissue Edmonton protocol Eye bank Immunosuppressive drugs Lung allocation score Machine perfusion Total body irradiation Frankenstein 's monster GND : 4201513 - 3 NDL : 00932625 Retrieved from `` https://en.wikipedia.org/w/index.php?title=Heart_transplantation&oldid=842391612 '' Categories : Cardiac surgery Organ transplantation Hidden categories : CS1 maint : Explicit use of et al. 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Question: where are the hearts that are used in transplants sourced from
Answer: a recently deceased organ donor