Talk:Heart transplantation

message: I felt it was about time this article was created :)!  D Dinneen —Preceding unsigned comment added by D Dinneen (talk • contribs) 12:55, 11 November 2006 (UTC)
thread_title: Article created

message: Can someone provide an image for this article, maybe a diagram showing the procedure? —Preceding unsigned comment added by D Dinneen (talk • contribs) 12:47, 12 November 2006 (UTC)
thread_title: Image required

message: why is some of the heart left in during a transplant?? — Preceding unsigned comment added by 193.62.251.36 (talk) 21:27, 21 November 2006 (UTC)
thread_title:  help 

message: I added the expand tag, and the image request.  This is a very nice article, and it would be good if someone could add in some of the history regarding the research that was done before Chris Barnard did the first transplant.  I know that there was some experimentation done on baboons, etc.  There was lots of research done by other pioneers.  Knowledge gained by practitioners over time and changes to procedure would be interesting.  Sorry I can't do this myself, all of my knowledge is hear-say. Peashy 09:44, 2 January 2007 (UTC)
thread_title: History/research

message: Why does Elizabeth Craze redirect here??  —Preceding unsigned comment added by 82.4.63.69 (talk) 21:06, August 24, 2007 (UTC) 
:Youngest survivor of the surgery. She has her own article now ! Jake the Editor Man  (talk) 20:00, 22 January 2008 (UTC)
thread_title:  Elizabeth Craze 

message: Further elaboration/opinion regarding autonomic innervation of a heart allograft requested. Systolic failure of the heart is well addressed by heart transplantation. A transplanted heart restores and preserves intrinsic sympathetic properties derived from the transplanted Sinoatrial and Atrioventicular Nodes and Purkinge fibers. Heart transplantation necessarily requires amputation of the cardiac branch of the Vagus Nerve and [thoracic spinal accessory nerves] thus allowing degradation of Diastole.--Lbeben (talk) 05:23, 16 August 2008 (UTC)
replies: text: Intervention in Chagasic Heart Failure now includes heart transplantation. Chagas gradually targets the parasympathetic fibers of the heart. Heart transplantation imparts a more immediate loss of parasympathetic control. HT for the essential indication of HFPef may be a precarious approach. — Preceding unsigned comment added by Lbeben (talk • contribs) 01:50, 7 June 2012 (UTC)
thread_title: Elaboration/opinion on autonomic innervation of heart allograft requested

message: The Prognosis section contains this paragraph:
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The record for heart transplant longevity in a senior recipient may go to Edward Daunheimer of Newburyport, Massachusetts, who received his heart on 19 February 1997 at the Tufts New England Medical Center at the age of 65 (the upper age limit for heart transplants). Mr. Daunheimer has so far lived a healthy life for 12 years with his new heart, defying statistical probabilities by a large margin.
----
The parenthetical statement (bolded) indicates that the upper age limit is 65, however Jerry Richardson (72), owner of the Carolina Panthers had a heart transplant on 2/1/09.
****
Thank you for contributing this information about Jerry Richardson. In 1997 (when Mr. Daunheimer received his heart), the upper age limit for heart transplants was 65. It may have been moved up since then--perhaps due in part to the success of Mr. Daunheimer's experience, i.e. the technology had clearly advanced enough to warrant such a change. Chillowack (talk) 00:25, 15 February 2009 (UTC)
thread_title:  Oldest recipient 

message: From the Columbus Dispatch
http://www.dispatch.com/live/content/local_news/stories/2009/08/10/aheart.html?sid=101
The section about him will need to be updated
17:54, 10 August 2009 (UTC)
thread_title:  Tony Huesman Dies on Aug 10, 2009 

message: Which country? Which currency?
Isn't this procedure just as free as every other procedure in most developed countries?
I spent a week last month in Intensive Care following a stroke. My total cost is $45 for the trip to the first of two hospitals.
Varlaam (talk) 18:58, 28 April 2011 (UTC)
thread_title:  $787,700 

message: It seems that there was a mistake in female survival rates. I've investigated 2 documents on americanheart.org. In the first one 1-year female survival rate coincides with three-year female survival rate. Therefore it is incorrect, and I've replaced it with the data in the second document.
1. http://www.americanheart.org/presenter.jhtml?identifier=4588 
2. http://www.americanheart.org/presenter.jhtml?identifier=3000090 
Vikasatkin (talk) 11:42, 25 June 2011 (UTC)
thread_title:  Female survival rates 

message: Can someone clarify that? Last time I checked there was an entirely different period. Does someone know if this great leap was in the article only, or in the actual medicine as well?
Venom4u 31 (talk) 14:05, 27 September 2011 (UTC)
thread_title:  "Post-operation survival periods now average 102 years"? 

message: If someone isn't notable enough to have their own wikipedia article, they shouldn't be in the section. If they are notable (WP:NOTE, they need pages created for them, otherwise the information on them should be deleted. Exceptions to this would be people who received e.g. groundbreaking transplants or long survival on their transplants. --Cptbigglesworth266 (talk) 10:19, 16 April 2015 (UTC)
thread_title:  Only Notable people should be in the notable people section 

message: moving this unsourced content here from the history section until it can be sourced
In 1945 the Soviet Pathologist Nikolai Sinitsyn successfully transplanted a heart from one frog to another frog, and from one dog to another dog. Both recipients survived the procedure.
On January 23, 1964, Dr. James Hardy performed the first heart transplant at the University of Mississippi Medical Center in Jackson, in which the heart of a chimpanzee was transplanted into the chest of Boyd Rush (age 68), who was dying, as a last effort trying to save him, as no human heart was available. Rush died after 90 minutes. Hardy dealt with severe criticism for performing the transplant, but the operation manifested the possibility of human heart transplantation. Three years later, the first successful human-to-human heart transplantation was performed in 1967 by Christiaan Barnard.
-- Jytdog (talk) 20:55, 24 May 2016 (UTC)
thread_title:  unsourced 1 

message: The content below is dramatically undersourced; can be restored once references are found and content is supported.
;Procedures
;Pre-operative
A typical heart transplantation begins when a suitable donor heart is identified. The heart comes from a recently deceased or brain dead donor, also called a beating heart cadaver. The patient is contacted by a nurse coordinator and instructed to come to the hospital for evaluation and pre-surgical medication. At the same time, the heart is removed from the donor and inspected by a team of surgeons to see if it is in suitable condition. Learning that a potential organ is unsuitable can induce distress in an already fragile patient, who usually requires emotional support before returning home.
The patient must also undergo emotional, psychological, and physical tests to verify mental health and ability to make good use of a new heart. The patient is also given immunosuppressant medication so that the patient's immune system does not reject the new heart.
;Operative
Once the donor heart passes inspection, the patient is taken into the operating room and given a general anaesthetic. Either an orthotopic or a heterotopic procedure follows, depending on the conditions of the patient and the donor heart.
;Orthotopic procedure
The orthotopic procedure begins with a median sternotomy, opening the chest and exposing the mediastinum. The pericardium is opened, the great vessels are dissected and the patient is attached to cardiopulmonary bypass. The donor's heart flushed with preservation solution before the heart is removed from the donor's body and packed in ice. Ice can usually keep the heart usable for fourCustodiol Htk Solution patient advice including side effects to six hours depending on preservation and starting condition. The failing heart is removed by transecting the great vessels and a portion of the left atrium. The patient's pulmonary veins are not transected; rather a circular portion of the left atrium containing the pulmonary veins is left in place. The donor heart is trimmed to fit onto the patient's remaining left atrium and the great vessels are sutured in place. The new heart is restarted, the patient is weaned from cardiopulmonary bypass and the chest cavity is closed.
The orthotopic procedure was developed by Shumway and Lower at Stanford-Lane Hospital in San Francisco in 1958.
;Heterotopic procedure
In the heterotopic procedure, the patient's own heart is not removed. The new heart is positioned so that the chambers and blood vessels of both hearts can be connected to form what is effectively a 'double heart'. The procedure can give the patient's original heart a chance to recover, and if the donor's heart fails (e.g., through rejection), it can later be removed, leaving the patient's original heart. Heterotopic procedures are used only in cases where the donor heart is not strong enough to function by itself (because either the patient's body is considerably larger than the donor's, the donor's heart is itself weak, or the patient suffers from pulmonary hypertension).
;'Living organ' transplant
In February 2006, at the Bad Oeynhausen Clinic for Thorax and Cardiovascular Surgery, Germany, surgeons successfully transplanted a 'beating heart' into a patient. Rather than cooling the heart, the living organ procedure keeps it at body temperature and connects it to a special machine called an Organ Care System that allows it to continue pumping warm, oxygenated blood. This technique can maintain the heart in a suitable condition for much longer than the traditional method.
;Non-beating heart transplant
The first successful non-beating heart transplant was achieved in Australia in 2014, performed by cardiothoracic surgeon Kumud Dhital. The transplant was made possible by the development of preservation technology able to preserve a heart, resuscitate it and to assess the function of the heart. The first patient to have this surgery was 57-year-old Michelle Gribilas. Papworth Hospital in England (where the first non-beating heart transplant in Europe was carried out) stated that the technique could increase the number of hearts available for transplant by at least 25%.
;Post-operative
thumb|right|Transplanted heart in the thorax of recipient
The patient is taken to the ICU to recover where they are started on immunosuppressants. When they are stable, they may move to a special recovery unit for rehabilitation. The duration of in-hospital, post-transplant care depends on the patient's general health, how well the heart is working, and the patient's ability to look after the new heart. Doctors typically prefer that patients leave the hospital 1–2 weeks after surgery, because of the risk of infection and presuming no complications. After release, the patient returns for regular check-ups and rehabilitation. They may also require emotional support. The frequency of hospital visits decreases as the patient adjusts to the transplant. The patient remains on immunosuppressant medication to avoid the possibility of rejection. Since the vagus nerve is severed during the operation, the new heart beats at around 100 beats per minute unless nerve regrowth occurs.
The patient is regularly monitored to detect rejection. This surveillance can be performed via frequent biopsy or a gene expression blood test known as AlloMap Molecular Expression Testing. Typically, biopsy is performed immediately post-transplant and then AlloMap replaces it once the patient is stable. The transition from biopsy to AlloMap can occur as soon as 55 days after the transplant.
-- Jytdog (talk) 01:53, 17 November 2016 (UTC)
thread_title:  unsourced 2

message: Per WP:MEDMOS the only people who should be here, are people who reliable sources say has had some impact on the field.  Michael J Fox is the classic example, with respect to Parkinsons.   None of these people appear to be like that. 
;Famous recipients
*Robert Altman (1925-2006), American film director (M*A*S*H, McCabe & Mrs. Miller, Nashville), transplant in 1995 (survival: 11 years)
*John C. Bogle (born 1929), American investor and philanthropist,  transplant in 1996
*Robert P. Casey (1932-2000), American politician (42nd Governor of Pennsylvania), transplant in 1993 (survival: 7 years)
*Dick Cheney (born 1941), American politician (46th Vice President of the United States), transplant in 2012
*Erik Compton (born 1979), Norwegian-American golfer, transplants in 1992 and 2008
*Glen Gondrezick (1955-2009), American basketball player (New York Knicks, Denver Nuggets), transplant in 2008 (survival: <1 year)
*Jonathan Hardy (1940-2012), Australian actor, writer and director (The Devil's Playground, Mad Max, Mr. Reliable, Moulin Rouge!), transplant in 1988 (survival: 24 years)
*Billy T. James (1948-1991), New Zealand comedian (The Billy T James Show), transplant in 1989 (survival: 2 years)
*Eddie Large (born 1941), British comedian (Little and Large), transplant in 2002
*Mussum (1941-1994), Brazilian comedian and actor (Os Trapalhões), transplant in 1994 (survival: <1 year)
*Norton Nascimento (1962-2007), Brazilian actor, transplant in 2003 (survival: 4 years)
*Kelly Perkins (born 1961), American mountain climber, transplant in 1995
*Jerry Richardson (born 1936), American football player (Baltimore Colts) and team owner (Carolina Panthers), transplant in 2009
*Sandro de América (1945-2009), Argentinian singer, transplant in 2008 (survival: <1 year)
*Sam Wyche  (born 1945), NFL player 1968-1976 and Head Coach, (Cincinnati Bengals 1984-1991), (Tampa Bay Buccaneers 1992-1995), transplant in 2016
 
;Other notable recipients
At the time of his death on August 10, 2009, Tony Huesman was the world's longest living heart transplant recipient, having survived for 30 years, 11 months and 10 days, before dying of cancer. Huesman received a heart in 1978 at the age of 20 after viral pneumonia severely weakened his heart.http://www.columbusdispatch.com/live/content/local_news/stories/2009/08/10/aheart.html?sid=101 The operation was performed at Stanford University under   Dr. Norman Shumway.Heart Transplant Patient OK After 28 Yrs (14 September 2006) CBS News. Retrieved 29 December 2006.
, the record holder for longest living heart recipient was Englishman John McCafferty. He received his heart on 20 October 1982. He died aged 73 on 9 February 2016, 33 years after his operation. The operation was performed at Harefield Hospital in Middlesex under Sir Magdi Yacoub.
Former Vice President of the United States Dick Cheney received a heart transplant on March 24, 2012. Because he was 71 years old at the time of the surgery, it sparked discussions about the upper age of transplant patients.
-- Jytdog (talk) 04:18, 22 February 2017 (UTC)
thread_title:  Famous recipients section 

message: And perhaps even more spectacularly, inspired by the rather limited success of Keith Reemtsma at Tulane, James Hardy (surgeon) transplanted the heart of a chimpanzee into the chest of his dying patient Boyd Rush.  This heart beat for about 60 to 90 minutes (sources vary) and then the man died without regaining consciousness.
And since this is not on the main path of history as it were, it's largely forgotten.  FriendlyRiverOtter (talk) 21:00, 5 July 2017 (UTC)
thread_title:  First heart transplant was performed by Dr. James Hardy on patient Boyd Rush in 1964.  Yes, really, please look it up. 

message: Norman Shumway: Father of heart transplantation who also performed the world's first heart-lung transplant, Obituary, The Independent [UK], 16 Feb. 2006. This also includes two paragraphs on the discovery and early use of cyclosporine.
::would like to find one or two more references in addition to McRae's book. FriendlyRiverOtter (talk) 18:43, 13 July 2017 (UTC)
thread_title:  references regarding Norman Shumway as father of heart transplantation 

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thread_title:  External links modified 

message: http://ucsdnews.ucsd.edu/archive/newsrel/health/02-18ValentineGift.asp
One particular patient.  Yes, we generally want good overviews, but added to this, one or two specific examples can be helpful.  FriendlyRiverOtter (talk) 21:24, 3 January 2018 (UTC)
thread_title:  example of rare heterotopic ("piggyback") heart transplant. 

message: Hello fellow Wikipedians,
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thread_title:  External links modified (January 2018) 

message: Why is this article so much shorter than it used to be? It's like the Reader's Digest version as compared to how it was 5-10 years ago. This is not Simple Wikipedia! 192.70.191.1 (talk) 18:47, 16 December 2021 (UTC)
replies: text: See #unsourced 1 and #unsourced 2 above. Graham87 (talk) 13:12, 20 February 2024 (UTC)
thread_title:  Abridged 

message: The illustration could be replace. It is a Pig heart (illustration from trasnmedics, the firm doing the OCS machine), using one of the 3 avaiblel preservation machine, representing less than 20% of all transplantzation happening worldwide.  Ambak' (talk) 14:09, 7 September 2023 (UTC)
thread_title:  OCS photo 

message: What about Alexis Carrel who did a heart transplantation for a dog in 1905 already, two years before Flexner said that it would be possible one day by surgery to replace diseased human organs 91.59.187.223 (talk) 12:40, 8 February 2024 (UTC)
thread_title:  History: Alexis Carrel 

message: Writing a friendly letter 41.150.217.248 (talk) 15:36, 15 April 2024 (UTC)
thread_title:  English