Heart TransplantThe first ever heart transplant was done on a dog, by Norman Shumway at Stanford University in California, 1958. This procedure was successful. The first person to perform a heart transplant on a human was Christiaan Barnard. It was performed on the 3rd of December 1967 at Groote Schuur Hospital in Cape Town. The patient (Louis Washkansky) needed a heart transplant when he found out that he was dying from chronic heart disease. Washkansky received the heart from Denis Darvall who was a 25-year-old woman who was killed in a car accident.

The technique that Barnard used in the procedure was developed by American researchers in the 1950s. After Washkansky’s surgery, he was given drugs to keep his body from rejecting the new heart and also to control his immune system. The drugs left him vulnerable to infections and sicknesses. Sadly, 18 days later he died from double pneumonia, other than that, his new heart was functioning normally up until his death.

A heart transplant is required when your heart is failing and other treatments aren’t working. End stage heart failure is a disease where the heart muscle fails to pump blood throughout the body. It doesn’t mean that the heart is going to stop beating, it means that the heart muscle is failing to pump blood normally because it is damaged, weak, or even both. Heart transplant surgical procedures take several hours but even longer if you’ve had other coronary heart surgeries in the past. If you’ve had previous coronary heart surgeries then the coronary heart transplant will be extra intricate and will take longer to put in than usual. Before the procedure, you receive general anaesthesia to put you to sleep throughout the process. The surgeon will then make an incision in your chest, over your breastbone. Once the incision is made, they will then separate your chest bone and open up your rib cage so that they can safely remove the diseased heart. When they remove the diseased heart, he or she will then will attach the essential blood vessels to the donor heart. Once the blood flow is restored, the surgeon will give your heart a little electric shock to get the heart beating. Your breastbone will then be closed with metal wires, and the tissues and skin will be closed with stitches. When you wake up after hours of being operated on you will be moved into an intensive care unit (ICU). That’s when you are given drugs for the pain, a ventilator to help you breathe and tubes in your chest to drain fluids from around your lungs and heart. You will be given immunosuppressants (medication). The medication that you are given will be required to be taken for the rest of your life to ensure the best life with the new donor heart. Immunosuppressants are a very powerful drug that has a range of side effects. At times, the side effects can be quite gruesome but it is required that never stop taking them unless your doctor tells you otherwise. The new heart will sufficiently help the patient’s lifestyle. Even though heart transplants save lives, there are risks that come with getting a new *donor* heart. During the operation/surgery, there are a number of things that could go wrong such as:Bleeding, infection, blood clots, heart attack, stroke, or even death Some other risks of having a heart transplant include:*Rejection to the donor heart – Rejection occurs when the immune system makes antibodies to try and destroy the donor heart, without realising that the donor heart is beneficial to the body. The patient is put on immunosuppressants (medication). Immunosuppressants slow down the activity of the immune system, to prevent it from attacking the donated heart.*Immunosuppressant side effects- The three main immunosuppressants are Tacrolimus, Mycophenolate Mofeti and Prednisolone. They are very powerful and are to be taken twice daily with or after food. Some side effects are headaches, tremors, pins and needles, nausea, vomiting, diarrhoea, weight gain, high blood pressure, weakened bones, diabetes, disturbance of sleep, and an increased appetite. Ethical- Ethical means right, unethical means wrong. It could be based on society, religion or personal opinions. An ethical concern might be that there is a 50-year-old man who has supported his family up until he was diagnosed with heart failure and was put on the list for a heart transplant. This man has never smoked, has been sober his whole life and has stayed well away from drugs. If there was another person that was in need of a heart who was 20-years-old and who has stuffed up their heart by drinking, doing drugs and smoking and the surgeon only had one heart for a transplant, he would have to make an ethical decision. The old man might be the sole income provider and he might have an elderly disabled wife who is totally dependant on him for her survival and the younger person could live longer with the change of lifestyle and could have a heart transplant when another heart is available in the future. Another ethical concern might be that there is a disabled person who is best friends with the surgeon, and is on the top of the list for a heart transplant, or an abled person who has been rushed into an emergency transplant. Both patients will die without a heart transplant. Does the surgeon go with morals and operate on his best friend who has poor quality of life, or with science and operate on the abled person who will have a good quality of life?