Life after a heart transplant

Heart transplantation is the choice of treatment for patients with chronic heart failure who, with the use of maximum medical and mechanical therapy, do not show improvement in the function of heart according to the 3rd and 4th degree by the NYHA (New York Heart Association) qualification (1). The patient is surgically transplanted with a healthy heart from a suitable donor. Patient mortality after heart transplantation has been greatly reduced by improving postoperative care which consists of the use of immunosuppressive therapy. The main goal of immunosuppressive therapy is to prevent rejection of the donor organ with minimal toxicity of the organism by monitoring the concentration of the drug in the blood and setting the dose appropriately, especially in the early postoperative period. In addition to immunosuppressive therapy, it is also important to prevent infections as a side effect of the body’s immunosuppression by introducing antibacterial and antiviral medications (2). An important role in maintaining the favorable health status of the organism is also played by regular pathohistological findings obtained by regular heart biopsy in order to detect acute rejection as soon as possible, which is most common in the first year after surgery. In addition to post-operative patient care, nutritional adaptation to metabolic disorders caused by medicinal post-operative therapy and physical activity are required to maintain optimal body weight, which should not deviate significantly from pre-operative. The education of the patient about the way of life after transplantation is carried out by a multidisciplinary team (nurses, physicians, physiotherapists…) that plays an important role in achieving, monitoring and maintaining a favorable health condition in order to extend life expectancy and improve the quality of life.