There is no doubt that a healthy donor heart has a radically positive impact when transplanted into the chest cavity of someone whose unhealthy birth heart has gone into failure. But the new heart also requires to be handled with care, involving both lifestyle considerations and medication.
The biggest assistance required by the transplanted heart is drugs – and specifically immunosuppressant drugs which block the body’s natural immune system to ensure the new heart, a foreign object, is not rejected by the recipient’s body.
The body’s immune system consists of antibodies and white blood cells which fight infection, bacteria and foreign tissue. A transplanted heart is regarded as a foreign tissue by the recipient body and doctors monitor H2 very closely for signs of rejection.
In addition, because the nerves leading to the heart are cut during surgery, the transplanted, denervated heart beats faster than a normal heart – about 100 to 110 beats per minute. For the same reason, the denervated heart also responds more slowly to the impact of physical exertion, requiring a closer observation of vital signs to avoid stress on H2.
The effect of suppressing the recipient immune system is that the recipient becomes susceptible to infection from a wide variety of sources and much of the post-transplant regime is focused on managing these other risks to the body.
Other considerations for a healthy post-transplantation life include getting sufficient rest; eating a healthy, well-balanced diet of properly cleaned and cooked foods while avoiding unpasteurized dairy products, soft eggs, raw meat (biltong) and raw fish (sushi); avoiding crowded public spaces including shopping malls and cinemas, especially during flu season; reducing close contact with anyone who has an active infection; washing hands thoroughly and regularly especially after going to the toilet and before eating, or after coughing or sneezing; wearing gloves when gardening or doing other dirty jobs; not smoking; staying away from animals that may be exposed to germs, including avoiding animal waste whether from cat litter, bird cages or fish tanks as the faeces of some animals contain live parasites and can cause infections.
Because of the immunosuppressants, transplant recipients also run the risk of contracting skin cancer as a result of over-exposing their “at risk” skin cells to the sun. It’s the reason I’ve taken to wearing floppy hats over my head of hair every day and not only like before to hide my unruly mop when I slipped to the shop early in the morning for emergency supplies. I understand the jury’s still out on whether Africans are as susceptible to skin cancer as northern hemisphere natives, but I’m trying hard not to be a contrarian and simply to heed the advice passed on by the heart transplant team.
Apart from medication, my daily, weekly or monthly treatment plans include up to 11 different blood tests, regular biopsies and physical examinations.