Why is a heart transplant not permanent?

Question

Why is a heart transplant not permanent? I read the average life is 11.5 years. Why do people say "if you survive the first 4 years" your average expectant life is 11.5 years. What happens in the first four years?

Answer 1

One must understand statistics and the underlying data that has been treated.  For example the sum of 100 + 4 = 104 but the average is 52.  If a person aged say 65 could live an additional 11.5 years that would be a good thing.  However, even without a transplant (no disease) 76.5 may be longer than the lives of brothers and sisters.

If someone rejects a heart and dies after less than a year that would strongly bias the statistics.  People needing heart transplants are generally in poorer overall heath than the general population.  There often is very little time to study the detailed health of the donor (who died in an accident and had a donor card, etc.).  Many advances are being made and statistics may reflect failures that can now be avoided.  Likely the worst challenges (immune system and reaction to necessary drugs) are sorted out within the first four years.

Answer 2

It can be permanent unless you get a rejection of some sort

In Australia we have a lovely lady who had her transplant at age 14 then it went bad so they did it again shes still well at this time and must be getting near 40 by now

Unfortunately the amazing doctor who did her transplants was murdered on his way to work .

some years back, but there were others to replace him and have done well.

I would think a lot depend on what age you are when you need to have it done.

Answer 3

The biggest problem is outright rejection.

Even if you match the blood type, the cells are not marked as yours, and you have to take drugs that suppresses your immune system from attacking the organ implanted.  If your body doesn't autoimmune reject it, then you are in ok shape.

Ripping out a heart from someone is quite traumatic.  Putting it into someone else is just as bad.  Technically, the heart is actually dead while being transplanted, so the cells in it have also been damaged a little, but not so much that they can't kick-start it back into working, so the lifespan of the heart is also reduced by that, besides the time that it was in use by the person who donated it.

But, it's an average.  People who receive healthy hearts from young donors get longer, people who die because their lifestyles and other factors not mentioned even with a new heart drop this average.  It's as simple as that.