“The oak fought the wind and was broken, the willow bent when it must and survived.”
– Robert Jordan
Does a Heart Transplant Change Who You Are?
Patients waiting for a heart transplant often ask me questions about changes that I experienced after my transplant surgery. Generally these questions relate to personality changes. Changes like thinking, feeling, loving, or acting differently. Are you curious to discover if these changes are real, or are they myths? This blog delves into the evidence and stories behind this phenomenon. I hope you find this interesting.
Heart transplants are life-saving, you only have one as a last resort. You are rolling the dice between a second chance at life or certain death. I have come to realise that transplant is not a cure but rather life extending surgery. A choice requiring lifelong medical treatment and management. They are highly risky. Life never truly goes back to normal. Rather it becomes a new normal.
When people discover I am a Heart Transplant recipient they have so many questions. If they are waiting to get a heart transplant they have very specific medical and logistical questions. This is exactly why I started the Wednesday Wynn Blog. The blog is a tribute to honour my donor. Of course it is also created to assist transplant patients and their loved ones on their journey.
Resources
Non transplant folk will ask very different questions. I aim to address the non medical questions in this post. This is largely because I have written so many posts. These specifically answer questions about the transplant processes of assessment, transplantation, rejection, complications and recovery. Please refer to the blog for these posts. Here are a few suggestions: Heart Transplant Eligibility. You can also learn about the Pros and Cons of a Heart Transplant. Finally, read about What it’s like to have a Heart Transplant.
If you need information about rejection or medications, I invite you to read the following resources. Explore Practical Tips On Taking Medications After A Heart / Lung Transplant. You can also read about Anti-rejection Medications After a Heart/Lung Transplant and Non Anti Rejection Medications After A Heart / Lung Transplant. Additionally, consider exploring Heart Transplant Rejection: A Guide to Survival.
Personality Changes After a Heart Transplant: Fact or Fiction?
Heart transplants are life-saving, but some recipients report changes in personality, emotions, or thinking patterns post-surgery. Are these changes real, or are they myths? What evidence and stories exist behind this phenomenon.
Some transplant recipients experience shifts in preferences (music, movies, hobbies, food) or emotions (depression, exhilaration, positivity, guilt). Even changes to temperament (volatile, impulsive, or aggressive). These changes can and do stem from several factors.
What Is The Psychological Impact Of Having An Organ Transplant?
Surgery and Illness
The trauma of surgery and the gratitude of receiving a second chance may alter one’s thoughts, perspective and behaviour. Organ recipients have shared with me some of their thoughts and responses to this question:
As a recipient each day is more precious.
Simple little moments are meaningful.
Memories, relationships and experiences become your focus.
You may stop sweating the “small stuff.”
Perhaps you are less likely to carry the burdens of others.
You let go of what no longer serves you or those you loved.
Material possessions are less important so long as you can meet your needs.
Self compassion and understanding increases, allowing yourself more time for self care than you did before.
Post-transplant, conflicting mental health issues may arise from depression to elation or from guilt to gratitude.
As loved ones of transplant recipients being aware of these emotions may be helpful. These emotions may shape personality or thinking patterns and be viewed in changes of behaviour.
Medical and Lifestyle Changes
Studies show that about 36% of heart transplant recipients report notable personality changes. Successful transplant recipients report improved heart function. This leads to increased energy and optimism. Improvements in overall health after the transplant may positively affect one’s personality and outlook on life.
Organ transplant recipients generally report that they feel more inspired to make and adhere to good lifestyle adjustments. They improve the “controllables” where they can. They become more attuned with diet, exercise, sleep, relaxation, stress reduction and relationships.
Physical and Emotional Recovery
Adjusting to the onslaught of transplant medications and ongoing Crucial Testing After A Heart Or Lung Transplant? impact time, energy levels and lifestyle. Particularly the first 12 months post transplant. Recovery after a transplant involves both physical and emotional adjustments to a “new normal.”
Let’s take the simple act of driving for instance.
You are not able to drive for 8 weeks or so after a transplant. This reduces your feelings and actual level of independence, which can be frustrating. I had to be driven to all my appointments for many months.
The anti-rejection medications rage a war on your body. One common example is Prednisone, which can increase hyperactivity, anxiety and nervousness. I became a very nervous and anxious passenger. As the prednisone levels were reduced I became a better passenger and was more calm in general.
Prednisone negatively impacts sleep. When you are severely sleep deprived you are more prone to negative emotions. Transplant recipients report increases in feelings of anger, frustration, irritability, sadness. Generally a significant decrease in positive moods was experienced.
Uncommon Reports:
Rare cases describe sudden, non-explainable shifts in food preferences or hobbies, potentially linked to the cellular memory hypothesis. During my research I found some interesting and bizarre cases. You can read about them using the references provided at the end of the post.
Managing Post-Transplant Psychological Changes
If you or a loved one feels different post-transplant, consider these simple suggestions which helped me navigate my heart transplant.
The transplant team can refer you to the transplant psychologist or social worker. I found the transplant coordinator provided extensive psychological resources both in hard copy and digital online resources. I also sought counselling from an independent psychologist who assisted me process my emotions after such a major life event.
You don’t know what you don’t know, right? The social worker was able to link me into a number of government and community programs and support groups.
Seek out and engage in support groups for transplant recipients in your local area or attached to your transplant hospital. I found a number of supportive online groups who are happy to share their knowledge and experiences.
Most importantly, you need to communicate openly with your GP. Also, talk authentically with your transplant team. This approach will help address and resolve your concerns.
What Does the Research Say?
Every organ has a purpose. The heart expands and contracts to pump blood. The kidneys filter the blood to remove waste, create urine and balance vital electrolytes for optimum health. The liver metabolises to support our immune and digestive systems via detoxification and vitamin storage. Our Pancreas releases enzymes to digest food and hormones. Specifically Insulin and Glucagon, to control blood sugar levels.
Did you know, the heart does not just beat, it also produces hormones. Specifically ‘atrial natriuretic peptide’ and ‘brain natriuretic peptide,’ which keep your fluid balance in check by working with the kidneys. This is why Fluid Retention and its resulting Fluid Restrictions go hand in hand with Heart Failure.
But that’s not all. These hormones also help balance your electrolytes and calm down your fight-or-flight response. The brain region pulling the strings behind this is the hypothalamus. This manages everything from your mood to biological balance.
Studies have found that these heart-produced hormones don’t just bounce back to normal after a transplant; they actually increase. And while some of this could be due to the surgery, there could be more to it. All vital organs produce peptides, amino acids, enzymes and or hormones, not just the heart.
So, when you get a new heart or organ, you’re not just swapping out an organ. You’re essentially getting a new hormone factory that potentially can impact more than your DNA.
Cellular Memory
All living things are made up of cells. From conception these cells evolve into tissues which become either an organ, skin, teeth etc. Cellular memory is a theory suggesting that donated organs might transfer aspects of the donor’s cellular memory. This transfer may impact personality or preferences.
This may seem far fetched. However, upon researching this, I found that studies have determined that even individual cells can possess simple memory capabilities.
More On Memories
We easily accept that memories are stored in the brain. Yes? Interestingly, memory also exists in the immune system. Let’s look at vaccines to prove this point.
Vaccines work by exposing our body’s immune system to selected pathogens (virus or bacteria). Vaccines then affect our white blood cells to become memory cells. This means we quickly develop a rapid immune response when we are next exposed to the pathogen. Hence preventing or reducing illness.
This process is called immunological memory. It accelerates our immune system’s response to infections. Interestingly, even some single-celled organisms exhibit a form of memory by getting used to repeated stimuli. Therefore a donor’s organ comes with its own hormone and peptide producing cellular memory. Fascinating isn’t it.
Epiphany
In hindsight this was a difficult post to write. It is such a broad topic which impacts so many people in vastly different ways. It really opens up a rabbit warren for further investigations. Again I could write a text book on this topic alone. The references below will assist you with further reading if I have piqued your interest.
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References
Carter, B., Khoshnaw, L., Simmons, M., Hines, L., Wolfe, B., & Liester, M. (2024). Personality changes associated with organ transplants. Transplantology, 5(1), 12–26. https://doi.org/10.3390/transplantology5010002
Cassella, C. (2024, May 17). Eerie personality changes sometimes happen after organ transplants : ScienceAlert. ScienceAlert. https://www.sciencealert.com/eerie-personality-changes-sometimes-happen-after-organ-transplants
Liester, M. B. (2020). Personality changes following heart transplantation: The role of cellular memory. Medical Hypotheses, 135, 109468. https://doi.org/10.1016/j.mehy.2019.109468
McGill University. (n.d.). Office for Science and Society. Retrieved November 19, 2024, from https://www.mcgill.ca/oss/article/medical-pseudoscience/donors-organ-donors-personality-lets-approach-sensibly
Taylor, P. A. (2024, May 7). Can a heart transplant really change someone’s personality? Metro. https://metro.co.uk/2024/05/07/can-a-heart-transplant-really-change-someones-personality-20789186/