The life and death construct in heart transplant patients

• Published in: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology Vol. 18; no. 1; pp. 48 - 56
• Main Authors: Palmar-Santos, Ana M, Pedraz-Marcos, Azucena, Zarco-Colón, Juan, Ramasco-Gutiérrez, Milagros, García-Perea, Eva, Pulido-Fuentes, Monserrat
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-01-2019; Oxford University Press
• Subjects: Adaptation, Psychological; Adult; Aged; Aged, 80 and over; Female; Heart; Heart Transplantation - psychology; Heart transplants; Humans; Male; Middle Aged; Qualitative Research; Quality of Life - psychology; Spain; Transplant Recipients - psychology; Transplants & implants; Vitamin C; Vitamin E; Spain; phenomenology; in-depth interviews; lived body; surgical enhancement; Heart transplant
• ISSN: 1474-5151; 1873-1953
• DOI: 10.1177/1474515118785088

Background:
The technological advances of medicine, and specifically the techniques of organ transplants, have allowed crossing the border of life and death. This is especially relevant in the case of heart transplant, since its symbolism requires a redefinition not only of these traditional concepts, but also of the body or of one’s own identity.
Aims:
To explore the experiences of patients after receiving a heart from a donor.
Methods:
A phenomenological qualitative approach, through Merleau Ponty and Levinas perspectives, was conducted to capture the subjective experiences of heart transplant patients. We conducted 22 in-depth interviews: 12 with heart transplant patients from two hospitals in Madrid (Spain), and 10 with relatives who lived with them.
Results:
The line between life and death is erased for heart transplant patients. Three main themes arose from the analysis: towards death, the frontier between life and death, and towards life. The need to redefine the concepts of life and death is structured around issues such as the thought of facing one’s own death and the concept of gift and resurrection.
Conclusion:
Organ transplant techniques open the door to a new definition of death, of the identity of the body and its parts and the limits of life. Considering the cultural, legal, psychological, social and symbolic elements involved in the heart transplant process, a qualitative approach provides new avenues of understanding the clinical process from the patients’ perspective.