I'm John Dark. I'm a consultant cardiothoracic surgeon

and head of the heart and lung transplant programme

at the Freeman Hospital in Newcastle upon Tyne.

Patients need a heart transplant

when they have what we call end-stage heart failure.

In about half the patients it's due to a disease of the muscle,

a condition called cardiomyopathy,

and in most of the rest it's due to damage from numerous heart attacks,

lack of blood supply to the heart muscle.

Many people have heart attacks for a whole range of reasons

connected with lifestyle and their genetic make-up.

It's only the most severely affected patients with these conditions,

the cardiomyopathy or the ischaemic heart disease,

that's lack of blood supply to the muscle,

who end up needing a heart transplant.

Nearly all patients who have heart attacks or cardiomyopathy

can be managed with tablets or some conventional form of surgery.

We need to make sure the patient is fit enough for a transplant.

If they get to that stage, we would put them on the waiting list for an organ.

We allocate organs by size and by blood group

and we give them to the sickest patients at any one time around the country.

The transplants are like any other form of heart surgery.

They're done through a cut down the middle of the chest.

We put the patient on a heart-lung machine

to make sure the rest of the body stays alive

in the period between taking out the old heart

and putting in the new heart.

The recovery from the transplant operation is usually fairly smooth,

although if you've been very sick beforehand,

it takes longer than if you weren't so sick beforehand.

The main difference between this sort of surgery and other heart surgery

is that you need to take the tablets to suppress your immune system.

They have a whole variety of side effects.

You are more prone to infections

and you're actually more prone to some forms of cancer.

We're offering transplants to the sickest patients.

Most of them would be dead in a matter of weeks or months

if they weren't able to receive a heart transplant.

Afterwards the level of activity can be huge.

We've had heart transplant patients who have climbed mountains,

who have gone back to regular work,

who have raised families, they've had babies.

I think it's important for everybody in the country to realise

that the results of heart transplantation are now very successful,

that we restore young adults who were faced with imminent death

back to a productive and lengthy life.

The results in children are very good indeed

and up to 90 per cent of children are alive ten years after their transplant.

These are children who would have been dead within a few weeks.

So we are dependent upon people consenting to organ donation,

thinking about organ donation, joining the organ donor register.