Heart transplants: Identity disruption, bodily integrity and interconnectedness

Abstract

Of heart transplant recipients, 30 per cent report ongoing or episodic emotional issues post-transplant, which are not attributable to medications or pathophysiological changes. To this end, our team theorized that cardiac transplantation introduces pressing new questions about how patients incorporate a transplanted heart into their sense of self and how this impacts their identity. The work of Merleau-Ponty provided the theoretical underpinning for this project as it rationalizes how corporeal changes affect one's self and offer an innovative framework to access these complex aspects of living with a transplanted heart. We used visual methodology and recorded 25 semi-structured interviews videographically. Both visual and verbal data were analyzed at the same time in an iterative process. The most common theme was that participants expressed a disruption to their own identity and bodily integrity. Additionally, participants reported interconnectedness with the donor, even when the transplanted heart was perceived as an intruder or stranger. Finally, transplant recipients were very vivid in their descriptions and speculation of how they imagined the donor. Receiving an anonymous donor organ from a stranger often leaves the recipient with questions about who they themselves are now. Our study provides a nuanced understanding of heart transplant recipients' embodied experiences of self and identity. Insights gained are valuable to educate transplant professionals to develop new supportive interventions both pre- and post-transplant, and to improve the process of informed consent. Ultimately, such insights could be used to enable heart transplant recipients to incorporate the graft optimally over time, easing distress and improving recovery.

Body‐Self Unity With a New Hip or Knee: Understanding Total Joint Replacement Within an Embodiment Framework

“…This observation suggests some parallels with experiences of transplantation, on which there is a larger literature (Table ). Research that takes a phenomenological approach to transplantation provides models for understanding TJR.…”

“…There is a tendency to ruminate on the origins of the organ, pondering the identity of its owner, and feeling gratitude and/or guilt toward that person . Indeed, transplant recipients report disruptions to identity and feelings of bodily integrity . Nevertheless, these models from the transplant literature may be useful in understanding TJR.…”

Exploring the experience of living with a heart transplant: a systematic review of the literature

“…Es un desajuste de la percepción personal y una desorganización de la identidad, que se relaciona con distintos aspectos entre los que están: la asimilación del nuevo corazón, la insistencia de algunos pacientes de que nada ha cambiado e incluso los que piensan que ahora tienen relaciones de parentesco con el donante 20,22,23 . Sobre esto, una mujer de 20 años decía: Me volví una extraña para todos mis amigos y un trabajador social de 30 años comentaba: durante mucho tiempo me sentí como si no fuera yo, como si fuera alguien más y no pudiera controlarlo 23 . Este trastorno de identidad que muchos pacientes experimentan les dificulta integrar el órgano en su propio cuerpo, recibiéndolo como un extraño, lo que les produce una gran insatisfacción con su imagen corporal 22 .…”

“…En ocasiones, los donantes son recordados como figuras centrales en sus vidas. Los pacientes sienten gratitud hacia el donante y su familia y al mismo tiempo, pena, porque para salvar su vida, otro ser humano ha tenido que morir 11,18,22,23,35 . Algunos se sienten en conexión con el donante, incluso piensan que vive dentro de ellos.…”

Why minds cannot be received, but are created by brains

“…New thought associations may spontaneously arise, personal identity may be disrupted (Mauthner et al 2015). If blood does not reach some parts of the brain, as it happens rather frequently in case of ischemic stroke, some functions are lost.…”