Heart Transplant

A surgical procedure to remove a severely diseased and damaged heart and replace it with a healthy heart from a donor who has died.

Parts of the Body Involved

Heart, chest

Reasons for Procedure

A heart transplant is done to treat irreversible, life-threatening heart diseases that cannot be managed using any other method. Transplant candidates are severely disabled by their heart condition but otherwise are in good health. The procedure is most often performed for the following reasons:
  • Cardiomyopathy (disease of the heart muscle)
  • Severe vascular obstruction unresponsive to other treatments
  • Congenital heart defects
  • Valvular defects leading to severe, unremitting congestive heart failure

Risk Factors for Complications during the Procedure

  • Pre-existing heart condition
  • Age: 60 or older
  • Lung disease, including chronic obstructive pulmonary disease (emphysema) and pulmonary hypertension
  • Poor circulation or other vascular disease
  • Kidney or liver disease
  • Smoking
  • Presence of serious active infection, such as tuberculosis
  • Treatment for cancer within the previous five years
  • Debilitation
  • Diabetes
  • Previous stroke or other damage to the blood vessels of the brain
  • Mental illness or continued substance or alcohol abuse
  • Auto-immune disease
  • Potentially recurrent heart disease

What to Expect

Prior to Procedure

Because of a shortage of donors, you may be on a transplant list for some time. You may need to carry a pager or cellular phone at all times so that the transplant team can reach you if a donor heart becomes available.

Your doctor will likely do the following:
  • Physical exam
  • Echocardiogram

Outcome

The surgical site in your breastbone heals in four to six weeks.

To reduce the chance that your body will reject the donor heart, you will need to take immunosuppressive drugs for the rest of your life. Your doctors will biopsy your new heart regularly to monitor for signs of rejection. Additional drugs may be ordered to manage side effects. These drugs may increase your risk of developing cancer, kidney disease, and weak bones.

More than 80% of heart-transplant patients live for at least one year following the surgery. Most return to normal activities, including work and exercise. A specific rehabilitation program may be suggested to speed recovery and restore cardiovascular health. The transplanted heart responds slowly to increases in physical activity.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills; you are more susceptible to infections while taking immunosuppressive medications
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Coughing up blood
  • Sudden headache or feeling faint
  • Sensation of your heart fluttering, missing beats, or beating erratically
  • Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine