This is surgery to remove a severely diseased and failing heart. It is replaced with a healthy heart from a deceased donor.
Normal Heart and Heart with Hypertrophic Cardiomyopathy
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A heart transplant is done if you have:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
More than 80% of heart transplant patients live for at least one year after surgery. Most return to normal activities, including work and exercise.
People over 60 years old are at increased risk of complications. Some factors that may increase the risk of complications include:
Be sure to discuss these risks with your doctor before the procedure.
There is a shortage of donors, so you may be on a transplant list for some time. You may need to carry a cell phone with you at all times. This is to allow the transplant team to reach you if a donor heart becomes available.
You may need to stay in the hospital for monitoring. You may need to be on continuous IV medications to help stabilize the function of your diseased heart. Some may need to have a mechanical pump called a ventricular assist device (VAD). The device will help to stabilize your heart while you are waiting for a transplant.
Before the procedure:
Before the surgery, your doctor will likely do the following:
General anesthesia will be used. You will be asleep during the procedure.
The doctor will cut through the skin and breastbone. The chest will be opened and you will be connected to a heart-lung machine. This machine takes over the functions of the heart and lungs during surgery. Most of your heart will be removed. The back wall of the left atrium with the pulmonary vein openings will be left in place. The donor heart will be prepared and sewn into place in your chest. Next, the blood vessels will be connected. After this, the blood will start to flow and warm the heart.
The new heart may begin beating on its own, or you may be given an electrical shock to get your heart started. For safety, you will also have a temporary pacemaker attached to the heart to help the heart beat stay regular. After the doctor is sure that the heart is beating fine, the blood will be rewarmed. The heart-lung machine will be slowly turned down and disconnected. Next, temporary tubes may be placed in the chest cavity to drain any blood that has collected. The chest will be closed with stainless steel wires. Lastly, the skin will be closed with absorbable sutures.
You will be closely monitored in the intensive care unit (ICU) with the help of some/all of the following:
You will also have your vital signs monitored.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
This procedure is done in a hospital setting. The usual length of stay is at least 2 weeks. Your may need to stay longer if you shows signs of rejecting the new heart or have other problems.
While you are recovering at the hospital, you will need to:
Your doctor may need to take a biopsy of your heart routinely and additionally as needed if you:
When you return home, do the following to help ensure a smooth recovery:
Adults will be started on cholesterol reducing medications 1-2 weeks after surgery
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for emergency medical services right away.
Scientific Registry of Transplant Recipients
Heart and Stroke Foundation of Canada
Cardiac transplantation immunosuppressive and adjunctive therapy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T909193/Cardiac-transplantation-immunosuppressive-and-adjunctive-therapy. Updated December 16, 2015. Accessed August 29, 2017.
Cardiac transplantation procedure and immediate postoperative care. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T909192/Cardiac-transplantation-procedure-and-immediate-postoperative-care. Updated October 30, 2015. Accessed August 29, 2017.
Explore heart transplant. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/ht. Updated December 9, 2016. Accessed August 29, 2017.
Evaluation and management of patients after cardiac transplantation. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T909194/Evaluation-and-management-of-patients-after-cardiac-transplantation. Updated December 1, 2015. Accessed August 29, 2017.
Heart transplant. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/CareTreatmentforCongenitalHeartDefects/Heart-Transplant_UCM_307731_Article.jsp. Updated July 24, 2015. Accessed August 29, 2017.
Patient's guide to heart transplant surgery. University of Southern California website. Available at: http://www.cts.usc.edu/ht-pg-hearttransplantprocedure.html. Accessed September 19, 2017.
Selection and timing of patients for cardiac transplantation. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T906136/Selection-and-timing-of-patients-for-cardiac-transplantation. Updated August 11, 2017. Accessed August 29, 2017.
Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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