A heart transplant removes a severely diseased and failing heart and replaces it with a healthy heart from a deceased donor.
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A heart transplant is done when all other methods have failed. It may be done because of:
All procedures have some risk. The doctor will go over some problems that could happen, such as:
Things that may raise the risk of problems are:
It may take some time to find a heart from a donor. Once one is found, the surgical team will meet with you to talk about:
General anesthesia will be used. You will be asleep.
An incision will be made in the breastbone. The chest will be opened. You will be connected to a heart-lung machine. It will take over the job of the heart and lungs during surgery. Most of the 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 the chest. 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 help start it. 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. Tubes may be placed in the chest cavity to drain any blood that has collected. The breastbone will be closed with stainless steel wires. The skin will be closed with absorbable stitches.
You will be taken to the intensive care unit (ICU) for observation. This may include:
Pain and swelling are common for several weeks. Medicine and home care help.
The usual length of stay is two weeks. If you have any problems, you may need to stay longer.
While you are recovering, the staff may:
Samples of your heart will need to be taken at regular intervals to look for signs of rejection. This can be done with biopsies.
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
There are also steps you can take to lower your risk of infection, such as:
It will take about eight weeks for the incision and muscles to fully heal. Full recovery will take about six months. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay your return to work.
Call your doctor right away if you are not getting better or you have:
If you think you have an emergency, call for medical help right away.
Scientific Registry of Transplant Recipients
Transplant Living—United Network for Organ Sharing
Heart and Stroke Foundation of Canada
Cardiac transplantation immunosuppressive and adjunctive therapy. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/cardiac-transplantation-immunosuppressive-and-adjunctive-therapy. Accessed March 23, 2021.
Cardiac transplantation procedure and immediate postoperative care. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/cardiac-transplantation-procedure-and-immediate-postoperative-care. Accessed March 23, 2021.
Evaluation and management of patients after cardiac transplantation. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/evaluation-and-management-of-patients-after-cardiac-transplantation. Accessed March 23, 2021.
Explore heart transplant. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/heart-transplant. Accessed March 23, 2021.
Fischer S, Glas KE. A review of cardiac transplantation. Anesthesiol Clin. 2013 Jun;31(2):383-403.
Heart transplant. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/CareTreatmentforCongenitalHeartDefects/Heart-Transplant_UCM_307731_Article.jsp. Accessed March 23, 2021.
Selection and timing of patients for cardiac transplantation. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/selection-and-timing-of-patients-for-cardiac-transplantation. Accessed March 23, 2021.
Last reviewed June 2021 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD