Heart Transplant

Heart Transplant?

A heart transplant is surgery to remove a damaged or diseased heart and replace it with a healthy donor heart.

Heart failure is a condition in which the heart is damaged or weak. As a result, it can't pump enough blood to meet the body's needs. "End-stage" means the condition is so severe that all treatments, other than a heart transplant, have failed.

Why the Procedure is Performed

A heart transplant may be done to treat:

• Severe heart damage after a heart attack
• Severe heart failure, when medicines, other treatments, and surgery no longer help
• Severe heart defects that were present at birth and can't be fixed with surgery
• Life-threatening abnormal heartbeats or rhythms that do not respond to other treatments

Heart transplant surgery may not be used in people who

• Are malnourished
• Are older than age 65 to 70
• Have had a severe stroke or dementia
• Have had cancer less than 2 years ago
• Have HIV infection
• Have infections, such as hepatitis, that are active
• Have insulin-dependent diabetes and other organs, such as the kidneys, that aren't working correctly
• Have kidney, lung, nerve, or liver disease
• Have no family support and do not follow their treatment
• Have other diseases that affect the blood vessels of the neck and leg
• Have pulmonary hypertension (thickening of blood vessels in the lung)
• Smoke or abuse alcohol or drugs, or have other lifestyle habits that may damage the new heart
• Are not reliable enough to take their medicines, or if the person is not able to keep up with the many hospital and medical office visits and tests

Before the Procedure

Once you are referred to a transplant center, you will be evaluated by the transplant team. They will want to make sure that you are a good candidate for a transplant. You will visit many times over several weeks or even months. You will need to have blood drawn and x-rays taken. The following may also be done:

• Blood or skin tests to check for infections
• Tests of your kidney and liver
• Tests to evaluate your heart, such as EKG, echocardiogram, and cardiac catheterization
• Tests to look for cancer
• Tissue and blood typing, to help make sure your body will not reject the donated heart

After the Procedure

You should expect to stay in the hospital for 7 to 21 days after a heart transplant. The first 24 to 48 hours will likely be in the intensive care unit (ICU). During the first few days after a transplant, you will need close follow-up to make sure that you do not get an infection and your heart is working well.

The recovery period is about 3 months and often, your transplant team will ask you to stay fairly close to the hospital during that time period. You will need to have regular check-ups with blood tests, x-rays, and echocardiograms for many years.

You must take drugs that prevent transplant rejection for the rest of your life. You will need to understand how to take these medicines, and know their side effects.

You can go back to your normal activities 3 months after the transplant as soon as you feel well enough, and after talking with your health care provider. However, avoid vigorous physical activity.