During the procedure
Heart transplant surgery usually takes about four hours — longer if you've had previous heart surgeries or if there are complications during the procedure. The surgeons will open your chest and connect you to a heart-lung machine to keep oxygen-rich blood flowing throughout your body.
The diseased heart is then removed, and the donor heart is sewn into place. The new heart often starts beating when blood flow is restored. Sometimes an electric shock is needed to make the donor heart beat properly.
You'll be in pain after the surgery, which will be treated with medications. You'll also have a ventilator to help you breathe and tubes in your chest to drain fluids from around your lungs and heart.
After the procedure
After you've had surgery to place your donor heart, you'll likely remain in the hospital for a week or two, and then you'll be closely monitored at your outpatient transplant center for about three months. While at the transplant center, you'll have regular tests, including blood work, lung function tests, echocardiograms, electrocardiograms and heart biopsies.
There are also several long-term adjustments you'll need to make after you've had your heart transplant. These include:
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Taking immunosuppressants. These medications decrease the activity of your immune system to prevent it from attacking your donated heart. Because your immune system will most likely never completely accept the new organ, you'll take some of these medications for the rest of your life.
These medications may cause noticeable side effects. With taking some post-transplant drugs, such as corticosteroids, your face may become round and full, and you may gain weight, develop acne or facial hair, or experience stomach problems. Some of the effects are more noticeable when you first start the drugs, but decrease in severity later on.
Because immunosuppressants make your body more vulnerable to infection, your doctor may also prescribe antibacterial, antiviral and antifungal medications. Some drugs could worsen — or raise your risk of developing — conditions such as high blood pressure, high cholesterol, cancer or diabetes. Over time as the risk of rejection is reduced, the doses and number of anti-rejection drugs can be reduced, but you will need some immunosuppressant medications indefinitely.
- Managing medications and therapies. After a heart transplant, taking all your medications as your doctor instructs is important. It's a good idea to set up a daily routine for taking your medications so that you won't forget. Keep a list of all your medications with you at all times in case you need emergency medical attention, and tell all your doctors what you take each time you're prescribed a new medicine.
- Cardiac rehabilitation. After your transplant, you may find it difficult to adjust to new lifestyle changes, such as diet and exercise. Cardiac rehabilitation programs can help you adjust to these changes so that you can regain your strength and improve your quality of life.
Emotional support. Your new medical therapies and the stress of having a heart transplant may make you feel overwhelmed. Many people who have had a heart transplant feel this way.
Talk to your doctor if you're feeling stressed or overwhelmed. Transplant centers often have support groups and other resources to help you manage your condition.
- What is a heart transplant? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/ht/ht_all.html. Accessed May 27, 2014.
- Mancini D, et al. Indications and contraindications for cardiac transplantation. http://www.uptodate.com/index. Accessed May 27, 2014.
- Colvin-Adams M, et al. OPTN/SRTR 2012 annual data report: heart. American Journal of Transplantation. 2013;14:113.
- Jessup M, et al. 2009 Focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults. Circulation. 2009;119:1977.
- What is a ventricular assist device? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/vad/vad_all.html. Accessed May 27, 2014.
- Pham MX, et al. Prognosis after cardiac transplantation. http://www.uptodate.com/home. Accessed May 27, 2014.
- Pina IL, et al. Rehabilitation after cardiac transplantation. http://www.uptodate.com/home. Accessed May 27, 2014.
- Yip DS (expert opinion). Mayo Clinic. Jacksonville, Fla. July 10, 2014.