Complications of surgery

Heart transplant surgery requires open heart surgery, which carries the risk of many complications, including:

  • Bleeding
  • Infection
  • Blood clots
  • Heart attack
  • Stroke
  • Death

Risks of having a heart transplant

Although receiving a donor heart can save your life, having a heart transplant has many risks. Risks include:

  • Rejection of the donor heart. One of the most significant risks after a heart transplant is your body rejecting the donor heart.

    Your immune system will see your donor heart as a foreign object that's not supposed to be in your body. Your immune system will try to attack your donor heart. Although all people who receive a heart transplant receive immunosuppressants — medications that reduce the activity of the immune system — about 10 percent of heart transplant recipients still have some signs of rejection that need treatment during the first year after transplantation. This is often effectively treated with medication.

    Usually the rejection is without any symptoms and requires only an adjustment of medications. If you miss doses of medications, however, the rejection can be severe and very serious. It's important that you follow the instructions as explained by your doctors.

    To determine whether your body is rejecting the new heart, you'll have frequent heart biopsies to test your heart tissue during the first year after your transplant. After the first year, the number of biopsies is significantly reduced.

  • Problems with your coronary arteries. After your transplant, it's possible the walls of the arteries in your heart (coronary arteries) could thicken and harden, leading to cardiac allograft vasculopathy (CAV). This can make blood circulation through your heart difficult and can cause a heart attack, heart failure, abnormal heart rhythms (arrhythmias) or sudden cardiac death.

    Your doctor may recommend annual tests after your transplant to monitor your coronary arteries for CAV.

  • Medication side effects. The immunosuppressants you'll need to take for the rest of your life may cause kidney damage and other problems. Other complications of these medications can include high blood pressure, high cholesterol, diabetes and a condition in which your bones become thin and weak (osteoporosis).
  • Cancer. Immunosuppressants can also increase your cancer risk. Taking these medications can put you at a greater risk of skin cancer, non-Hodgkin's lymphoma and other solid tumors. Regular checkups are necessary to detect the development of cancer.
  • Infection. Immunosuppressants decrease your ability to fight infection. Some heart transplant recipients may develop an infection that requires them to be admitted to the hospital during the first year after their transplant. The risk of infection decreases over time as the amount of immunosuppressant medication is decreased.