Heart Transplant

A heart transplant can give a person a healthier heart and better blood flow. If the transplant is successful, the new heart will work much better than the old one.

What is a heart transplant?

A heart transplant is a surgery to replace a failing heart with a healthy donor heart. A heart may fail due to advanced heart failure caused by conditions such as coronary heart disease, cardiomyopathy, congenital heart disease or serious rhythm disorders.

During surgery, doctors remove the patient’s heart and connect the donor heart to the main blood vessels. These vessels help move blood to and from the heart. In some people, such as those with certain congenital heart conditions or severe lung disease, surgeons may perform a combined heart-lung transplant. 

How does a transplant affect the heart?

Before surgery, doctors match a donor heart to the recipient based on blood type and body size. After the transplant, your medical team will watch you closely for signs of heart rejection. Rejection can affect the heart muscle or the heart’s arteries.

To lower the risk of rejection, you will need to take immunosuppressive medications. These medications help keep your immune system from attacking the new heart and must be taken for life. Your medical team will carefully adjust the amount you take to protect your heart while limiting side effects, such as infection or cancer.

What can I expect if my child is a heart transplant recipient?

When a child receives a heart transplant, the new heart can grow and adapt as the child grows. Your child will need to take medications for life to help protect the new heart and manage side effects from the transplant.

As your child becomes an adult, their medical care will move from a pediatric heart transplant cardiologist to an adult heart transplant cardiologist.

Medical follow-up

After your transplant, you will need regular checkups with a transplant cardiologist. At these visits, you will have blood tests to check your immunosuppressive medication levels and watch for side effects.

You may also have tests, such as an electrocardiogram (EKG), echocardiogram or Holter monitor, to check your heart’s rhythm and how well it’s working. After a transplant, your care team checks for rejection using blood tests, and in some cases, a small heart tissue sample, called a biopsy, especially during the first year.

Your doctor will also check the blood vessels of your new heart regularly, often once a year, using imaging tests such as cardiac catheterization or CT scans to look for narrowing. Regular medical checkups are important to help keep you healthy overall.

Activity restrictions

After recovery, many people who have had a heart transplant can be physically active, but activity recommendations should be personalized based on your health or recovery. Talk with your transplant cardiologist about activities that are safe and right for you.

Endocarditis prevention

Endocarditis is an infection of the inner lining of the heart. Some people with congenital heart disease need antibiotics before certain medical and dental procedures to help prevent this infection. Most heart transplant recipients don’t need antibiotics unless they develop heart valve disease in the transplanted heart.

Pregnancy

Women who have had a heart transplant may have complications during pregnancy. Some immunosuppressive medications can affect the baby. There may be a higher risk of heart rejection, especially in the months after the baby is born. If you are thinking about becoming pregnant, talk with your transplant cardiologist and obstetrician about the risks and benefits. 

Will I need more surgery?

A heart transplant can help you live a more active and fulfilling life. However, some people may need more procedures or surgery later. For example, if your heart rhythm becomes slow, you may need a pacemaker.

People with congenital heart disease who have had repairs for narrow blood vessels may also need surgery or catheter-based procedures after a transplant.

Sometimes, a transplanted heart can fail because of rejection or damage to the heart muscle or arteries.