heart transplant is a procedure in which a surgeon removes a diseased heart and
replaces it with a donor heart. During a heart transplant, a mechanical pump
circulates blood through the body while the surgeon removes the diseased heart
and replaces it with a healthy heart from a recently deceased donor.
The surgeon connects the donor heart to the major blood vessels and hooks
the heart up to wires that temporarily control the heartbeat. The procedure
takes several hours.
Doctors call it the "Hollywood heart attack": a middle-aged man breaks into
a cold sweat, grimaces, and clutches his chest-just like in the movies. Trouble
is, in real life, heart attack symptoms don't always announce themselves so
dramatically. More often they are insidious and puzzling, such as unexplained
fatigue or abdominal discomfort, and many people wait for hours before seeking
Big mistake, doctors tell WebMD. The ability to quickly spot signs of heart
attack, angina, and stroke...
To prevent the body from rejecting the donor
heart, your surgeon will give you powerful drugs (immunosuppressants)
immediately after surgery, and you must continue to take them.
What To Expect After Surgery
After a heart transplant, the recovery
process is similar to the process after other heart surgeries.
You will spend about 1
to 2 weeks in the hospital after surgery. You may have to stay longer depending
on your health and if you have complications from surgery. While in the
hospital, you will start a cardiac rehabilitation program. And your doctors will check on your
heart to make sure your body isn't rejecting it.
A cardiac rehab program can help you recover from your surgery and be active again.
Your transplanted heart will respond to activity a little differently. Your heart rate will not increase like it used to. And you will have a higher resting heart rate. This is because some of the nerves that control your heart were cut during your surgery.
A heart transplant is an option when
the heart no longer works well enough and a person is at risk of dying. A heart
transplant may be considered when a person has severe heart disease and is
likely to benefit most from a donor heart. A person might be a candidate for a
transplant when any of these conditions are true:
The person has end-stage heart failure,
ischemic heart disease, cardiomyopathy, or congenital heart
The person has a low chance of living as long as 1 year
without a heart transplant.
The person has no other serious
medical conditions that would reduce his or her life
The doctor strongly expects that a heart transplant
will increase survival and improve the person's quality of life.
At some centers, transplant candidates must demonstrate
that they have quit smoking and/or overusing alcohol for a period of time (such
as 4 to 6 months) before they are considered for placement on a transplant
How Well It Works
In carefully selected people, a
heart transplant can be very successful.
About 81% of all people
who receive heart transplants survive for at least 1 year. About 75% survive 3
years, and 68% survive 5 years. About 50% survive 10 years.1
Risks from heart transplant include:
Rejection of the donor heart.
To check for rejection, every 3 to 4 months
surgeons test a sample (biopsy) of the heart tissue and also perform
echocardiography, electrocardiography (ECG, EKG), or blood
If your body rejects the heart, you will receive additional
drugs (such as immunosuppressants or steroids) to suppress your immune system
so that it does not reject the donor heart. These additional drugs may have
serious side effects, including an increased risk of infections and
Other risks, such as:
Side effects (for example, infections,
ulcers, or bone loss) that may occur from steroid therapy used to suppress the
Side effects that may occur from a drug
(cyclosporine) given to prevent rejection of the donor
Clogging of the arteries (atherosclerosis) that may develop
in the donor heart. (This is usually a complication and is an important
limiting factor that affects long-term survival.)
What To Think About
After a heart transplant, you must
follow a strict lifestyle involving daily medicines and regular medical care,
which includes regular sampling (biopsies) of the transplanted heart tissue to
check for rejection.
You may wait a year or longer for a donor
heart. But with maximal medical therapy, more than half of people on
waiting lists survive for an extended period of time.
receive a donor heart according to the:
Pham MX, et al. (2008). Surgical treatment of heart
failure, cardiac transplantation, and mechanical ventricular support. In V
Fuster et al., eds., Hurst's The Heart, 12th ed., pp.
761-790. New York: McGraw-Hill.
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
Robert A. Kloner, MD, PhD - Cardiology
August 10, 2011
WebMD Medical Reference from Healthwise
August 10, 2011
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