Overview of heart transplant

A heart transplant, also called cardiac transplant, is surgery to replace a damaged or diseased heart with a healthy heart from a donor. It is life-saving surgery when all other heart failure treatments have not worked.

At Dignity Health, our highly skilled and experienced heart surgeons utilize the latest advancements in medical and surgical technology for better patient outcomes.

To learn more about an emergency heart transplant, Find a Doctor today and make an appointment.

Why it's necessary

A heart transplant is only recommended for those with serious (life-threatening) end-stage heart failure.

In order to be considered a candidate for a heart transplant, you must be diagnosed with end-stage heart failure. Your doctor will also need to make sure that you are healthy for the surgery.

You may have some standard tests done, in addition to cardiac testing, to measure the current health and capacity of your organs. These may include kidney, lung, and liver testing. Women may also need a Pap smear and mammogram to rule out cancer and gynecologic conditions before going on a transplant waiting list.

You will also undergo blood testing to make sure that the donor heart matches your blood type. This makes it less likely that your body will reject the new heart.

Common conditions treated with a heart transplant

Doctors perform heart transplants most commonly to treat end-stage heart failure — a condition where the heart can’t pump enough blood to the body. People with end-stage heart failure are disabled and cannot tolerate even light activity such as walking.

Heart failure is most often caused by coronary artery disease. Currently, coronary artery disease is the number one killer of both men and women in the U.S. This disease is caused by stiffening and shrinking of the major blood vessels (arteries) of the heart due to a buildup of fatty deposits. Other conditions that can contribute to heart failure include:

• Valvular disease (issues affecting the valves that regulate blood flow in the heart, including rheumatic fever and congenital disabilities)
• Previous heart attacks
• Cardiomyopathy (in which the heart muscle itself is too weak to maintain adequate blood circulation throughout the body, a condition caused by structural issues within the heart, long-term high blood pressure, aging, diabetes, or disorders of other muscles)
• Infections, such as myocarditis
• Sleep apnea
• Excessive alcohol use
• Obesity
• Chronic lung disease or pulmonary hypertension (high blood pressure in the lungs)
• Anemia (low red blood cell count)

Heart transplant also can treat advanced heart conditions that don’t respond to other treatments, including:

• Life-threatening arrhythmias
• Congenital (present at birth) heart disabilities
• Severe angina, which is chest pain related to heart disease

Types

Generally speaking, there are two types of heart transplants.

The most common is an orthotopic heart transplant. In this type of procedure, your old heart will be removed through an incision in the middle of your chest. Your old heart is then replaced with a healthy heart from a donor.

Sometimes, it is also possible to complete a heterotopic heart transplant, in which a healthy donor heart is implanted in your chest, “piggy-backed” on your old heart. This type of transplant is used when you have some heart function remaining; the donor heart helps your heart pump.

Risks

Heart transplants are a type of open-heart surgery. While most heart transplant recipients experience a significantly better quality of life and improved heart function after the surgery, the procedure does come with some risks.

Heart transplants are a major surgery, which is why it is only considered as a life-saving treatment for people with advanced heart disease and heart failure.

Some of the potential risks of heart transplant surgery include:

• Rejection (in which your body sees the new heart as an invader and your immune system attacks it)
• Bleeding
• Blood clots or stroke
• Infection

Your Dignity Health doctor will advise you regarding the potential risks and benefits of any procedure.

Preparation

Before being placed on a waiting list for a donor heart, your doctor may ask you to make some lifestyle changes, such as:

• Quitting smoking
• Stopping all alcohol consumption
• Losing weight or following a special diet
• Indicating that you want a heart transplant and are willing to take care of the new heart after the procedure

If you are a candidate for a heart transplant, your name will be put on a waiting list until a donor heart becomes available. You may need to carry a pager or other device with you at all times while you are on this list so that your doctor can contact you at very short notice.

Once a donor heart becomes available and matches with you, it generally needs to be transplanted within four hours. If you aren’t already in the hospital, your transplant center will likely expect you to arrive within two hours from the time they contact you. Have a plan and be ready at all times while you’re on the waiting list.

A cardiac surgeon will perform your heart transplant in a Dignity Health hospital. Heart transplants are a type of open-heart surgery that involves making an incision down the chest and through the breastbone. A heart-lung machine takes over the job of pumping oxygen-rich blood to your body while you undergo surgery.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.