A heart transplant involves replacing a diseased heart with a healthy heart from a deceased organ donor. You may need a heart transplant if you have end-stage heart failure due to a condition such as coronary artery disease, congenital heart disease, or a viral infection. Heart transplant is for people for whom other treatments and medications have not worked but who are otherwise healthy. To be eligible for heart transplant you must undergo a rigorous screening process by a medical team, which will examine your medical history and review your test results, and will evaluate your willingness and ability to make certain lifestyle changes. The team will also assess your chances of survival.
If you are eligible, you will be placed on the United Network for Organ Sharing (UNOS) transplant list. This is a national list consisting of organ donor information. The purpose of the list is to keep track of information such as blood type and length of time on the waiting list, and to fairly distribute organs when they become available, either from a person who recently died and had previously arranged to be an organ donor (or their family has agreed to the donation), or from someone who is brain dead, such as from a car accident or gunshot, and are on life support but are showing no brain activity.
Waiting for a healthy heart is a long process and there is a shortage of hearts. The waiting can be stressful and frustrating for patients and families. Many people who wait will likely die before receiving a healthy heart.
If you are a match to a donor heart and it is your “turn” to receive a heart, you will be notified right away for heart surgery. Surgery is done in the hospital under general anesthesia (you’ll be asleep and will feel nothing). The surgeon will make an incision (cut) and will open your chest, holding the ribs and tissue away from the heart. Your arteries and veins will then be connected to a heart-lung bypass machine, which does the work of the heart while your own heart is being removed. When the donor heart is transplanted into your chest, the surgeon reconnects the arteries and veins to the new heart.
You will then move to the intensive care unit (ICU) and remain under close observation for several weeks. During this period, you’ll participate in a cardiac rehabilitation program involving activities and movement to strengthen your heart and its functions, and to monitor for any signs of heart transplant rejection or infection. Once you’re back home, you will continue your recovery program by taking anti-rejection medications and following any diet and lifestyle recommendations provided by your doctor.
Heart transplant rejection is a common complication and may lead to death in some patients. Nonetheless, heart transplant has a good overall success rate and helps improve quality of life for many people. The survival rate is 85 percent at one year post-surgery.
At Lankenau Heart Institute our Heart Failure Program provides advanced cardiac treatments and procedures for patients with end-stage heart failure. Through our partnerships with prominent transplant programs in the Philadelphia region we’re able to ensure our heart failure patients have access to heart transplant services.
Genetic evaluation is becoming an important part of personalized care, as many health conditions have a genetic basis and genetic test results can help to guide medical decisions. Our genetic counselors provide consultations related to cancer genetics, cardiovascular genetics and prenatal genetics.
