Table of ContentsView AllTable of ContentsThe NeedWho Is Eligible?The ProcessDonor SearchesThe ProcedureRisksOrgan RejectionWarning SignsPrognosisInsurance Concerns
Table of ContentsView All
View All
Table of Contents
The Need
Who Is Eligible?
The Process
Donor Searches
The Procedure
Risks
Organ Rejection
Warning Signs
Prognosis
Insurance Concerns
A hearttransplantis a major surgery that involves replacing your diseased heart with a healthy donor heart. It is used as a last resort when drugs and other therapies no longer work in treating advancedheart failure.
Heart failure is a chronic problem that prevents your heart from pumping blood through the rest of your body as it should. The problem can occur asleft-sided heart failure,right-sided heart failure, orcongestive heart failure.
People chosen to have a heart transplant have the most severe types of heart disease. While there are risks, it may be the only chance for someone with advanced heart disease to live a somewhat normal life.
This article includes information about heart transplants, why they are done, and the process of getting one. It also describes risks, signs of problems, and common outcomes.
Akarawut Lohacharoenvanich / Getty Images
Why Are Heart Transplants Performed?
A heart transplant is performed to treat people with end-stage heart failure. The procedure is done when symptoms persist despite therapy with optimal medical, surgical, and device treatment.
Heart failure is the primary reason people receive a heart transplant. Some other reasons transplants are performed include the following:
How Heart Disease Is Treated
Who Might Get a Heart Transplant?
People regarded as having the most severe types of heart disease are likely to get a heart transplant. When you are approved for a heart transplant, you are placed on the heart transplant waiting list based on the severity of your condition.
The criteria used to determine disease severity are based on guidelines from theUnited Network for Organ Sharing (UNOS). UNOSis a private nonprofit organization that manages the U.S. organ transplantation system under contract with the federal government.
Based on UNOS criteria, the heart transplant status levels include the following:
You may be ineligible for a heart transplant if you have one of the following conditions, among others:
How to Get on the Waiting List for an Organ Transplant
What’s the Process for Getting a Heart Transplant?
The process for getting a heart transplant begins with a referral from your cardiologist to a heart transplant center. You will typically be assigned a transplant coordinator to help you navigate the heart transplant process.
Before becoming a candidate for a heart transplant, you will undergo evaluations in the following areas:
After you receive insurance approval for your pretransplant evaluation, you will undergo a series of tests and exams to assess the functions of your heart, lungs, and other bodily systems which can include the following:
In the meantime, your team will continue to monitor your health to ensure you remain eligible to receive a donor heart when it becomes available.
How Are Donors Found for Heart Transplants?
Donors for heart transplants are people who have been declared dead based on tests that establish brain death. They must be supported on a ventilator to maintain their breathing so their heart can continue beating.
Typically, a donor heart must meet the following criteria:
When a donor heart is available, it is entered into the OPTN, which matches it to ensure the best possible outcomes. A donor heart is matched to a heart transplant candidate based on factors that include the following:
If your transplant team rejects a heart offered to you for transplant, the heart is offered to other candidates in the order that they match to the donor heart.
What Happens During a Heart Transplant?
The process that happens during a heart transplant is carefully planned. When a donor heart becomes available, a retrieval surgeon travels to the hospital where the heart is stored to assess it and transport it to a transplant center. Timing is critical because a retrieved heart only lasts four to six hours after removal from the donor’s body.
When a donor heart is found, you will have to go to the hospital immediately to prepare for surgery. Routine heart transplant surgery can be performed in less than four hours while more complex cases can take up to nine hours or longer.
A heart transplant is typically performed using the standard orthotopic approach, which involves the following procedure:
Rarely, surgeons use an alternative procedure, called the heterotopic approach (also called the piggyback approach), for heart transplant surgery. This involves placing the donor heart on the right side of your chest while your diseased heart remains in place. It is used to maintain circulation when there is a risk of severe acute rejection.
What Are the Risks Associated With a Heart Transplant?
The risks associated with a heart transplant involve all the risks common to other types of surgery. They can include the following:
Some of the risks associated with a heart transplant are linked to the medications you must take to prevent or treat your body’s rejection of your new heart. Taking these medications can involve the following risks:
What About Organ Rejection?
Organ rejection occurs when yourimmune systemmounts an immune response against the transplanted heart. This occurs because your immune system recognizes your new heart as a foreign body. Organ rejection is part of your immune system’s normal defense systems.
After a heart transplant, you must take immunosuppressant drugs to counter the natural response of your immune system against your new heart. However, organ rejection can occur immediately after surgery or months or years later.
Having organ rejection does not mean that your organ transplant was a failure. Between 50% and 80% of heart transplant recipients have at least one rejection episode.
Make sure to keep all regular follow-up appointments after your transplantation. Contact your healthcare provider immediately if you have any of the following symptoms of organ rejection:
Warning Signs of Infection After a Heart Transplant
Warning signs of infection after a heart transplant require immediate care. The main sign of infection is typically afeverhigher than 100.4 degrees F. Contact your healthcare provider if you have any of the following signs of infection after a heart transplant:
Signs of infection at the surgical incision can include the following:
Signs of Infection After Surgery
Can You Lead a Normal Life After a Heart Transplant?
For many people, it is possible to lead a normal life after a heart transplant. There are no specific activity restrictions for people who have heart transplants. However, your outlook and limitations may vary based on many factors, including your age and other medical conditions, so it is difficult to predict how long your heart transplant will last.
Generally, the heart transplant survival rate is excellent. In the United States, the average survival rate after heart transplantation is 91%. Research indicates that about half the people who received heart transplants between 1990 and 2007 in the United States were alive at 10 years after their heart transplant.
A heart transplant enables most people with previous end-stage heart failure to resume a normal life. At three years post surgery, about 75% of people with heart transplants have no or minimal symptoms and live without limitations to daily activities. At five years after a heart transplant, about 45% of patients work at least part-time.
The median survival rate for people with heart transplants is longer than 12.5 years and it improves every decade. If you outlive your donor heart, you may have the possibility of a re-transplantation (a second transplant) based on your condition at the time your new heart fails.
Are Heart Transplants Covered By Insurance?
Factors include the type of plan you have, the medical facility used, and the type of procedures you require. Even with health insurance, you should expect to pay out-of-pocket costs for coinsurance and deductibles.
Your medical facility may require proof that you can meet your financial responsibilities. If you need a heart transplant, your facility may assign a financial adviser to help you understand payment options like secondary insurance and grants that may help pay your portion of the procedure’s costs.
Summary
A heart transplant is done when there are no other options for treating your diseased heart. When faced with severe end-stage heart disease, a heart transplant may be your only option to survive.
The process of getting a heart transplant is lengthy and stressful. However, the outcome of a heart transplant can give you the chance to live a somewhat normal life compared to living with heart disease.
While a heart transplant is risky, the survival rates are very good. A strong support system, adherence to follow-up care, and a medication schedule can support optimal results.
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Heart Association.Types of heart failure.Barnes-Jewish Hospital.Conditions leading to heart transplant.Penn Medicine.Heart transplant waiting list.UPMC.Before your heart transplant.St. Vincent’s Hospital Heart Health.Heart transplant.UCSF Health.Heart transplant.Organ Procurement and Transplantation Network (OPTN).Donor matching system.Yale Medicine.Heart transplant.Flécher E, Fouquet O, Ruggieri VG, Chabanne C, Lelong B, Leguerrier A.Heterotopic heart transplantation: where do we stand?.Eur J Cardiothorac Surg. 2013;44(2):201-6. doi:10.1093/ejcts/ezt136University of Rochester Medical Center.Heart transplantation procedure.Temple Health.Heart transplant rejection.Wolters Kluwer UpToDate.Patient education: heart transplantation (beyond the basics).Northwestern Medicine.Symptoms of transplant-related infections.American Heart Association.Heart transplant.Penn Medicine.Heart transplant recovery.Wilhelm MJ.Long-term outcome following heart transplantation: current perspective.J Thorac Dis. 2015;7(3):549-551. doi:10.3978/j.issn.2072-1439.2015.01.46The Ohio State University Wexner Medical Center.How long do transplanted organs last?Milliman Research Report.2020 U.S. organ and tissue transplants: cost estimates, discussion, and emerging issues.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Heart Association.Types of heart failure.Barnes-Jewish Hospital.Conditions leading to heart transplant.Penn Medicine.Heart transplant waiting list.UPMC.Before your heart transplant.St. Vincent’s Hospital Heart Health.Heart transplant.UCSF Health.Heart transplant.Organ Procurement and Transplantation Network (OPTN).Donor matching system.Yale Medicine.Heart transplant.Flécher E, Fouquet O, Ruggieri VG, Chabanne C, Lelong B, Leguerrier A.Heterotopic heart transplantation: where do we stand?.Eur J Cardiothorac Surg. 2013;44(2):201-6. doi:10.1093/ejcts/ezt136University of Rochester Medical Center.Heart transplantation procedure.Temple Health.Heart transplant rejection.Wolters Kluwer UpToDate.Patient education: heart transplantation (beyond the basics).Northwestern Medicine.Symptoms of transplant-related infections.American Heart Association.Heart transplant.Penn Medicine.Heart transplant recovery.Wilhelm MJ.Long-term outcome following heart transplantation: current perspective.J Thorac Dis. 2015;7(3):549-551. doi:10.3978/j.issn.2072-1439.2015.01.46The Ohio State University Wexner Medical Center.How long do transplanted organs last?Milliman Research Report.2020 U.S. organ and tissue transplants: cost estimates, discussion, and emerging issues.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Heart Association.Types of heart failure.Barnes-Jewish Hospital.Conditions leading to heart transplant.Penn Medicine.Heart transplant waiting list.UPMC.Before your heart transplant.St. Vincent’s Hospital Heart Health.Heart transplant.UCSF Health.Heart transplant.Organ Procurement and Transplantation Network (OPTN).Donor matching system.Yale Medicine.Heart transplant.Flécher E, Fouquet O, Ruggieri VG, Chabanne C, Lelong B, Leguerrier A.Heterotopic heart transplantation: where do we stand?.Eur J Cardiothorac Surg. 2013;44(2):201-6. doi:10.1093/ejcts/ezt136University of Rochester Medical Center.Heart transplantation procedure.Temple Health.Heart transplant rejection.Wolters Kluwer UpToDate.Patient education: heart transplantation (beyond the basics).Northwestern Medicine.Symptoms of transplant-related infections.American Heart Association.Heart transplant.Penn Medicine.Heart transplant recovery.Wilhelm MJ.Long-term outcome following heart transplantation: current perspective.J Thorac Dis. 2015;7(3):549-551. doi:10.3978/j.issn.2072-1439.2015.01.46The Ohio State University Wexner Medical Center.How long do transplanted organs last?Milliman Research Report.2020 U.S. organ and tissue transplants: cost estimates, discussion, and emerging issues.
American Heart Association.Types of heart failure.
Barnes-Jewish Hospital.Conditions leading to heart transplant.
Penn Medicine.Heart transplant waiting list.
UPMC.Before your heart transplant.
St. Vincent’s Hospital Heart Health.Heart transplant.
UCSF Health.Heart transplant.
Organ Procurement and Transplantation Network (OPTN).Donor matching system.
Yale Medicine.Heart transplant.
Flécher E, Fouquet O, Ruggieri VG, Chabanne C, Lelong B, Leguerrier A.Heterotopic heart transplantation: where do we stand?.Eur J Cardiothorac Surg. 2013;44(2):201-6. doi:10.1093/ejcts/ezt136
University of Rochester Medical Center.Heart transplantation procedure.
Temple Health.Heart transplant rejection.
Wolters Kluwer UpToDate.Patient education: heart transplantation (beyond the basics).
Northwestern Medicine.Symptoms of transplant-related infections.
American Heart Association.Heart transplant.
Penn Medicine.Heart transplant recovery.
Wilhelm MJ.Long-term outcome following heart transplantation: current perspective.J Thorac Dis. 2015;7(3):549-551. doi:10.3978/j.issn.2072-1439.2015.01.46
The Ohio State University Wexner Medical Center.How long do transplanted organs last?
Milliman Research Report.2020 U.S. organ and tissue transplants: cost estimates, discussion, and emerging issues.
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