When a donor organ becomes available, the recipient needs to come to the hospital immediately. This is why we stress that patients should always carry a cell phone and why we work with patients and their families to help ensure that they have a reliable plan in place for getting to the hospital.
While our surgical team prepares the transplant recipient for surgery, the donor heart evaluation will be completed. If we determine that the heart is an appropriate match, the recipient and their family will be notified that we are going to proceed with surgery.
Heart transplant surgery is a complicated procedure that, even under ideal conditions, can last six to eight hours or more. After general anesthesia is administered, the patient will be placed on a heart-lung machine, which keeps oxygenated blood flowing throughout the body, and a ventilator to take over the patient’s breathing. Next, a long incision will be made through the chest and the sternum (breastbone) to access the diseased heart. After the surgical team removes the old heart from the great arteries and veins, the new heart is sewn into place.
If the donated heart does not start beating properly right after blood flow is restored, an electric shock is administered to create proper function. The surgical team will then assess the function of the new heart and make sure that none of the blood vessels are leaking. Once the team determines that the heart is working properly, the patient will be taken off the heart-lung machine, and the chest will be closed.
Following surgery, patients will be taken into the intensive care unit to be monitored closely for up to several days. During that period, our medical team will look for signs of organ rejection or any other complications. Patients may remain on a ventilator during this period of observation.
After leaving the ICU, patients will typically remain in the hospital to recover for an additional week or more. After returning home, patients will return to the hospital for frequent check-ups during the next several months and then annually.
In recent years, heart transplantation has become increasingly successful through the development of immunosuppressive medications that better prevent rejection of donated organs. These drugs accomplish this by inhibiting the body's immune system from identifying the new organ as foreign.
It is necessary for all patients to take these medications for the rest of their lives following a transplant. A successful transplant can be undermined very quickly by the failure of patients to take their medications appropriately and responsibly.