What is a heart transplant?

A heart transplant is a surgery that replaces a damaged or diseased heart with a healthy donor heart. It is a treatment for end-stage heart failure and other severe heart conditions. Heart transplantation is a life-saving surgery used when all other medical and surgical options have failed. 

The most common type of heart transplant is an orthotopic heart transplant, in which the original heart is removed and replaced with a donor heart. A heterotopic heart transplant involves sewing a donor heart next to the original heart.

A heart transplant is a major surgery with significant risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all your treatment choices before having a heart transplant. 

Other procedures that may be performed

Your doctor may perform other procedures in addition to a heart transplant. Diseases that cause serious damage to the heart can also cause serious damage to other organs. These include the kidney, lung and liver. For example, cystic fibrosis can damage both the heart and the lungs. 

Some patients may need another organ transplant in addition to a heart transplant. Your doctor will determine your eligibility for combination transplant surgery.

Combination transplant surgeries are rare but can include:

  • Kidney transplant replaces a diseased or damaged kidney with a donor kidney.
  • Liver transplant replaces a diseased or damaged liver with a donor liver.
  • Lung transplant replaces a diseased or damaged lung with a donor lung. 

Why is a heart transplant performed? 

Your doctor may recommend a heart transplant that is used to treat end-stage heart failure and other severe heart conditions. End-stage heart failure is the most common reason for a heart transplant.

Heart failure is also called congestive heart failure. It is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's tissues and organs. The heart keeps pumping, but not as efficiently as a healthy heart. 

Heart failure is usually a symptom of another heart problem. Heart failure can result from coronary artery disease, heart valve disease, high blood pressure (hypertension), heart infection (endocarditis), and disease of the heart muscle (cardiomyopathy).

Your doctor will only consider a heart transplant for you if all other medical and surgical treatment options have failed. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a heart transplant.

Your doctor may recommend a heart transplant to treat: 

  • Congenital heart defects, which are heart defects present at birth
  • End-stage heart failure, the most advanced form of heart failure in which a person is generally disabled and unable to function in even very light activities
  • Life-threatening arrhythmias, which are abnormal heartbeats, or heart rhythms
  • Severe angina, heart disease-related chest pain that is unresponsive to all other treatments

Who performs a heart transplant?

A cardiac surgeon who specializes in transplant surgery performs a heart transplant. Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. A cardiac surgeon may also be known as a cardiothoracic surgeon. Cardiac transplant surgeons have completed additional education and training in a heart transplant fellowship program.

How is a heart transplant performed?

Your heart transplant will be performed in a hospital. It requires open heart surgery. Open heart surgery involves making an incision in the chest and through the breastbone (sternum).

Heart transplant surgery uses a heart-lung machine (cardiopulmonary bypass). This machine temporarily takes over the heart’s job of pumping oxygen-rich blood to your organs and tissues. It allows your surgeon to remove the heart and sew in the donor heart. The surgery takes four hours or longer.

Your surgeon will advise you on how long you need to stay in the hospital based on a variety of factors based on your diagnosis, age, medical history, and general health.&