Types of anesthesia that may be used

Your surgeon will perform your heart transplant using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put you in deep sleep. You are unaware of the surgery and will not feel any pain.

You may also receive a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.

What to expect the day of your heart transplant

You will be placed on a heart transplant waiting list if you are eligible for a heart transplant. A variety of factors determines who gets a donor heart when one becomes available. These factors include tissue, blood, and size matching. 

Sometimes a donor heart matches more than one person on the waiting list. In this case, length of time on the waiting list and physical location in relation to the donor heart may play a role in who gets the heart. 

A donor heart generally needs to be transplanted within four hours. Patients waiting for a heart are often in the hospital already. If not, most transplant centers require patients to be in immediate contact while on the waiting list. Your transplant center may expect you to arrive at the hospital within two hours of contact. 

When you arrive at the transplant center, you can generally expect to:

Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.

Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.

  • Talk with the anesthesiologist or nurse anesthetist about your anesthesia.
  • A surgical team member will start an IV.
  • The anesthesiologist or nurse anesthetist will start your anesthesia.
  • A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
  • A catheter (tube) will be placed in your bladder to collect urine during and after the surgery.
  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the surgery and your recovery until you are alert, breathing effectively, and your vital signs are stable.

What are the risks and potential complications of a heart transplant?  

As with all surgeries, a heart transplant involves risks and potential complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.  

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing 
  • Bleeding, which can lead to shock'
  • Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
  • Infection and septicemia, which is the spread of a local infection to the blood
  • Pneumonia, which is a lung infection

Potential complications of a heart transplant

Complications of a heart transplant include:

  • Cardiac allograft vasculopathy (CAV). This is a chronic condition. It occurs when the coronary arteries on the new heart become narrowed. Coronary arteries supply the heart with blood. CAV decreases blood supply to the heart and may cause serious damage. CAV is the major long-term cause of donor heart failure and death following a heart transplant. 
  • Complications from anti-rejection drugs, including cancer and other side effects
  • Complications from not following your lifelong healthcare plan necessary after transplantation
  • Death
  • Failure of the donor heart
  • Heart attack or stroke
  • Rejection of the heart