Heart transplant

A heart transplant is an operation in which a failing heart is replaced with a healthier donor heart. Heart transplant is a treatment that's usually reserved for people whose condition hasn't improved enough with medications or other surgeries. While a heart transplant is a major operation, your chance of survival is good with appropriate follow-up care.

Heart transplants are performed when other treatments for heart problems haven't worked, leading to heart failure. In adults, heart failure can be caused by: A weakening of the heart muscle (cardiomyopathy) Coronary artery disease Heart valve disease A heart problem you're born with (congenital heart defect) Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments Failure of a previous heart transplant In children, heart failure is most often caused by either a congenital heart defect or cardiomyopathy. Another organ transplant may be performed at the same time as a heart transplant (multiorgan transplant) in people with certain conditions at select medical centers. Multiorgan transplants include: Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure. Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions. Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases if the conditions cannot be treated with only a heart transplant or a lung transplant. A heart transplant is not right for everyone, however. You might not be a good candidate for a heart transplant if you: Are at an advanced age that would interfere with the ability to recover from transplant surgery Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease Have an active infection Have a recent personal medical history of cancer Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not using recreational drugs, not smoking and limiting alcohol use

Besides the risks of having open-heart surgery, which include bleeding, infection and blood clots, risks of a heart transplant include: Rejection of the donor heart. One of the most worrying risks after a heart transplant is your body rejecting the donor heart. Your immune system may see your donor heart as a foreign object and try to reject it, which can damage the heart. Every heart transplant recipient receives medications to prevent rejection (immunosuppressants), and as a result, the rate of organ rejection continues to decrease. Sometimes, a change in medications will halt rejection if it occurs. To help prevent rejection, it's critical that you always take your medications as prescribed and keep all your appointments with your doctor. Rejection often occurs without symptoms. To determine whether your body is rejecting the new heart, you'll have frequent heart biopsies during the first year after your transplant. After that, you won't need biopsies as often. Primary graft failure. With this condition, the most frequent cause of death in the first few months after transplant, the donor heart doesn't function. Problems with your arteries. After your transplant, it's possible that the walls of the arteries in your heart could thicken and harden, leading to cardiac allograft vasculopathy. This can make blood circulation through your heart difficult and can cause a heart attack, heart failure, heart arrhythmias or sudden cardiac death. Medication side effects. The immunosuppressants you'll need to take for the rest of your life can cause serious kidney damage and other problems. Cancer. Immunosuppressants can also increase your risk of developing cancer. Taking these medications can put you at a greater risk of skin cancer and non-Hodgkin's lymphoma, among others. Infection. Immunosuppressants decrease your ability to fight infection. Many people who have heart transplants have an infection that requires them to be admitted to the hospital in the first year after their transplant.

Preparations for a heart transplant often begin weeks or months before you receive a donor heart.