Heart transplant

In extremely severe heart failure, a heart transplant may be advised to improve the length and quality of life. Surgeons remove the donor heart, keep it cool in a special solution, and transport it to the hospital where the critically ill recipient is waiting. Surgeons remove the diseased heart, leaving the back walls of the atria (the heart's two upper chambers) intact. They sew the new heart into the chest, atria to atria, and reconnect the blood vessels. Blood can now flow through the new heart into the bodily organs needing it.

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A heart transplant is extraordinarily demanding on many levels. Because there are so many more candidates for transplants than there are available hearts, the heart transplant list must be carefully screened. A multidisciplinary team of heart doctors, nurses, social workers, and bioethicists scrutinize the individual's medical history, diagnostic test results, social history, and psychosocial evaluation. The questions are many. Can the patient survive the procedure—and even if the likely answer is yes, will the patient comply with the years of disciplined aftercare necessary? Transplant specialists often say that those who have had a transplant have to think of themselves as chronically ill. They will have to take many medications, visit the doctor for frequent checkups, exercise faithfully, watch their diet, and be on guard for symptoms that could indicated their body is rejecting the donor heart.

If you are approved for the transplant list, you have to wait for an available donor. The wait is often long, and it is always stressful. A sturdy support network of family and friends is essential. A healthcare team must monitor you and closely control your heart failure. Your transplant coordinator explains how you will be notified should a heart become available and learns where you can be reached at a moment's notice.

If a heart does become available, a surgeon from the transplant center flies to the hospital where the donor has died to recover the donor heart, first examining it to make sure it is in good condition. The surgeon removes the donor heart and places it in a cooling solution in an insulated container for transport to the hospital where it will be implanted.

This section also includes frequently asked questions about heart transplantation.