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Heart Transplant Surgery

The surgical process

Heart transplant is performed under general anesthesia with the patent on a bypass machine, which keeps oxygen-rich blood flowing throughout the procedure. It generally lasts four to six hours, longer if the patient has had previous coronary surgery or if there are complications. The surgeon exposes the chest cavity and opens the pericardium. The diseased heart is removed, leaving the back part of the left atrium in place. The donor heart is implanted and the chest is closed. In some patients both heart and lungs may be transplanted during the same procedure.

Following surgery

Immediately after surgery, patients receive pain control medication. A ventilator is used to help a post-operative patient breathe and tubes are inserted in the chest to drain fluids from around the lungs and heart.

The post-surgery hospital stay will last one to two weeks. For about three months afterward, transplant recipients are closely monitored on an outpatient basis, including blood work, echocardiograms, electrocardiograms and heart biopsies.

Long-term recovery

After a heart transplant, patients must make some permanent long-term adjustments, including:

  • Taking immunosuppressants, which are required to prevent the immune system from rejecting the new heart.  These drugs may cause some significant side effects, including weight gain, facial hair or stomach problems, but many of these decrease in severity as time passes.  Because they suppress the immune system, however, a patient is more susceptible to infections, so the physician may also prescribe anti-viral, anti-bacterial or anti-fungal drugs.
  • Cardiac rehabilitation and lifestyle changes such as regular exercise and diet that keep a transplanted heart healthy.  Diets may restrict calories, fluids, salt, fats, carbohydrates and/cholesterol and exclude consumption of alcohol, which adversely affects the function of immunosuppressants in preventing rejection.
  • Emotional support to deal with the inevitable stress and changes that follow a transplant.  Memorial Hermann Hospital sponsors Mended Hearts, a support group for heart patients, their families and caregivers, at various locations throughout the metro area.