The Heart Transplant Procedure


Basic guidelines to the heart transplant procedure including before and after the transplant. (Information sauce thanks to THE BRITISH HEART FOUNDATION)


What sort of People need a Heart transplant?

Most Heart Transplants are carried out on people with severe heart failure. The cause of heart failure is usually coronary heart disease, or cardiomyopathy  (A disease of the heart muscle).


However not everyone who has severe heart failure is suitable for a transplant and the number of transplants is limited by the lack of available donors.


In a small number of cases, transplants are carried out on people who have abnormalities of the heart valves or congenital (Problems at birth) abnormalities of the heart.


I Need a Transplant… what next?

If you are referred for a heart transplant you will need to have a transplant assessment. This involves a range of tests and assessments to make sure that a transplant is the best option for you.

You will probably need to go into hospital for about three to five days to have the assessment.

Some of the tests that are carried out are:


Blood tests.

Urine tests

Tests to find out how well your lungs are working

Tests on your heart – catheterization, stress tests, thallium tests and a biopsy.


The transplant assessment also gives you and your family the chance to meet the members of the transplant team, and to ask any questions.

 The team includes the surgeon, specialist transplant nurses, physiotherapists and psychologists.

 You may also get the chance to speak to others such as myself who have had a transplant.


The Results of the Assessment

After your assessment the doctors at your medical centre will decide whether you will need a transplant and whether you are suitable for this form a treatment. They may decide on one of the following:


1.    That you should go on the active transplant waiting list – this means you may be called for a transplant at any time.


2.That you are acceptable for a transplant but that you do not have severe heart failure – This means you will be put on a provisional waiting list and will only have a transplant if your condition gets worse.


3.That you need further investigation or treatment before a decision is made.


  4. That you should be referred to another centre for a second opinion. – This doesn’t often happen as most transplant centres in the U.K. have very similar conditions for accepting patients for a heart transplant.


Waiting for a Heart Transplant.

Once you are on the waiting list, the right heart might come along in a few days, months or years. Unfortunately, suitable hearts do not become available in time for everyone who is on the waiting list.


When you are on the waiting list it is important that you can be contacted at short notice. Your transplant centre may supply you with a bleeper or radio bleeper.


The doctor who referred you to the transplant centre will be responsible for your care during this waiting time. If your condition changes or if you need to start a new treatment, your doctor will tell the transplant team.

If your condition changes you may need to have another assessment to make sure that you are still suitable for a transplant. Some people may have to be taken off the waiting list either temporarily (For example, why they are having treatment.) or permanently; if this happens your doctors will explain why and work out a follow up plan for you.


Receiving the Call

Your transplant centre will contact you when they find a donor heart, which they think, is suitable.

They will check that you have no new medical problems and will ask you to go to the centre.


It is important to remember the following:

1.    Do not eat or drink anything from the time you get the call from the transplant centre.


2.    Bring all your current medications with you.


3.    Bring a bag with essential items for a hospital stay.


When you are admitted to your hospital you will be assessed quickly. Some of the tests you may have had before will be done again.


All the usual preparations for major surgery will be carried out, including shaving your chest if necessary and bathing.


What happens after the operation?

After the operation you will be moved to the intensive care unit, just as you would be after routine heart surgery.


You will have wound along your breastbone, as the surgeon has to cut into the breastbone to get access to your chest.

 You will have chest drains – tubes – which have been inserted into the chest area to drain fluid from your chest. Other tubes will be attached to veins in your arms and neck, to pass fluid and blood into your circulation. You will be sedated and continue breathing with the help of a ventilator machine for at least several hours until your condition is stable and you are able to breathe for yourself.


Many patients wake the following morning – others take a little longer. If all is well you will be moved out of the intensive care unit as soon as you are in a stable condition. You may be moved to a high-dependency ward or step-down ward.

Some transplant patients are nursed in special areas but often these will be on the same wards as other patients who have had routine surgery on the heart and chest.


It is usual for transplant patients to be kept in a separate room or bay and for a number of visitors to be restricted. Your visitors will only be asked to wear gloves, masks, and gowns if there is a particularly high risk of infection.

What medication will I need to take after the transplant?

All transplant recipients will need to hold the up most commitment to making sure there heart remains healthy.

 All transplant recipients will take medication for the rest of their lives.

  All patients will be asked to take immunosuppressants – medication that reduces the body’s immune system and protecting the transplanted organ from rejection, other medication may also be given.





Transplants United (C)2005