Heart Transplant Surgery: Preparation and Procedure

The amount of time for a heart transplant depends on the complexity of your case and if you need other procedures.

If you do not have a VAD, surgery should take three or four hours.

If you have a VAD that needs to be removed, or you've had prior chest surgeries, it should take six to eight hours.

You may be in the OR longer than the actual procedure because the transplant team must work with the donor site.

While the length of survival for a transplanted heart continues to improve, the current median amount of time at our center is nine years, with the longest ever recorded at our center being 36 years and 10 months.

During your heart transplant, your surgeon and care team will:

• Connect you to a heart-lung machine. It does the work of your heart and takes the strain off your lungs. It pumps filtered, oxygen-rich blood into your body so your heart is still during the operation.
• Remove your diseased heart
• Replace it with the healthy donor heart

After a donor heart is placed into an open chest, the surgeon attaches it to the surrounding major blood vessels. It should usually start beating once blood flow is restored, but an electric shock can be used to get it started if necessary.

Also called a cardiopulmonary bypass machine, this is what replaces the heart's pumping motion while it is outside of the body. It also adds oxygen to the blood and performs the job of the lungs. The machine can operate for hours.

After your heart transplant, you will:

• Start taking anti-rejection drugs right away. When your body detects something new, your immune system begins working to fight what it views as a threat. Anti-rejection drugs suppress your immune system's natural response, so your body will accept the new organ.
• Be in the Cardiothoracic ICU for about three days before moving to a room on the transplant floor.
• Stay in the hospital for about 10-14 days, but this varies based on how sick you are prior to your transplant.

During this time, the heart transplant team will:

• Watch for rejection, infection, or other problems.
• Teach you coughing and breathing exercises that you'll need to do often. These help keep your lungs clear and prevent pneumonia.
• Adjust your medications to find the right mix.
• Work with you and your caregiver to get ready for taking care of yourself at home.
• The nutritionist on your care team will also create and review an eating plan for you to follow at home.

Before you leave the hospital, make sure you and your caregiver clearly understand:

• Your medicine schedule
• The meal plan and nutrition guidelines
• Any other instructions for at-home care
• Your follow-up care schedule (blood work, clinic visits, and testing)

For people who need more help after heart transplant surgery, we may suggest spending time in inpatient rehab before going home.

Please feel free to ask members of your UPMC heart transplant team to explain anything you're unsure of and answer any questions you may have. We're here for you through each stage of your transplant journey.