Heart Transplant

A heart transplant may be considered if you have severe heart failureand medical treatments are not helping.

• Conditions that may eventually require a heart transplant include:
• coronary heart disease – a build-up of fatty substances in the arteries supplying the heart, which block or interrupt blood flow to the heart 
• cardiomyopathy – where the walls of the heart have become stretched, thickened or stiff 
• congenital heart disease – birth defects that affect the normal workings of the heart 

If your doctor thinks you might benefit from a heart transplant, you'll need to have an in-depth assessment to check whether you're healthy enough to have one before being placed on a waiting list.

A heart transplant needs to be carried out as soon as possible after a donor heart becomes available.

The procedure is performed under general anaesthetic, where you're asleep. While it's carried out, a heart-lung bypass machine will be used to keep your blood circulating with oxygen-rich blood. 

A cut is made in the middle of the chest. Your own heart is then removed, and the donor heart is connected to the main arteries and veins. The new heart should then begin beating normally.

You'll usually need to stay in hospital for around 2 or 3 weeks after a heart transplant. Most people are able to start returning to many of their normal activities within a few months. Your transplant team can give you advice about how long you may need to avoid certain activities during your recovery. You'll need to have regular check-ups with your transplant team after the transplant.

You'll also need to take medicines called immunosuppressants for the rest of your life. Without these medicines, your body may recognise your new heart as foreign and attack it (rejection).

A heart transplant is a complex and risky procedure. Possible complications include:

• the immune system recognising the transplanted heart as foreign and attacking it (rejection) 
• the donated heart failing to work properly (graft failure) 
• narrowing of the arteries supplying the heart (cardiac allograft vasculopathy) 
• side effects from the immunosuppressant medication, such as an increased vulnerability to infections, weight gain and kidney problems 

Many of these problems are treatable, although sometimes another heart transplant may need to be carried out if possible.

Most people can eventually return to their normal activities after a heart transplant and experience a significant improvement in their symptoms for many years. But it's a major operation and some of the complications can be life threatening.

Overall:

• 80 to 90 in every 100 people will live at least a year 
• 70 to 75 in every 100 people will live at least 5 years 
• 50 in every 100 people will live at least 10 years 

Some people have survived for more than 25 years after a heart transplant.

Joining the NHS Organ Donor Register 
British Heart Foundation: Heart Transplant 
BHF Patient booklet
NHS: Heart transplant
NHS Patient booklet - Heart failure and transplantation

Hepatitis C and Organ Donation
NHS, Transplant waiting list: hepatitis C donor organs
British Transplantation Society UK Position Statement