Who needs a heart transplant?
Heart transplant surgery may be considered if you have severe heart failure. If your condition is serious and other treatments are not managing to improve things or control your symptoms, your cardiologist may send you to a heart transplant centre for a transplant assessment.
Your assessment will determine whether you need a transplant and whether you are suitable for one. Based on your assessment, you may be considered:
- Suitable for a transplant, in which case you will be put onto the transplant waiting list. This means you could be called for a transplant at any time.
- Potentially suitable for a transplant, but the consultants do not think your condition is severe enough to put you on the waiting list. If this happens your case will be reviewed regularly. If your condition gets worse, you will go on the waiting list.
- In need of further investigations or treatment. This means that more information is needed before a decision is made.
- Unsuitable for a heart transplant. This could be for a number of reasons. The transplant team will explain why you are not suitable and discuss other treatments.
How long is the wait?
Donor hearts may come from anywhere in the UK or occasionally from other countries in Western Europe. The team will try to reduce as much as possible the amount of time between removing the heart from the donor and transplanting it into you.
When considering whether a heart is a good match, the team will look at the quality of the heart, the size, and importantly, how well it matches your blood and tissue type.
If you are considered suitable for a heart transplant you will be added to the transplant waiting list. Once you are on the list, a suitable heart may come along within a few days or it may take many months or even years.
Unfortunately, suitable hearts do not become available for everyone and only 8 out of 10 people receive the heart transplant they require. Around half the people accepted onto the heart transplant waiting list receive a transplant within three years.
How the operation works
A heart transplant operation usually takes between four and six hours:
- At the start of the procedure you’ll be given a general anaesthetic.
- The surgeon will make a cut in your breastbone to get access to your heart. You will be connected to a heart-lung bypass machine which makes your blood circulate around your body.
- Your surgeon will then work on transplanting your new heart.
- When this is finished, they will start your heart beating again. When your heart begins to take over pumping and your condition is stable, the heart-lung machine will be turned off.
- The surgeon will then close your breastbone with wire, which will stay there for the rest of your life.
After the operation you will be moved to the intensive care unit. Most people wake the following day. You will be sedated and breathe with the help of a ventilator machine until you are able to breathe for yourself. From there, you’ll be moved into a high dependency unit or ‘step down’ ward.
Following the operation, you will have a wound along your breastbone and you’ll also have ‘chest drains’ – tubes which have been inserted in the chest area to drain fluid from your chest. You will be given fluids and medicines through small tubes attached to your arms or neck.
What happens after the heart transplant?
Most people leave hospital within about four weeks of the operation, but depending on your condition, you may need to stay in hospital for longer.
In the first few months after your surgery you will need to spend a lot of time visiting the hospital. Your transplant team will talk to you about practical arrangements for after your surgery.
Although you will be weak after the operation, recovery can be very quick. It is important to build up your level of activity gradually. You should avoid activities involving pushing, pulling or heavy lifting until your breastbone is fully healed, which can take up to three or four months.
What you can do to help your recovery
To make sure that your heart transplant is as successful as possible, you may need to adjust your lifestyle. Here are some things you can do to aid your recovery:
- Attend all your appointments – this allows doctors to monitor your health and alter medications if needed.
- Take your prescribed medication.
- Wear sunblock when you go outside as after a transplant you are at a higher risk of developing skin cancer.
- Don’t smoke – this will help to keep your heart healthy.
- Do regular physical activity such as walking around your home and building up short walks outside.
- Eat a healthy, balanced diet to protect your heart. This includes eating lots of fruit, vegetables and whole grain.
- Aim to control your cholesterol and blood pressure levels by swapping saturated fats for unsaturated fats, maintaining a healthy weight, and reducing salt in your diet.
- Be aware of personal and food hygiene to avoid infection. You can do this by:
- avoiding coming into contact with anyone who has an infection
- not consuming high-risk foods that could cause food poisoning such as raw eggs, mayonnaise, raw meats, unpasteurised milk and cheeses, and shellfish
- keeping your pets healthy, wormed and vaccinated. You should also avoid changing cat litter trays (the infection toxoplasmosis is carried by cats)
- washing your hands after gardening or if you have been handling any pets.
It’s a good idea to take part in a cardiac rehab programme. The aim of the programme is to help you recover as quickly as possible. The programme includes supervised exercise and advice on how to lead a healthy lifestyle.
Find out more about cardiac rehab.
It’s normal to feel a bit worried about how you will manage following your heart transplant. Every person reacts differently, but it’s important to talk to someone you trust about how you feel.
While you’re in hospital you can talk to the specialist transplant nurse or other members of your transplant team. The staff at your transplant centre can give you details of who you can contact after you’ve left hospital in case you have concerns. Most transplant centres also run outpatients support clinics which can help you and your family adjust to life after a heart transplant.
It’s important to remember that the transplanted heart is no more than a pump and that it does not change your personality or behaviour.
Find out more about caring for someone with a heart condition
What complications might there be?
There can be other complications after a heart transplant. While most of the complications are manageable, the transplant team will monitor you closely during this time.
The most common complications are:
- when the body attempts to reject the new heart
- problems with the kidneys
- a higher risk of some forms of cancer.
For more information about possible complications, download our free Heart Transplant booklet.
Life after a heart transplant
Once you’ve recovered from surgery many people are able to return to a wide range of activities including driving, holidays, sporting activities, and work.
You will need to take a number of medicines, including immunosuppressants (also known as anti-rejection medicines), for the rest of your life. Without them your body would rapidly recognise your new heart as ‘foreign’ and try to reject it. This type of medicine can have side-effects which your doctor will discuss with you.
Having a heart transplant aims to improve your quality of life and prolong your survival. Over 70% of heart transplant patients live for over five years.
Where can I find out more?
- Our heart transplant booklet talks in detail about heart transplantation and is for people who have had, or are waiting for, a heart transplant. It's also suitable for family and friends.
- The NHS Blood and Transplant is a special health authority that provides a blood and transplantation service to the NHS. This includes managing the donation, storage and transplantation of organs, alongside making sure that donated organs are matched and used in a fair way.
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If you have any questions or if anything is worrying you, you can talk to your transplant team or call our Heart Helpline on 0300 330 3311.
Do you want to help find donor hearts?
Did you know that in the UK over 1,300 people a year die in need of an organ? That's around three people every day.
Nine out of ten people say they support organ donation, but only one in three are registered.
You can help by signing up to the NHS Organ Donation Register, and spreading the word to your family and friends. This is a register for anyone who wants to donate their heart or other organs.
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