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Why Choose Penn Medicine

When a heart transplant is your best option, Penn offers the largest heart transplant program in the region. Our surgeons perform more transplants than all other area hospitals combined. When you choose Penn for heart transplant surgery, you find:

  • Experience: Since our program began in 1987, our cardiac surgeons have completed almost 1,500 heart transplant surgeries. 
  • Surgical expertise: Our academic surgeons operate on high-risk patients who are often turned away from other programs. 
  • Multi-organ transplantation: Penn has the ability to perform multi-organ transplantation, allowing you to receive a new lung, liver or kidney when your heart is replaced.
  • Comprehensive care: The Penn Transplant Institute guides you through the transplant process from evaluation to post-op care. Following surgery, multiple levels of care personalize your recovery to your progress and needs. 

Heart Transplant Procedure Overview 

If you have heart failure that is not improving with medication and other cardiac procedures, you may be a candidate for heart transplant surgery. During a heart transplant, cardiac surgeons use open-chest surgery to replace your diseased heart with a healthier donor heart. The first steps in the heart transplant process are heart evaluation by the Penn transplant team and inclusion on the heart waiting list.

Heart transplant surgery is a team effort. The Penn heart failure treatment team includes experienced nurse practitioners, renowned cardiac surgeons, specialized cardiac anesthesiologists and intensive care doctors. Working together, they provide you with focused care from evaluation through surgery to surgical recovery.

Heart Transplant Surgery: What to Expect

When a donor heart becomes available, the Penn transplant team sends a surgeon to harvest the heart. When both you and the donor heart arrive at the hospital, your doctors evaluate the donor heart once more to ensure that it is a good match for you.

Heart transplant surgery is open-chest surgery that takes from six to 12 hours. Penn’s cardiac anesthesiologists administer general anesthesia to keep you sleeping and comfortable for the duration of the surgery. During the procedure, your surgeon will:

  • Connect you to a heart-lung bypass machine, which will continue to pump blood to your body during the surgery.
  • Make an incision in your chest to gain access to your heart.
  • Remove the diseased heart.
  • Fit the donor heart into place and attach the major blood vessels.
  • Ensure that the new heart is functioning as expected.
  • Close the incision.

When the procedure is complete, our cardiac team will transfer you to our heart and vascular surgical intensive care unit (ICU) to recover.

Risks Associated with Heart Transplant Surgery

Any open-chest surgery comes with risks including infection, bleeding and blood clots. Additional risks associated with organ transplant include:

  • Rejection of donor heart: Your immune system may recognize your donor heart as foreign and try to reject it. Not all patients experience symptoms with rejection. To monitor rejection, our cardiac team conducts regular heart biopsies for the first year following the transplant. If rejection is detected, we prescribe immunosuppressant medications to halt the rejection.
  • Primary graft failure: Sometimes even a well-matched donor heart does not function correctly during the first few months following a transplant. This condition is the most common cause of death after a heart transplant. 
  • Artery complications: A complication of heart transplant is cardiac allograft vasculopathy, which is a thickening of your artery walls. This condition affects the movement of blood through the heart and can lead to heart attack, heart failure, arrhythmias or sudden cardiac death.
  • Immunosuppressant side effects: After your heart transplant, you will take immunosuppressant medication for the rest of your life. Taking this medication can cause kidney damage, increase your risk of developing certain cancers and decreases your ability to fight infection.

Recovering from Heart Transplant Surgery

Recovery from heart transplant surgery begins the moment surgery ends. At Penn, we guide you every step of the way. The teams in our surgical intensive care unit and cardiac step down unit monitor your progress and deliver individualized support.

Your cardiology team supports your recovery even after you are back home. For several weeks after discharge, you’ll visit the Penn Transplant Institute weekly for check-ups and monitoring. Your cardiologist will recommend outpatient cardiac rehabilitation to help you regain strength and prevent future cardiac events.

Once you have fully recovered, Penn’s cardiology team will monitor you annually or more often if needed. Learn more about post-heart transplant surgery care offered at Penn.

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