Heart transplant surgery

What is a heart transplant?

During heart transplant surgery, we replace your failing heart with a donor heart. The Penn Medicine Heart Transplant team is ready 24 hours a day for notification that a donor heart is available.

Who is a candidate for heart transplantation?

Your journey at the Penn Medicine Heart Transplant Program starts with a detailed eligibility and evaluation process to determine whether a donor heart is appropriate for you. General qualifications for a heart transplant include: 

  • Age under 70 
  • Health insurance coverage for the procedure 
  • Overall good health, without active cancer, uncontrolled diabetes, obesity, or current alcohol or drug abuse 
  • Access to a support system to help with recovery 

What to expect during heart transplant surgery

If you’re at home when a donor heart becomes available, we call you and tell you to come to the hospital. If you’re already at the hospital, we prepare you for surgery. At the same time, we send a surgeon to evaluate the heart and bring it to the hospital. 

Even though being matched with a donor heart is an exciting time, it's normal to feel nervous about heart transplant surgery. Our team is here to support you from the minute you arrive. 

Heart transplantation is an open-chest surgery that lasts six to 12 hours. You receive general anesthesia to keep you asleep and comfortable. You’ll be connected to a heart-lung bypass machine that does the work of your heart and lungs and circulates blood to your body during the procedure.  

Your surgeon then makes an incision down the middle of your chest and through your breastbone (sternum) to get access to your heart. They remove the diseased heart and fit the new donor heart into your chest. Once the blood vessels are attached to your new heart, the team disconnects the bypass machine and makes sure the heart starts beating and functioning normally. 

What is heart transplant recovery like?

Recovery and life after heart transplant surgery begin the moment surgery ends.  After surgery, we transfer you to the heart vascular intensive care unit (HVICU) for approximately one week.  You then go to the cardiac step-down unit to prepare for discharge.

About one in five people need extra support to help their new heart recover. Your surgeon may place a temporary device during surgery to help your heart function. When you wake up, you may notice extra tubes or machines next to your bed.

While you’re in the ICU, your heart transplant team removes these devices as your heart starts to function on its own. Your hospital stay may last up to two weeks.

Risks after heart transplantation

Like all surgeries, heart transplantation carries a risk of bleeding, blood clots, and infection. In addition, we carefully watch for two serious complications in the hours and weeks after transplant: 

  • Primary graft failure: This serious complication happens right after a heart transplant. The donor heart fails to work properly when it’s transplanted into the recipient’s body. We prioritize monitoring in the CICU to look for signs of primary graft failure.  
  • Rejection of the donor heart: Your immune system is designed to recognize the donor heart as a foreign object in your body. When this happens, the immune system attacks the new heart, called rejection. You’ll have regular heart biopsies to check for rejection. Early detection can help us reverse the process. 

Penn Medicine’s top-rated heart transplant program

If a heart transplant is your best option, you want an experienced team on your side. At Penn Medicine, our heart transplant specialty has almost 40 years of experience with even the most complex cases. We’re also one of the few transplant centers in the U.S. that perform all types of dual-organ heart transplants.  

Our team of highly skilled doctors and nurses leads a family-centered approach to transplant medicine that puts you and your loved ones first. Your caregivers are always welcome at your bedside and at care team meetings. We tailor your recovery plan to your needs and wants, to help you heal faster. And we’re here for your whole recovery—and beyond. You’re part of the Penn Transplant Institute family for life. 

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