Heart Transplant

When and Why a Heart Transplant is Necessary

Heart disease is the leading cause of death among Americans, with the Centers for Disease Control and Prevention reporting that someone dies of a cardiovascular disease every 33 seconds.

Millions of Americans have heart failure, a common cardiovascular disease. While the condition name sounds like your heart is suddenly and immediately failing, that’s not usually the case.

Heart failure is a progressive disease, meaning it worsens over time. Many people with the condition are considered to have early-stage heart failure, which means they’re either simply at risk for heart failure (stage A) or in pre-heart failure (stage B).

Stage C is symptomatic, which is when a person experiences symptoms of heart failure, such as shortness of breath, fatigue and swelling in the feet, ankles and legs. Even after a person has symptomatic heart failure, medications and lifestyle changes may help alleviate symptoms for years. If symptoms advance to a point where they interfere with daily life or cause repeated hospitalizations, a person is considered to have advanced heart failure.

At that stage, a heart transplant may be recommended if other treatment options don’t help. Heart transplants may also be recommended in certain other situations, including when the heart is severely damaged by a heart attack, when a person has life-threatening abnormal heartbeats that are nonresponsive to treatment or when a severe, unfixable heart defect is present at birth.

Understanding the Evaluation Process

While there’s a significant need for heart transplants in the United States, not every person who needs a transplant is eligible for one. Many people who are seriously ill with heart failure or other heart health conditions have other health-related factors that can make them poor candidates for a heart transplant.

The process of having a heart transplant begins with being evaluated to determine whether you’re an appropriate candidate. The evaluation process is thorough and contains many different tests to ensure you’re healthy enough for a successful heart transplant, including:

• Blood tests
• Imaging tests
• Psychological evaluation
• Pulmonary function tests

A heart transplant evaluation may involve meeting with multiple members of our transplant care team, including cardiologists, heart failure specialists, a dietitian, nurses and a pharmacist. If you’re an appropriate candidate for a heart transplant, you’ll be placed on the United Network for Organ Sharing list.

Managing Your Health Until a Heart Transplant

After being added to the heart transplant list, it can take months or even years to be matched with a donor heart. As you wait, your cardiology team may recommend another treatment option known as a ventricular assist device, or VAD, to help keep your heart functioning.

The left ventricle of the heart is responsible for pumping oxygenated blood from the heart to the aorta. From there, blood is transported throughout the rest of the body. Ventricular assist devices are exactly what they sound like—they operate by assisting your heart in pumping blood.

In late-stage heart failure, the heart has to work much harder to pump blood. Left ventricular assist devices, called LVADs, perform the function of the left ventricle, which takes strain off the heart itself.

In some cases, the right side of the heart, which pumps blood to the lungs, may also need support. Right ventricular assist devices, called RVADs, are used for this purpose.

If a VAD is recommended for you, a small pump will be surgically implanted in the body. This pump is connected by tubes to the heart and the aorta and then connected to a controller and batteries outside of the body.

VADs are often used as temporary support for patients who are waiting on a heart transplant, but can also be used on a longer basis for those who are not eligible for a transplant.

What to Expect After a Heart Transplant

During a heart transplant, a damaged or weakened heart is replaced by a healthy donor heart. The transplant itself typically takes between three and eight hours.

Once the transplant is complete, your transplant journey is only beginning. For several days after a heart transplant, you’ll remain in the cardiac intensive care unit, where you’ll be carefully monitored by a team of experts.

We’ll continue to monitor you regularly in the months after you are discharged from the hospital. Any type of transplant, including a heart transplant, carries a risk for organ rejection. During this time, we’re watching for signs of rejection, as well as infection or other complications.

Now that you have a new heart, we want you to thrive! In the months and years after a heart transplant, we’ll connect you with the lifelong care you need for success, including medications to prevent rejection, nutrition and exercise support, mental health services, and integrative health and well-being services.

If you believe you may be a candidate for a heart transplant, call (212) 746-5166 for more information or to schedule an appointment.