Heart transplant

Complex operation where a severely diseased heart is removed and replaced with a healthy heart obtained from a recently deceased donor. 


A heart transplant is usually carried out for end-stage heart failure, and it is a rare procedure due to the lack of available donors. Heart transplant is the ultimate resort in the treatment of the following conditions:

  • Severe heart failure - where the conventional treatment has failed, and the patient is expected to die within a year.
  • Congenital heart disease - which would ultimately lead to heart failure and death if no further conventional treatment is possible or available options have failed.
  • Intractable angina or life-threatening arrhythmias - a very rare indication for a heart transplant due to the good availability and efficacy of conventional treatment.

Candidates for heart transplant are normally referred to tertiary heart centres for detailed investigation and assessment, including echocardiography and left and right cardiac catheterization, to exclude contraindications to the operation, e.g. kidney dysfunction, which would be exacerbated by immunosuppressive medication needed following the transplant. Heart transplant is also not recommended in people with a history of poor adherence to medication and hospital appointments due to the need for life-long follow up after the surgery.

The operation

Patients on the waiting list for heart transplant need to be contactable 24/7 and get to the hospital immediately upon request to minimize the delay between the retrieval and transplant of the donated heart. During the heart transplant, the patient is connected to a heart bypass machine, the diseased heart is removed, and then the new heart is connected to the main arteries and veins.

Follow up

All heart transplant patients need life-long care with frequent visits to the hospital, regular tests and multiple medications. The actual operation is a major procedure, but it is normally successful with a dramatic improvement in patients' quality of life who were previously extremely incapacitated.

The challenge is long-term care. A correct level of immunosuppression should balance the prevention of rejection of the heart and side effects, including susceptibility to kidney problems, osteoporosis, infections, and cancer. This, however, needs to be considered in the context of the bleak prognosis of terminal heart failure without a heart transplant.

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