Heart Transplant
Heart Transplantation: What to Expect

Heart Transplantation: What to Expect

Stanford Hospital performs approximately 40 to 50 heart transplants each year. Our patients range in age and have almost every type of end-stage heart disease. We know that a heart transplant is a life changing experience, and all of your concerns are important to us. Our goal is to provide you and your family with all of the information and support you need. At any point, please feel free to ask your transplant team questions, or download the Heart Transplant Patient Manual for more detailed information.  Below you'll find a general outline of what you can expect from the transplant process.

Before Your Surgery

Once you are accepted as a transplant candidate, Stanford will list you on the United Network for Organ Sharing (UNOS) national computer system. Patients are listed by blood type, height, weight and urgency. The categories for urgency are:

The amount of time you wait for a donor will depend on your UNOS status, your blood type and size, and how long you have been waiting on the list. You may wait a few days or over a year. The donor's body must be close to your own height and weight. Your pre-transplant cardiologist will discuss the possible length of your wait with you.

You may wait at home or in the hospital, depending on whether you need IV medications and other devices to support your heart. Since hearts can be transplanted only within a short time of being taken from the donor, you may be asked to move temporarily near the hospital. You will need a cell phone so you can be contacted immediately if a donor organ becomes available while you are away from home.

Transplant Surgery

As soon as a donor heart becomes available you will be contacted by the transplant surgeon. Once you arrive at the hospital you will have an IV placed, blood drawn, and receive a chest x-ray. The surgeon and an anesthesiologist will see you and take your medical history. The surgeon will review the surgical procedure and the risks of the operation with you and your family. There is usually several hours of wait time between notification of donor availability and the actual procedure.

Once it is time for your operation, a team of anesthesiologists will take you to the operating room where you will have additional special IVs placed. You will then be given medications to put you to sleep. A breathing tube will be placed into your airway to help you breathe and a urinary catheter will be placed to drain your bladder during the surgery. As the surgery begins an incision will be made in the midline of your chest. A heart-lung bypass machine will take over the work of the heart and lungs. While this is occurring another team of surgeons will travel to the donor's hospital. Once there, the team will examine the donor's heart to make absolutely certain that it is a suitable match. Once the donor team arrives with your new heart the diseased heart will be removed and replaced with the healthy donor organ. The operation usually lasts between five and six hours, but can last longer if you have had previous open-heart surgery or have a left ventricular assist device in place.

Recovery

After your surgery is completed you will be taken to the intensive care unit to recover. You will be on a breathing machine for at least six to eight hours while the effects of the anesthesia wear off. Once the breathing tube is removed, nurses and physical therapists will work with you to gradually increase your activity level.

Most patients stay in the ICU for two to three days, although this varies depending on the pace of your recovery. While in the ICU you will be sharing a room with another patient. Once you are stable, you will be transferred into a private room in the Intermediate ICU. Since you are in a private room, your family members can visit as much as they want and can even spend the night in the room with you. Your family is highly encouraged to spend as much time as possible at your bedside in the Intermediate ICU. This is where you and your caregivers will learn how to take care of your new heart. Your nurses and the transplant pharmacists will also teach you your new medication regimen.

Physical and occupational therapists will work with you to build up your strength and stamina. They will tell you about the safest and most effective ways to increase your activity after your hospital discharge. The Transplant Dietitian will educate you and your caregivers about proper nutrition related to various aspects of your transplant health. Your assigned social worker will work with you and your family to address coping, local housing, resources and forms which may need to be completed.

Discharge

As you near discharge, the transplant coordinator will teach you more about your transplant and inform you of how the transplant team will monitor you for potential complications. Once you have recovered from surgery, have no outstanding medical issues, are able to independently take your new medications and have received all the required education, you will be discharged from the hospital, and based on your home location, you will be required to live within a short distance from Stanford, for up to 12 weeks as needed.

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