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Q&A: Making a Decision about Heart Transplantation

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Posted by Eman Hamad, MD

Except for “heart attack,” maybe no words about heart-related issues are scarier than “heart transplant.” Why would someone need one? What is a “registry”? What do you need to do afterwards? Well, they say that knowledge is power, so check out this post to learn all about the answers to those questions. Plus, you’ll discover why the Temple Heart and Vascular Institute may just be the best place for you to be if you need this type of specialized care.

When Would I Need a Heart Transplant?

If your heart is diseased and can’t recover on its own, then it can be replaced with a healthy heart from a deceased donor. This can help to improve your quality of life and help you live longer. Most often, heart transplants are done on patients who have end-stage heart failure, a condition in which your heart is severely damaged, and on people who have failed other treatment options. End-stage heart failure can be caused by conditions like coronary heart disease, viral infections, or hereditary conditions.

If you have severe heart disease that doesn’t respond to other treatments, you may be eligible for heart transplant surgery. As long as you’re healthy enough for surgery, you’ll be placed on a waiting list for a donor heart by an organization called “the National Organ Procurement and Transplantation Network.” This is the national network that handles the organ-sharing process for the United States. If a donor heart that matches your size and other requirements is found, you’ll need to have your transplant surgery right away.1

What Happens Afterwards?

After the surgery, you’ll recover in the hospital’s intensive care unit (ICU) and stay in the hospital for up to three weeks. During your recovery, you may start cardiac rehabilitation. That’s a medically supervised program to address exercise, nutrition, stress, and risk factors like smoking. Before you leave the hospital, you’ll learn how to keep track of your overall health (like monitoring your weight, blood pressure, pulse, and temperature) as well as learning the signs of your body rejecting the heart transplant. For the first three months after leaving the hospital, you’ll come back many times for tests to check for infection or rejection of your new heart, to test your heart function, and to make sure you’re recovering well.1

How About the Risks?

There’s no getting around it: heart transplant has some serious risks. Sometimes the donor heart fails and cannot function. This is called primary graft dysfunction, and it’s the most frequent cause of death for the first month after transplant. Your immune system also may reject your new heart. Rejection is most likely to happen within six months after the transplant. You’ll need to take medicines for the rest of your life to help prevent your body from rejecting your new heart. These medicines weaken your immune system and increase your chance for infection. A condition called “cardiac allograft vasculopathy” is a common and serious complication of heart transplant. It’s an aggressive form of atherosclerosis (hardening of the arteries) that over time can block your heart’s arteries and cause the donor heart to fail.1

With All Those Risks, Why Is Transplant Still a Good Option?

Believe it or not, even with these risks, heart transplant has a good success rate that has only gotten better over the decades. Recent survival rates are about 90 percent at one year after surgery, with survival rates decreasing by about three to four percent each additional year after surgery because of serious complications.1

The Temple Heart & Vascular Institute Difference

Temple has one of the most experienced heart transplant programs in the region, and our surgeons have performed well over 1,300 transplants since 1984. We can often offer options to patients with complex heart disease that other hospitals can’t. In addition, our surgeons have pioneered methods to improve donor organ health and try to avoid post-transplant complications.2

If you or someone you care about has severe heart disease and may require a transplant, one of the best moves you could make is to contact the Temple Heart & Vascular Institute.


  1. Accessed December 1, 2017.
  2. Accessed December 1, 2017.

Editor's Note: This page was updated on 3/4/21 to reflect accurate number of heart transplants performed since 1984.

Eman Hamad, MD

Dr. Eman Hamad is Director of the Advanced Heart Failure and Transplant Program at Temple. Dr. Hamad specializes in advanced heart failure therapies including transplantation and mechanical circulatory support. She is a member of several organizations, including the American Heart Association.

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