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Heart Transplant

During a heart transplant, a specialized team removes your diseased heart and replaces it with a healthy heart from a donor. The procedure is a major surgery that involves risk. But with close monitoring and the supportive care of an experienced team, many people are able to lead a relatively normal life after heart transplant.

A heart transplant is typically the last option for heart failure treatment when medicine, lifestyle modifications, and other treatments can no longer manage the condition and prevent it from getting worse. If other forms of treatment aren't preventing your symptoms from worsening, a heart transplant might be for you.

National Leaders in Heart Transplantation

Temple has some of the best heart transplant outcomes in the Philadelphia region and is among the best in the country. Our physicians manage some of the most complex patients including those who need multiple organ transplantation (heart-lung, heart-liver). The benefits of our expertise include:

  • 85.0% of our patients who receive a heart transplant are living with a functioning heart 1 year after their procedure.
  • Our expertise in donor heart assessment results in faster time to transplant. 70.9% of Temple patients received a donor heart within 1 year. The national average is 55.2%.
  • Transplant eligibility criteria here are broader than most. Patients who have been turned down for transplantation at other centers may be eligible at Temple.

Learn more about how Temple’s Heart Transplant Program is setting the standard for excellence.

If you’re considered a candidate for heart transplant at Temple, you will be placed on a waiting list for a donor heart. Once your heart transplant has been performed, a team of heart transplant specialists will monitor your care throughout your life.

Getting on the Heart Transplant Waiting List

Temple’s Heart Transplant Program has a reputation for shorter time to transplant for waitlist candidates. Part of our success is due to our expanded transplant criteria, which allows more patients to qualify for this life-saving surgery.

To get on the waiting list, you must have an appointment with Temple advanced heart failure specialist. Our heart failure team will perform an evaluation. This includes a physical exam, diagnostic tests and a psychological assessment, which help us determine if you’re a good heart transplant candidate.

Temple’s comprehensive pre-transplant evaluation is an important step in the process, as there is a high demand for transplant organs and a relatively low supply.

Our recently expanded heart transplant criteria allows us to consider patients who:

  • Are up to age 74 (age 70 at other centers)
  • Have a BMI up to 35
  • Have had cancer within the past 5 years
  • Are HIV positive
  • Have other significant conditions
  • Have had multiple sternotomies

Once you’re added to the waiting list, you may get an organ that day or you may wait years. This depends on how well you match with a donor and how sick you are.

If you require biventricular support while you wait for a donor heart, Temple surgeons and advanced heart failure specialists work with you to provide support and consider options, including heart pumps (also called mechanical circulatory support or VAD) or a total artificial heart.

How a Heart Is Transplanted

During a heart transplant, your chest is opened (called sternotomy) and your failing heart is removed and replaced by a healthy heart from a deceased donor. you’re placed on a heart-lung machine, which will take over for your heart to pump blood and to help you continue breathing during the surgery.

Heart transplant not only saves lives but also helps patients get back to many activities that were previously impossible for someone with severe heart failure.

Learn more about our evaluation process, the heart transplant waiting list, and what to expect during heart transplant surgery.

Conditions Treated

Heart failure occurs as a result of conditions that make the heart work harder than it should. A number of conditions may lead to heart failure, including:

  • Lifestyle, such as smoking, eating a diet high in cholesterol and unhealthy fats, and physical activity
  • Coronary artery disease, when plaque builds up in your arteries and prevents blood flow
  • Damaged heart muscle from previous heart attack
  • Uncontrolled high blood pressure, which over time causes the chambers of the heart to enlarge and weaken
  • Diseased heart valves, where the flaps of tissue that keep blood flowing forward fail to open or close
  • Hypertrophic cardiomyopathy, in which injury or disease makes the walls of the heart too thick, too stiff, or too weak and large
  • Abnormal heart rhythms (arrhythmias), in which the normal electrical pattern of the heart is disrupted and becomes too fast, too flow or irregular

Whether your heart failure is the result of a congenital (from birth) condition or a condition that develops later in life, a heart transplant can dramatically improve your quality of life.

Mechanical Circulatory Support and Devices

If you’re unable to undergo a heart transplant or need additional support while on the heart transplant waiting list, a heart pump may be an option for you. These include mechanical circulatory support (MCS) and artificial hearts. These devices might be implanted in those who are:

  • Awaiting transplant
  • Expected to regain full heart strength and function with treatment
  • Deemed ineligible to receive a transplant

Mechanical circulatory support enables patients with end-stage heart failure to live longer and feel better. These devices are often used as a “bridge” treatment leading to transplant.

Ventricular Assist Device (VAD)

One common mechanical circulatory support method is a ventricular assist device. VADs, also known as mechanical heart pumps or circulatory assist devices, function in different ways. Some mimic the pumping of the lower chambers of the heart (ventricles), while others pump blood continuously through a tube. The heart is not replaced, just assisted by mechanical circulatory support.

HeartMate LVAD

Artificial Hearts

An artificial heart differs from a VAD in that the device is implanted in place of your damaged heart. The SynCardia Total Artificial Heart is available to those who are waiting for a donor heart.

The artificial heart is implanted much like a donor heart. The artificial heart is powered by a device outside the body to restore proper blood flow.

The Post-Transplant Process

Recovery from a heart transplant can take about 3 months, depending on your age, other medical conditions and overall health. Generally, the heart transplant recovery process occurs in several steps:

First 24 hours in the hospital

For the first day after you receive your new heart, you will recover in the intensive care unit (ICU). You will be on a breathing machine for several hours until the anesthesia wears off.

Once the breathing tube is removed, nurses and physical therapists will begin working with you to gradually increase your activity level.

Cardiothoracic step down unit

You may remain in ICU for 4 to 5 days, after which you will be moved to the cardiothoracic step down unit. Here, you will have a private room to protect against infection.

Temple’s multidisciplinary heart transplant team will evaluate your progress with multiple tests and adjust medications accordingly. You will increase your activity in various physical therapy sessions.

Follow-up care after discharge

Temple’s expert transplant team will continue to support you well after your discharge home. From physical therapy to medication management, you receive optimal care to ensure a healthy recovery.

As part of your long-term care of your new heart, you will take powerful anti-rejection drugs, which suppress the immune system so the donor heart is not damaged. Additional medications will help fight infections due to the body’s lower immunity.

Patient’s post-discharge role and responsibilities

Recipients of heart transplants assist in taking care of their donor organs with a combination of healthy diet, exercise and daily medications. Temple’s team of caregivers will perform regular follow-up and biopsies for close monitoring of the transplanted heart especially in the first 6 months to a year.

You’ll receive education on how to maintain a low-fat, low-salt diet and refrain from smoking. Emotional support from other heart transplant patients is available through our Heart Failure Support Group, where peers and family members can share their experiences and learn from one another.

Connect with Temple’s Heart Failure Support Group >

Organ Rejection

Sometimes, the body’s immune system will attempt to reject the transplanted heart because it views your new heart as a foreign body. You will take anti-rejection and immune-boosting medications to prevent organ rejection.

Most episodes of rejection can be detected early, treated and reversed. To detect and treat episodes of rejection, our specialists perform biopsies after each transplant. We give each patient a customized medication and nutrition plan, and follow up with them on a regular basis.

An Experienced Heart Transplant Team

Our program is one of the most experienced in the world. We have performed more than 1,300 heart transplants — including many dual-organ transplants, such as heart-lung and heart-kidney. Our surgeons have also pioneered methods to make donor organs more available and avoid post-transplant complications.

Ready for an Appointment?

Find a doctor near you, request an appointment, or call 800-TEMPLE-MED (800-836-7536) today.

Page medically reviewed by:
Eman A. Hamad, MD
February 8, 2021