Each transplant center is located within a designated region, and its potential recipients are put on that region's list. Organs are offered first to the sickest patients who match blood type and size. If a match is not found within the region, organs may be offered to patients outside the region.

Once a possible match is found between the donor organ and the patient, the surgeon will make the final decision on whether it's the best match to proceed with transplantation.

Members of the transplant team will evaluate you regularly and adjust medical treatment as necessary. Sometimes patients may need hospitalization and intravenous drugs to support them during the waiting period. Occasionally, mechanical circulatory support devices are necessary. The transplant team will ensure you have the appropriate care for your needs.

After the surgery, you will typically spend 2 to 3 days in the cardiac surgery intensive care unit and about 5 to 7 days on the transplant observation ward. During this time, you will be constantly monitored to ensure that your new heart is functioning well and that there are no complications from the surgical procedure. You also will begin taking special medications to help prevent your body from rejecting your new heart. 

Before you are discharged, you and your family will receive education and instructions about how to manage your medications, take care of your surgical incision and schedule follow-up visits in our outpatient clinic.

Heart transplant recipients must take many different medications, each prescribed for a specific therapeutic reason. They fall into four categories:

• Immunosuppressants: Drugs and agents that shut down the body's natural immune responses that would damage your new heart.
• Antibiotics, antivirals and fungicides: Drugs that fend off infection while your natural immune responses are disabled.
• Vitamins, minerals and nutritional supplements: Compounds to aid your body in its efforts to heal and maintain proper functioning.
• Coronary disease prevention and antihypertensive medications: Drugs to prevent coronary artery disease and regulate blood pressure.

Most medications will be required immediately after transplant surgery. Over the first year, adjustments will be made by your transplant team, which may include lowering the dosages and frequency on some medications that may continue for the rest of your life, and possibly discontinuing others.

After your hospital discharge, you will be closely monitored on an outpatient basis by the post-transplant team. This will include regular tests on your new heart, including blood work, echocardiograms, heart biopsies and clinic visits with a transplant cardiologist. The transplant team will communicate with your cardiologist and primary care physician to provide seamless, coordinated care.

The appropriate time for you to return to work will depend on at least two factors: how you are feeling after surgery, and what type of work you will be doing. As soon as your incision is healed and you are feeling well, you can discuss with your transplant cardiologist when to return to work. Some patients are able to return to work relatively quickly. We encourage patients to resume working as soon as they feel ready and the transplant cardiologist considers the decision medically safe. Generally, most recipients can return to work within 6 months following surgery.

Some patients may experience rejection after heart transplantation. This is an attempt by your body to attack your transplanted heart, which your immune system sees as a foreign object. You must take anti-rejection medication for the rest of your life to keep this from happening. Rejection, if it occurs, is likely to happen in the first year after transplant. Rejection typically occurs without symptoms—it is often diagnosed during a scheduled biopsy, which is why it will be important to comply with your schedule of follow-up visits after your transplant surgery. 

If rejection is detected, it may require adjustment of medications or other therapies. When detected early, most rejection episodes can be resolved successfully.