Patient's Guide to Heart Transplant
Heart transplantation offers hope to patients when other treatments have not been successful. Once it is determined that a heart transplant is the best option for you, after undergoing a comprehensive heart transplant evaluation, planning and preparing is often the next step to help you on the road to a quicker recovery.
Our patients have access to a collaborative team of cardiologists, cardiothoracic and transplant surgeons, specially trained nurses, 19 transplant coordinators who are available 24/7 and a support team that includes a dedicated dietitian, social worker, psychiatrist, financial coordinator to help you avoid unexpected costs, pharmacist and physical and occupational therapists. Your cardiologist and medical care team will request that you carefully follow their guidelines on how you can best prepare for a heart transplant.
Since the program's founding in 1988, our doctors, surgeons, researchers and faculty have made pioneering discoveries in surgical techniques, anti-rejection technologies and cardiac support devices, some of which are now used worldwide. This combination of experience and expertise provides our patients with an innovative and deeply individualized care plan that results in superior outcomes and reduced post-transplant complications, consistently surpassing government benchmarks.
Adult Transplant Handbook
To help you prepare for your heart transplant, we've created a comprehensive handbook as a reference guide for patients, their families and caregivers. This handbook is designed to provide a better understanding of the heart transplant program at Cedars-Sinai, the associated postoperative recovery and the lifetime follow-up care required of all heart transplant recipients. Your cardiologist and medical care team will most likely share a printed version of this handbook with you.
Frequently Asked Questions
You may have questions about the process for a heart transplant at Cedars-Sinai. Find answers here to some of the commonly asked questions.
Unfortunately, there is no way to predict how long a given patient will remain on the waiting list for a donor heart. The wait time is dependent on several factors, including the urgency for transplantation, the size of the heart, blood type, tissue type and how long you have been on the waiting list, to name a few significant ones. The time may vary from several days—when a heart is needed urgently—to months or, in some cases, years.
It's important you stay healthy during the waiting period. We want you to be as healthy as possible when a heart becomes available for you.
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.
As you prepare for, receive and recover from your heart transplant, strong support is available for you and your family. Cedars-Sinai and various organizations in your community can provide educational, financial and emotional assistance.
It's normal to feel nervous before your transplant. Meeting others going through a similar experience can help, as you learn from them and share your own experiences with them. There are 2 support groups available at Cedars-Sinai that you may be interested in attending.
A support group is available for all Cedars-Sinai organ transplant patients. For more information about this meeting, please contact our social work team at 310-423-5389.
In addition, there is a regular discussion of topics specific to heart transplant that is open to all heart transplant patients, family and caregivers. To learn more about this heart transplant support group, please contact our social work team at 310-423-5389.
We also have a heart transplant ambassador program, which offers an opportunity for heart transplant recipients to share their experiences and offer encouragement to other heart transplant patients and their families, new or on the waiting list. To connect with a heart transplant ambassador, contact the cardiac patient liaison at 310-467-4938.