Heart Transplantation General Information
At Northwestern Memorial’s Center for Heart Failure at the Bluhm Cardiovascular Institute, our team of heart transplant clinicians evaluates each patient to see if he or she may benefit from receiving a heart transplant. Those who could benefit from a transplant must:
Heart transplantation contributes to a longer, healthier life. It requires dedication, attention to detail, and a team effort that involves the patient, the patient's family and friends, and health care providers.
Potential Complication of Heart Transplantation: Acute Rejection
We closely follow patients in the heart transplantation program to minimize post-surgery complications including rejection and infection, both of which are common after heart transplantation.
Patients may experience at least one acute rejection episode in the first year after surgery. The immune system plays a role in acute organ rejection: White blood cells in the body recognize what is part of the body, and what is not. These cells protect the body from foreign invaders. When a donor heart is transplanted into a patient, the white blood cells will attempt to attack the foreign organ and destroy it.
Patients take anti-rejection medication for the rest of their lives to help prevent acute rejection, and they take additional medication to treat acute rejection.
Most of the time, acute rejection does not cause any outward symptoms, so it is necessary to monitor patients using heart biopsies. Outpatient heart biopsies are routinely performed in our cardiac catheterization lab.
Recovery and Discharge
Hospital stays following heart transplantation are tailored to each individual patient's recovery. Most patients remain in the hospital for one-and-a-half to two weeks after surgery.
We teach patients about medications, diet, activities, exercise plans and follow-up care before discharging them from the hospital. After returning home, patients return to see their cardiologist for care that focuses on managing side effects of medications, preventing rejection and infection, and promoting a healthy lifestyle.
When patients go home, they return to a life that is free from the symptoms of heart failure. They regain a more normal lifestyle, including activities they could not do when they had advanced heart failure. Many patients return to work, while others choose to retire.
Heart Transplantation Surgery and Life Expectancy
During heart transplantation, we remove a patient’s diseased or sick heart and replace it with a healthy donor heart. Life expectancy after heart transplantation has improved dramatically over the years. While patients with advanced heart failure have severely shortened lives because of heart disease, those who undergo heart transplantation may have as much as a 90% 1-year survival, and 55% 10-year survival—with excellent quality of life.
Potential Complication of Heart Transplantation: Infection
Heart transplantation patients have increased risk for infection because of the anti-rejection medicines they take. Anti-rejection medicines decrease the immune system's ability to fight an infection, so we teach patients the symptoms of infection so can spot it early, notify their doctor, and receive appropriate treatment.
Potential Complication of Heart Transplantation: Chronic Rejection
After heart transplantation, the heart can develop a unique type of coronary disease. The coronary artery vessel walls become thicker, making it more difficult for blood to flow properly. This is called chronic rejection.
Chronic rejection is fairly common and usually occurs more than one year after surgery. Although most patients do not experience chest pain (angina) with chronic rejection, it is possible. Eating a low-fat diet; exercising; and taking anti-rejection medicines, aspirin, and other medications as prescribed may help reduce the risk of developing severe chronic rejection. We monitor coronary artery disease in patients with heart transplantations using cardiac catheterization or other imaging studies.
Medications After Heart Transplantation
The most important medications that patients take after heart transplantation are the anti-rejection medications. Patients typically take:
For a few months after heart transplantation, patients may reduce their anti-rejection medications to reduce the risk of infection.
For more information regarding heart transplant or to obtain a consultation, please contact the Bluhm Cardiovascular Institute at 312-NM-HEART (664-3278) or request a first time appointment online.
For more information regarding clinical trials related to heart failure, please visit the Clinical Trials Unit of Northwestern, send an email or call 312-926-4000.