Heart Transplant

What is it you ask?

A heart transplant replaces the

patient's heart with a donor
heart.
Why would I need one?

The most common reason you

would need a heart transplant
is when one or both of the
ventricles aren’t functioning
properly and you have severe
heart failure.
 Risk Factors
Can be modifiable or
unmodifiable. Family
history of cardiac
disease can
increase your risk.
Pre-op
It may be weeks, months or years before you get matched
with a donor. The donor will have to have the same blood
type and similar body size to the recipient. You will be
evaluated to see if a heart transplant is right for you or if
other, less invasive measures can be done. Your condition
will be monitored while you are waiting for transplant to
watch for changes that may interfere with surgery. The
doctor may refer you to join a cardiac rehabilitation to help
improve your health status before the transplant.
Pre-Op Day of Surgery
● Informed consent is a legal document that explains the tests, treatments, or procedures that you may need.
Make sure all your questions are answered.
● An IV is a small tube placed in your vein that is used to give you medicine or liquids.
● General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given
through your IV or face mask.
● Antirejection medicine: These help prevent your body from rejecting your new heart. You may need to take
this medicine for the rest of your life.
● Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
● Foley catheter: a tube that is put into your bladder to drain your urine into a bag.
● Nasogastric tube: A nasogastric tube is put into your nose and down into your stomach. The tube may be
attached to suction to keep your stomach empty.
Pre-Op Day of Surgery
● Monitoring:
○ Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your
heart's electrical activity.
○ A pulse oximeter is a non-invasive device that measures the amount of oxygen in your blood.
○ Arterial line: An arterial line is a tube that is placed into an artery (blood vessel), usually in the wrist or
groin. An arterial line may be used for measuring your blood pressure or for taking blood.
○ Swan-Ganz catheter: This is a thin tube put in a vein near your collarbone, or in your neck or groin.
The tube goes into your heart and through to a blood vessel in your lungs. A Swan-Ganz can monitor
the fluid in your blood vessels. The pressure in your heart and lungs may also be monitored. The
catheter may also be used to give medicines or IV fluids.
Perioperative During surgery, you are connected to a
heart-lung machine which circulates and
oxygenates your blood for you. The
pericardium is opened up and the heart is cut
at the great arteries leaving behind the backs
of the left and right atria. The new heart is
fitted and sewn into the remaining part of the
heart. Chest tubes are placed to promote
drainage as you heal and pacing wires are
brought out of the chest wall through the skin
in case there is a need for electrical pacing
of the new heart.
Post-op
-Heart transplantation takes about 3 to 5 hours. The hospital stay
after this operation is usually 7 to 14 days.

-Will be in ICU for a few days where chest tubes and pacer wires
are typically removed and then moved to surgical floor.

-Immunosuppressants are administered the day of the transplant

to prevent rejection

-Rejection, if it occurs, often begins soon after transplantation

but can occur after weeks, months, or even years.

-The most common complications in the PACU are hypotension,

hypertension, and dysrhythmias. The most common cause of
hypotension is unreplaced fluid loss which can lead to
hypovolemic shock.
Complications from transplanted heart
• Rejection • Kidney problems

• Infections • Gout

• Cancer • Osteoporosis

• Atherosclerosis • Graft-versus-host disease

 Follow up visits with your doctor
● You will need to have regular, lifelong follow-up visits with your caregiver after
your transplant. Your blood or urine may be tested often to check the level of
antirejection medicine in your body. You may need to give sample tissue to
determine if your body is accepting the new heart.

● You may need repeat ECGs, an echocardiogram, cardiac catheterization, and

magnetic resonance imaging of your heart. Ask your caregiver when to come back
to have your stitches or chest drains removed. Keep all appointments. Write down
any questions you may have.

● After your heart transplant, you may have feelings of sadness and guilt. You may
have trouble thinking about how the heart in your chest came from someone who
has died.
When to Contact a Healthcare Provider
● One or both of your ankles are swelling.

● You are dizzy and feel like you are going to faint (pass out).

● You fall when trying to get up and walk.

● You feel anxious and can't think clearly.

● You have a cough, sore throat, or a cold sore.

● You have pain in your surgery site that does not get better after taking medicine.

● Your stitches or staples are loose or coming out.

● You have questions or concerns about your condition, medicine, or care.

Medications You May Be Sent Home On
● Antirejection medicine: These help prevent your body from rejecting your new heart.
You may need to take this medicine for the rest of your life.
● Heart medicine: You may need medicines to control your heartbeat and blood pressure.
● Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait
until the pain is severe before you take this medicine.
● Cholesterol medicine: These decrease the amount of cholesterol in your blood.
● Antimicrobial medicine: These prevent a bacterial or fungal infection.
Are you an organ donor?
Works Cited
Cardiac Transplant Program. (n.d.). Retrieved December 02, 2017, from http://columbiasurgery.org/heart-transplant/surgery-
postoperative-care

Heart Transplant. (2017, September 12). Retrieved December 02, 2017, from
http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/CareTreatmentforCongenitalHeartDefects/Heart-
Transplant_UCM_307731_Article.jsp#.WiXpEa2ZmRt

L. (2014). Medical-Surgical Nursing. St. Louis, MI: Jeff Patterson.

M. Hertl. Heart Transplantation. (July 2017). Retrieved December 02, 2017, http://online.statref.com.ezproxy.cayuga-
cc.edu/Document.aspx?docAddress=tq1qN-
aWzU2XkSIZMNjeSw%3d%3d&goBestMatch=true&Index=0&Scroll=12&searchContext=heart+transplant%7cc0%7c%7c10%7c1%7c0%7
c0%7c0%7c0%7c%7cc0&SessionId=27CB0FDIONYOYNLI

Mayo Clinic Staff. (2017, September 19). Heart transplant. Retrieved December 02, 2017, from https://www.mayoclinic.org/tests-
procedures/heart-transplant/details/how-you-prepare/ppc-20206292