University of Virginia Health System

Heart Transplantation

The Procedure

The heart transplant is performed by the cardiothoracic surgery team. The surgical team removes the donor heart (and occasionally lungs and generally the liver, kidneys and pancreas) from the donor patient. Because of the difficulty of preserving the heart muscle, hearts are required to be transplanted within 4 hours of removal.

The surgical team removes the recipient’s heart. The donor heart is then attached to the major blood vessels and to the right atrium and left atrium of the recipient's native heart.

Once a transplant is completed the transplant recipient is moved to the intensive care unit for a stay of between 2 and 4 days. The patient will generally be moved to another care unit for a total stay of between 7 and 14 days after the transplant.

The First Few Days

In the early period after the heart transplant, special precautions will be taken to ensure that the recipient remains infection-free: everyone entering the hospital room will be required to wash their hands and people who are ill should not come to visit until they are well. Transplant recipients require close monitoring and follow-up after transplantation, especially during the first post-transplant year and includes frequent lab work, biopsies and appointments with UVa's heart transplant team.

Recovery

Recovery from the operation brings with it the recognition that maintaining good health will involve many factors, some of which are familiar while many are entirely new. The transplant team will lead the heart transplant recipient in a training program that will focus on these many factors, including: 

• Transplant immunology
  • How transplant medications work
• Detecting rejection
  • Biopsy schedule
  • Echo schedule
  • Heart Failure symptoms
• Medications
  • Why we give them
  • Why they work
  • Side effects
  • Interactions with other medications
• Opportunistic Infections
  • CMV
  • Pneumocystis Pneumonia
• Infection control
  • Washing hands, masks, staying out of crowds
  • Vaccinations
• Vital Signs
  • How often
  • How to record
  • When to call vital signs in to the office
  • When to contact the transplant coordinator with abnormal values
• Nutrition
  • Weight control
  • Calcium and Magnesium replacement
  • Cholesterol education
• Exercise/Denervation
  • Cardiac Rehabilitation
• Lab Work
  • When to have lab work completed