What is a heart transplant?

A heart transplant is a surgery that replaces a heart that no longer functions properly with a healthy heart from a deceased donor. The donor is someone who has recently passed away.

If you have severe ('end-stage') heart failure, your heart can't pump enough blood around your body. This makes it hard for your organs to keep working properly. If other treatments don't work, you may need a heart transplant to keep you alive.

When a donor heart becomes available, it is matched to people on the waiting list based on blood group and body size. The heart is usually offered to the person who needs it most urgently.

Read more about organ and tissue donation, organ transplants and life after a transplant.

What are the benefits of a heart transplant?

A heart transplant can improve your quality of life and even save your life. If you are living with heart failure, your ability to do ordinary day-to-day tasks and physical activities may be limited. You may not be able to look after yourself and work.

After your heart transplant and a recovery period, you should be able to gradually return to your regular activities. Talk to your health care team before going back to work.

Children can also return to school after recovering from their transplant.

What does a heart transplant involve?

A heart transplant has several steps and is performed under general anaesthetic. As soon as a donor heart becomes available, you will be called to go to the hospital. You will need to stop eating and drinking (fast) to prepare for surgery.

A heart transplant can take between 4 and 10 hours. Your doctor will make a cut down the middle of your chest. Usually, your surgeon will remove your heart and replace it with the donor heart. Sometimes, they may attach the new heart to your existing heart.

Once your new heart is in place, your surgeon will connect it to temporary pacing wires. Until your new heart starts working, you will be connected to a machine that pumps blood around your body.

Your donor heart will be surgically removed from a donor who has recently passed away.

How can I prepare myself for a heart transplant?

If your healthcare team believes you are suitable for a heart transplant, you will be placed on a waiting list for a donor heart. Your medical team will closely support and monitor you during this time.

To prepare, you will have medical tests at an outpatient clinic every 4 to 8 weeks to check your health. If you have other medical conditions, such as diabetes, your doctors will help you control your blood sugar levels. This can improve your health before and after the transplant.

You will also meet with a psychologist. They will assess your:

• coping skills
• support network
• commitment to the life-long treatment needed after a heart transplant

At the same time, you will begin a cardiac rehabilitation program. This program will help you make lifestyle changes, such as improving your diet and doing regular exercise. This can improve your health and support your recovery after the transplant.

Read more about preparing for surgery.

How soon will I recover?

After your transplant, you will stay in hospital for 10 to 14 days. In the first few days after surgery, you will be in intensive care, then move to the cardiac ward once you are stable.

Your heart rhythm will be closely monitored and your healthcare team will encourage you to take part in physiotherapy. You will also need to take medicines to lower your immune system. This helps prevent your body from rejecting the transplant.

When you are well enough to go home, you will have regular medical check-ups. You will also join exercise and education programs, known as cardiac (heart) rehabilitation.

A team of health professionals will work together to support your recovery. This team includes:

• doctors
• nurses
• physiotherapists
• occupational therapists
• dietitians
• social workers

What complications can happen?

After your heart transplant, complications may happen, including:

• infections
• rejection of your donor heart
• diabetes or cancer as side effects from anti-rejection medicines

Rejection of your donor heart

Your immune system may reject your heart immediately after your surgery (acute rejection) or many years later (chronic rejection). Rejection happens when your body sees your new heart as foreign and attacks it.

Rejection is one of the biggest risks after a transplant. To prevent this, you will need to take anti-rejection medicines for the rest of your life. You will also have regular check-ups to monitor for signs of rejection.

Rejection doesn't always cause symptoms. Ongoing chronic rejection can lead to coronary artery disease. Contact your transplant team if you have:

• fatigue (tiredness)
• loss of appetite
• shortness of breath
• swelling in your ankles or hands (oedema)
• weight gain

Since anti-rejection medicines weaken your immune system, it's important to avoid infections. Find out how to maintain a healthy lifestyle after a transplant.

Are there alternatives to a heart transplant?

A heart transplant is the best treatment for severe heart failure, but other options are available if a transplant isn't possible.

Treatments to help manage your symptoms and improve quality of life include:

• medicines — to treat your heart failure or other conditions that affect your heart
• surgeries — to improve heart function
• procedures — such as insertion of a mechanical device into your chest to help your heart
• cardiac rehabilitation programs — to support heart health

What will happen if I decide not to have a heart transplant or it is delayed?

If you choose not to have a heart transplant or if it's delayed, your doctors will adjust your medical care to support you.

There is a waitlist for donor hearts, as not enough are available for everyone who needs one. While you wait, your doctors may refer you to palliative care.

Palliative care can help manage symptoms and improve your quality of life, whether you are waiting for a transplant or choosing not to have one. It offers support for people living with severe heart failure or other chronic illnesses.

Learn more about how to become an organ and tissue donor.

Resources and support

• Transplant Australia offers information about heart transplants.
• Australian Heart and Lung Transplants Association offers support to heart and lung transplant patients and their families.
• Heart Foundation's support program, MyHeart MyLife, helps people living with heart disease and those who care for them.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Other languages

• Heart Foundation offers brochures about heart health in a range of community languages.

Aboriginal and/or Torres Strait Islander peoples

• St Vincent's Heart Health and the Heart Foundation offer heart health information for Aboriginal and/or Torres Strait Islander people.