Not every patient with advanced heart failure will need a heart transplant. We carefully evaluate each patient to ensure that the option is pursued only when all others have been exhausted.
Heart Transplant Clinic: Comprehensive, Personalized Care
The Heart Transplant Clinic is the dedicated, central home for our patient’s pre-transplant evaluation and post-transplant care. To meet the many needs transplant patients may face, the clinic’s multidisciplinary team of experts includes transplant coordinators, dietitians, pharmacists, social workers, psychologists, case managers and financial counselors. We understand that the overall quality of care before, during and after a patient’s transplant surgery is crucial to a successful transplant process.
Preparing for Heart Transplant
Before transplant, patients are thoroughly screened to ensure that they are healthy enough for transplant. The evaluation covers mental and physical health, and includes blood tests, a medical history review and diagnostic tests of the lungs and other body systems.
Once accepted for transplant, patients are placed on the United Network for Organ Sharing (UNOS) wait list. Transplant coordinators facilitate education for patients and families to help them take the best care of themselves once out of the hospital.
Heart Transplant Surgery
Heart transplant surgery is complex and the approach varies based on each patient’s unique needs. The entire process is orchestrated by transplant coordinators who guide patients and their families through each step. Generally, surgery lasts about four to five hours.
Heart transplant at Froedtert Hospital involves the skills of heart surgeons, transplant cardiologists, anesthesiologists, nurses, technicians and other professionals, all specialists in the procedure. They prepare patients for surgery and administer general anesthesia to help them remain unconscious during the surgery.
Once patients are asleep, surgeons make an incision down the center of the chest and separate the two halves of the breastbone to allow access to the heart. The patient’s blood supply is rerouted temporarily from the heart to a cardiopulmonary bypass machine (heart-lung machine). At this point, the patient’s diseased heart is removed, the healthy donor heart implanted and the patient’s blood supply connected to the new heart. Physicians then shock the heart to start it beating and pumping blood.
Following a thorough check of the heart’s function and the blood connections, the breastbones are rejoined and the chest incision closed. Patients then proceed to the recovery room.
Recovery From Heart Transplant Surgery
Following surgery, heart transplant patients receive care in the cardiovascular intensive care unit for two or three days until they are moved to a surgical nursing unit when their condition is more stable. Nurses who staff the units are specially trained to care for heart transplant patients. Post-transplant patients are seen daily by cardiologists for the medical component of their care, and by heart transplant surgeons for post-surgical care. Patients can expect to be in the hospital for about two weeks.
Life-Long Transplant Care Resources
Heart transplant patients need follow-up care for the rest of their lives. Patients may also need pacemakers or other heart and vascular care in the years following their heart transplants. Our Heart and Vascular team provides the full continuum of heart care options. Additionally we offer a Transplant Support Group that is open to any heart, lung or abdominal (liver and kidney) transplant patient and their caregivers.
Post-transplant coordinators in our Heart Transplant Clinic work with patients to coordinate every aspect of their follow-up transplant care. Having dedicated, experienced staff and knowledgeable resources all in one location gives patients a familiar place where their unique needs are well-understood and met.
For more information about the heart transplant process, see our FAQ.
FAQ and Resources
What conditions lead to the need for a heart transplant?
Most people who become candidates for a heart transplant have severe heart failure from one of several causes.
- Ischemic cardiomyopathy. These patients may have had multiple heart attacks or they may have had coronary bypass surgery and no longer have any vessels to use for a bypass procedure. They also may not be able to undergo further stent procedures.
- Idiopathic cardiomyopathy. These patients, who tend to be younger, have heart failure with an unknown cause.
- Congenital heart disease. This emerging group of patients are people who have congenital heart disease that was either repaired when they were children or was never repaired. Now their hearts are starting to fail, and transplant may become an option.
Do I have any other treatment options besides transplantation?
There are a variety of treatment options available, including ventricular assist devices (VADs), but there is no one solution for every patient. Before considering transplantation, other treatments generally have been exhausted. While some organ transplants may be considered life-enhancing, a heart transplant is normally undertaken as a lifesaving procedure.
Who are good candidates for heart transplant?
Determining who is a good candidate depends on many factors. It can depend on the severity of the patient’s heart failure, overall health and whether they suffer from coronary disease, valve disease or some other condition.
Am I too old for a heart transplant?
While patients over age 70 are generally less likely to receive a transplant, that is not an absolute standard. Age is one of many factors considered.
Will other medical problems eliminate me from consideration?
Diseases that could limit the patient’s longevity or ability to recover might disqualify them from becoming a transplant candidate. For example, patients who have had cancer in the past five years are unlikely to receive a transplant.
How do I get on the transplant list? What about wait times?
If patients and physicians feel they have exhausted all treatment options and need to consider heart transplant, patients will undergo an extensive evaluation. The transplant physicians and team will review patient medical histories, conduct diagnostic tests and assess social and mental readiness for transplant. We want to make sure that patients are healthy enough for the surgery and able to comply with the care regime required after transplant to keep healthy.
Once approved for transplant, the care team will make arrangements for the patient’s name to be placed on the transplant waiting list and will discuss wait times with them. Wait times may vary greatly depending upon blood type.
I live a few hours away. Can I have pre-transplant testing done closer to home?
Transplant coordinators make it a priority to schedule pre-transplant screenings all in one day or as is most easy and convenient for patients. It is preferred that tests related to the evaluation are done at our facility so results are timely and coordinated. If scheduling becomes a problem, however, transplant coordinator can suggest other options.
What will my life be like after heart transplant?
Many people are able to resume normal activities and work without limitations after heart transplant. Patients will need to consider themselves heart transplant patients for the rest of their lives, however, as they take medications, have regular check-ups and stay as healthy as possible. Some patients find that other conditions develop after transplant, such as diabetes, kidney disease or high blood pressure. Keep in mind that conditions are manageable compared to the heart condition that led to transplant. No matter what, the transplant care team will be there with the care, tools and support patients need to live the highest quality of life.
Will I ever need another heart transplant after my first heart transplant?
Heart transplant patients generally live 13 – 15 years after their first heart transplant before a second transplant may be needed. Thanks to today’s medical advancements, it is not unusual for patients to live long enough to need more than one transplant.
Where can I get more information?
- United Network of Organ Sharing (UNOS) – Information about the organ allocation process and access to various national, regional, state and center-specific data reports.
- Transplant Living – A patient education site sponsored by UNOS to inform about life before and after transplant.
- Scientific Registry of Transplant Recipients – Generates reports to compare survival rates of heart transplant facilities across the country
- Visit Children’s Wisconsin, Versiti Blood Center of Wisconsin and the Medical College of Wisconsin to learn more about our Transplant Center partners.
Transplant and the COVID-19 Vaccine
Transplant patients may be at a higher risk of severe COVID-19, and we have seen worse outcomes if they do get it. Due to the increased risk, we recommend transplant patients get the vaccine.