Expectations after surgery:

Heart transplant prolongs the life of a patient who would otherwise die. About 80% of heart transplants are alive 2 years after the operation. The main problem, as with other transplants, is graft rejection. If rejection can be controlled, the patient's survival can be increased to over 10 years.

Drugs that prevent transplant rejection must be taken for the rest of the patient's life. Normal activities can resume as soon as the patient feels well enough and after consulting with the doctor. However, vigorous physical activities should be avoided.

The major problems are the same for all major organ transplants:

• Finding a donor
• Fighting the rejection effect
• The cost of the surgery
• Avoiding infection
• Avoiding blocked blood vessels in the transplanted organ

Finding a donor can be difficult. In heart transplantation, the healthy heart must come from a person who recently died or is on life-support and is brain dead. This is different than a kidney transplant, because a kidney may be donated by a living person.

Timing is very important because there is no good way to keep a donor heart alive for long periods of time. A person in need of a heart transplant may be kept alive on artificial heart devices for longer and longer periods of time. However, artificial hearts also have major risks. While some of these devices are fully approved, others are still considered experimental.

Fighting rejection is an ongoing process. The body's immune system considers the transplanted organ an infection and fights it. For this reason, organ transplant patients must take drugs such as cyclosporine and corticosteroids that suppress the body's immune response. The downside of these drugs is that they weaken the body's natural defense against infection.

Convalescence:

The recovery period is about 6 weeks. The patient must move the legs often to reduce the risk of deep venous thrombosis. The stitches or clips are removed about 1 week after surgery.