During heart transplant surgery, we replace your failing heart with a donor heart. The Penn Heart Transplant Program team is ready 24 hours a day for notification that a donor heart is available.
If you are at home, we call you and have you come in. At the same time, we send a surgeon to evaluate the heart and bring it back to the hospital.
Heart Transplant Surgery: What to Expect
It's normal to feel nervous about surgery. Our skilled, compassionate team understands these feelings and helps put you at ease. Before surgery, we educate you so you know what to expect before, during and after surgery.
Heart Transplant Procedure Step-by-Step
Heart transplantation is an open-chest surgery. To prepare you, we place tubes to provide support and help us monitor how you are doing. These tubes include:
- An intravenous (IV) line in your arm or hand to give you medicine and fluids
- Thin tubes (catheters) inserted into blood vessels in your neck and wrist to take vital measurements and blood samples
- Foley catheter in your bladder to drain urine
- Stomach tube to drain stomach fluids
Penn's cardiac anesthesiologists administer general anesthesia to keep you sleeping and comfortable. The anesthesiologist also tracks your blood pressure, oxygen levels and heart rate.
During the procedure, your surgeon:
- Makes an incision down the middle of your chest and through your breastbone (sternum). Your breastbone runs from the top of your chest to just below your breasts.
- Splits your sternum open using a retractor tool which holds the sternum apart during the surgery.
- Connects you to a heart-lung bypass machine. The machine collects blood from your veins, adds oxygen to the blood, then pumps the blood to the rest of your body. By rerouting blood around your heart, the surgeon can operate while making sure your body and brain still receive the oxygen they need.
- Separates the major blood vessels and removes the diseased heart.
- Fits the donor heart into the chest cavity, sews it in place and attaches the blood vessels.
- Re-establishes blood flow to the heart and disconnects the bypass machine. If the heart does not start beating on its own, it may require an electric shock.
- Makes sure the new heart is functioning as expected and there are no leaks. Your surgeon may place a pacemaker or other device to temporarily support your new heart.
- Removes the retractor, closes the sternum and sews the sternum together with thin wires.
- Closes the incision using sutures or surgical staples and covers the incision with a sterile bandage.
- Places temporary tubes in your chest to drain blood and fluids from around the heart while you heal.
Dual-Organ Transplants
We partner with other transplant programs in the Penn Transplant Institute to provide heart-lung, heart-liver and heart-kidney transplants. Our transplant surgeons throughout the institute are known and respected for their expertise. They work closely together to ensure you receive the highest level of care.
For heart-lung transplants, you receive the heart and lungs at the same time. For heart-liver and heart-kidney transplants, we transplant the heart first, then the liver or kidney a few hours later.
Transfer to the ICU
Recovery begins the moment surgery ends. After surgery, we transfer you to the cardiothoracic ICU where the average stay is about five days. You then go to the cardiac step-down unit to prepare for discharge. Learn more about heart transplant recovery.
About one in five patients need extra support to help their heart recover. Your surgeon may place a temporary device during surgery to help your heart function. When you wake up, you may notice extra tubes or machines next to your bed. While you are in the ICU, your heart transplant team removes these devices as your heart starts to function on its own.
How Long Does Heart Transplant Surgery Take?
Heart transplant surgery lasts between six and 12 hours. The exact time depends several factors. If you've had previous open heart surgery, the procedure may take longer. Placement of a temporary device to help support your heart while you recover also increases the duration of the surgery.
A Practice Run
Sometimes after a closer evaluation, we find that the heart is not a good match after all. You may feel disappointed, but we make this decision to protect you. It's important to be patient and stay positive. If you need to talk to someone, let our social workers know. We offer a range of heart transplant support services to help you cope during your transplant journey.
Heart Transplant Surgery: Why Choose Penn Medicine?
If a heart transplant is your best option, you want an experienced team on your side. The Penn Heart Transplant Program is one of the top programs in the U.S. When you choose us for heart transplant surgery, you'll find:
- Extensive experience: The Penn Heart Transplant program has decades of experience in heart transplantation, including complex, high-risk cases other centers cannot accept.
- Complete care: From surgery to the intensive care unit (ICU) to the step-down unit, our teams work together seamlessly to help you recover and prepare you for discharge.
- Multi-organ transplants: We are one of the few transplant centers in the U.S. that perform all types of dual-organ heart transplants. This expertise allows you to receive a new lung, liver or kidney when we replace your heart.
- Homelike accommodations: For patients who live outside the Philadelphia area, we offer affordable lodging at the Clyde F. Barker Penn Transplant House.
"The First Thing I Felt Was My Heartbeat"
Chemotherapy led to heart failure and heart transplant. When Derek felt his heartbeat after surgery, he was overwhelmed and committed to never taking his good health for granted. Find out more about Derek's story and how one year after his transplant, he finished a triathlon.
Make an Appointment
Please call 800-789-7366 or request a callback.