The information on this page is not intended to answer all of your questions. If you have a question not answered here, please contact your Cedars-Sinai Heart Transplant Coordinator.
How long will it take for me to get a heart transplant?
Unfortunately, there is no way to predict how long a given patient will remain on the waiting list for a donor heart. The waiting time is dependent on several factors including the urgency for transplantation, size of the heart and blood type. The waiting time may vary from several days when a heart is needed emergently, to months or, in some cases, years.
How are donor hearts matched?
Each transplant center is located within a designated region and potential recipients are on a regional list. Organs are offered to the patients who are the sickest who also match the blood type and size. If a match is not found within the region, organs may be offered from outside the region.
What is the difference between Status 1 and Status 2 patients?
Status 1A is the top priority status. These patients are critically ill, either staying in intensive care units and/or receiving advanced life support therapies. Any available donor hearts would first be offered to status 1A patients on the waiting list.
Status 1B is the next highest priority status after 1A. These patients require special intravenous medications called inotropes (for example, dobutamine, milrinone) to help their heart function adequately while they are waiting for a donor heart. Under current UNOS rules, patients listed as status 1B may wait either in the hospital or at home depending on their medical condition.
Status 2 patients do not require intravenous medications while waiting for transplantation and, for the most part, are not hospitalized while they wait. Donor hearts would be offered to Status 2 patients when there are no Status 1A or Status 1B patients who would be suitable recipients.
What happens if my heart disease worsens while I wait for a donor heart?
Members of the transplant team evaluate candidates regularly and adjust medical treatment as necessary. Sometimes patients need hospitalization and intravenous drugs to support them during the waiting period. Occasionally, mechanical-assist devices are necessary.
How long will I be in the hospital after my transplant surgery?
After the surgery, you will typically spend one to two days in the recovery room, two to three days in the Intensive Care Unit (ICU), and about seven days in the transplant unit. During this time, you will be constantly monitored to ensure that your new heart is functioning well and there are no complications from the surgical procedure. You will also begin taking special medications to help prevent your body from rejecting your new heart. Before you are discharged, you and your family will receive education and instructions on how to manage your medications, take care of your incision site and schedule follow-up visits in our out-patient clinic.
What are all the different medications for?
Heart transplant recipients must take many different medications, each prescribed for a specific therapeutic reason. They fall into four categories:
- Immunosuppressants—drugs and agents which shut down your body's natural immune responses that would damage your new heart.
- Antibiotics, Antivirals and Fungicides—drugs that intercede to fend off infection because your natural immune responses are now disabled.
- Vitamins, Minerals and Nutritional Supplements—compounds to aid your body in its efforts to heal and maintain proper functioning.
- Coronary-Disease Preventing and Antihypertensive Medications—drugs to prevent coronary artery disease and regulate blood pressure.
Most medications will be required immediately after transplant surgery. Over the first year, adjustments will be made by your transplant team, which may include lowering the dosages on some medications and possibly discontinuing others.
Who will take care of my health needs after I leave the hospital?
After your hospital discharge, you will be closely monitored on an out-patient basis by the post transplant team. This will include regular tests on your donor heart, including blood work,echocardiograms, heart biopsies and clinic visits with a transplant cardiologist. The transplant team will communicate with your cardiologist or primary care physicians to provide seamless, coordinated care.
How soon can I return to work?
The appropriate time for you to return to work will depend on at least two factors: how you are feeling after surgery and what type of work you will be doing. As soon as your incision is healed and you are feeling well, you can discuss with your transplant cardiologist when to return to work. Some patients are able to return to work relatively quickly. Whenever deemed medically safe by your transplant cardiologist, we encourage patients to resume working as soon as they feel ready. Generally, most recipients can return to work within six months following surgery.
What happens if rejection occurs after transplantation?
Some patients may experience rejection after heart transplantation. Because rejection typically occurs without symptoms, it is often diagnosed during a scheduled biopsy, which is why it is so important to comply with your schedule of follow-up visits after your transplant surgery. If rejection is detected, it may require adjustment of medications or other therapies. When detected early, most rejection episodes can be resolved successfully.