Mechanical Circulatory Support & Heart Transplantation Program

A donor heart must be transplanted within four hours to remain viable. 

Donors and recipients must have compatible blood types.

Donors and recipients must have compatible body sizes, e.g. a heart from a donor who is six feet tall may be too large for a recipient whose height is only five feet.

When two recipients are equally compatible with a donor, the heart is given to the patient whose illness is most severe and/or who has been on the transplant list the longest.

To ensure that the donor heart is received in less than four hours, the surgical team that removes the heart from the donor remains in constant contact with the recipient team at the Heart Center.

While waiting for the heart to arrive, the recipient is prepared for surgery as quickly as possible. The patient is placed on an extracorporeal membrane oxygenation machine, also known as ECMO. Upon arrival of the donor heart, the surgeons remove the recipient's diseased heart, then prepare and implant the new heart. Following the 90-minute procedure, the patient is removed from the heart-lung machine. Once heart function is stable, the patient is moved to the intensive care unit for further care.

Rejection occurs when the patient's immune system recognizes the new heart as foreign and mounts an immune reaction to it. The new heart is biopsied routinely to look for evidence of rejection, and immunosuppressive medication is adjusted, as necessary.

At home, patients watch for other signs of rejection, including shortness of breath, flu-like symptoms and low-grade fever. Although recipients must take anti-rejection medication for the rest of their lives, the first year following the transplantation procedure is the most critical. Fortunately, severe rejection is very rare, and most cases can be treated by increasing rejection medications.