Heart transplantation is surgery to remove a damaged or diseased heart and replace it with a healthy donor heart.

Finding a donor heart can be difficult. The heart is donated by someone who has been declared brain-dead but remains on life support. The donor heart must be matched as closely as possible to your tissue type to reduce the chance that your body will reject the new heart.

The patient is put into a deep sleep with general anesthesia, and a cut is made through the breast bone.

• The patient's blood is circulated through a heart-lung bypass machine to keep the blood oxygen-rich during the surgery.
• The patient's diseased heart is removed and the donor heart is stitched in place. The heart-lung machine is disconnected. Blood flows through the transplanted heart.
• Tubes may be inserted to drain air, fluid, and blood out of the chest for several days, to allow the lungs to fully re-expand.

A heart transplant may be recommended for:

• Severe angina that can no longer be treated with medications or surgeries to repair the coronary arteries
• Severe heart failure, when medicines, other treatments, and surgery no longer help. Possible causes of severe heart failure are:
  • Coronary artery disease
  • Cardiomyopathy (disease of the heart muscle)
  • Heart valve disease with congestive heart failure
• Severe heart defects that were present at birth and cannot be fixed with surgery
• Life-threatening abnormal heart beats or rhythms that do not respond to other therapy

Heart transplant surgery may NOT be recommended for patients who have:

• Had cancer
• Infections such as hepatitis, that are considered to be active
• Insulin-dependent diabetes with poor function of other organs
• Kidney, lung, nerve, or liver disease
• Malnutrition
• Other diseases that affect the blood vessels of the neck and leg
• Smoking, alcohol or drug abuse, or other lifestyle habits that may damage the new heart

The doctor may also recommend against a heart transplant if there is concern that the patient will not be able to comply with the many hospital and doctor's office visits, tests, and medications needed to keep the new heart healthy.