Heart Transplant Surgery
When an organ becomes available, a transplant donor coordinator will call you. Calls like this often come at night, so be sure to answer your phone. Make sure your coordinator has all the contact phone numbers for you and your friends/family so they can find you at any time.
The donor coordinator will review your current health status, and give you instructions for coming to the hospital. Please be sure to:
- Have the donor coordinator’s name and the hospital’s phone number.
- Ask if you should stop any of your medicines. If you take insulin for diabetes, ask what to do about your insulin.
- Stop all foods and liquids. If you have taken insulin, make sure you mention this to the nurse coordinator.
- Remember to bring the items you’ll need while in the hospital (transplant handbook, etc.).
- Make sure you bring your cell phone with you and it is charged in case the donor coordinator needs to contact you while you are on the road.
- Make sure you have someone to drive you.
Once you arrive at the hospital, please stop at the admissions department. They will know you are coming and will direct you to your room. After you are admitted, we will do blood tests and prepare you for surgery.
Your family can stay with you until it is time to go to the operating room. We will then direct them to the waiting area for the Cardiac Surgical Unit on the third floor. After your surgery, the surgeons will meet your family there.
The transplant procedure
The actual heart transplant will take about 3-6 hours. A surgical coordinator/and OR staff will be available to give your family emotional support and keep them informed.
After surgery, you will be taken to the Cardiac Surgical unit (CSU). You will stay there until you are stable and can breathe on your own. Visiting hours are limited. You will be on reverse isolation while in the unit and only immediate family will be allowed in your room.
You may be slow to wake up after surgery. We will give you medicine to control pain and help you relax. You will find that several tubes were placed in your body during surgery.
Endotracheal (breathing) tube: You will have a tube in your throat to help you breathe. It may be uncomfortable, but we will give you medicine to help you relax. You cannot talk while the tube is in your mouth. The doctors will remove the tube when your lungs are working well and you are awake enough to breathe on your own. Some people do not even remember having this tube in place, because of the medicines given for relaxation.
Chest tubes: Chest tubes will be placed to help drain fluid from your chest. You will have the tubes for a few days.
Foley catheter (urinary tube): This tube drains the urine from your bladder. It is important to monitor your urine output and kidney function carefully.
Intravenous (IV) lines: You will have many IV lines, including a central line. This tube is placed in a large vein in your neck. We use it to give medicines, fluids and blood transfusions. It is also used to take blood samples and check fluid pressures in the body.
Nasogastric tube: This helps keep your stomach empty so you don’t get nauseated (feel sick to your stomach). During surgery, the tube is placed in the nose and goes down into your stomach. It will stay in place until you can pass gas.
The transplant unit
Once you are stable and your breathing tube has been removed, we will move you to the transplant unit on 8A. You will be in a private room. If no medical reasons prohibit it, a family member may stay in your room in the transplant unit. Because transplant patients have a high risk of infection, we ask that children under 12 years of age not visit the transplant unit. We will facilitate a visit with a child under 12 in a waiting room on an adjacent unit or in the Main Lobby.
We will draw blood for tests daily. You will also have X-rays. Visits from your surgeons and cardiology teams will also occur daily.
You will learn about your medicines and how to take care of yourself. You and your support person(s) will be educated about how to care for yourself. Your nurses and coordinator will work closely with you as you learn. You and your support person will attend a pharmacy education class and nutrition class prior to discharge. Your support person must be available for an education session with the coordinator prior to your discharge. By the time you go home you will know your medications and how to take them. You will know how to record your lab values, check your blood pressure and more. Once you go home, you will need to keep track of your lab values, blood pressures, daily weights, and blood sugars. Please bring your transplant log to all clinic visits.
Leaving the hospital
You can expect to stay in the hospital for seven to 14 days after surgery. Some people stay longer, depending on their condition before surgery. Your first biopsy to check for rejection will be done before discharge. This procedure is the same as a right heart catheterization, and a few heart cells will be analyzed for evidence of rejection. There should be minimal discomfort from this procedure, though you may feel some pressure when the catheter is inserted. Once we have the results and if all right, then you can discharged.