Dr. Sunil Agarwal

Heart Transplant


A heart transplant is surgery to remove the diseased heart from a person and replace it with a healthy one from an organ donor. To remove the heart from the donor, two or more healthcare providers must declare the donor brain-dead. Before you can be put on a waiting list for a heart transplant, a healthcare provider makes the decision that this is the best treatment choice for your heart failure. A healthcare team also makes sure you are otherwise healthy enough to go through the transplant process.

  • Why might I need a heart transplant?

    End-stage heart failure is a disease in which the heart muscle is failing severely in its attempt to pump blood through the body. It means other treatments are no longer working. End-stage heart failure is the final stage of heart failure. Despite its name, a diagnosis of heart failure does not mean the heart is about to stop beating. The term failure means the heart muscle is failing to pump blood normally because it is damaged very weak, or both.

    Some causes of heart failure include:

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    • Heart attack (myocardial infarction or MI)
    • Viral infection of the heart muscle
    • High blood pressure
    • Heart valve disease
    • Heart defects present at birth (congenital)
    • Irregular heartbeats (arrhythmias)
    • High blood pressure in the lungs (pulmonary hypertension)
    • Alcoholism or drug abuse
    • Chronic lung diseases, such as emphysema or chronic obstructive pulmonary disease (COPD)
    • Heart muscle is enlarged, thick, and stiff (cardiomyopathy)
    • Low red blood cell count (anemia)

    Your healthcare provider may have other reasons to recommend a heart transplant.

    • Infection
    • Bleeding during or after the surgery
    • Blood clots that can cause heart attack, stroke, or lung problems
    • Breathing problems
    • Kidney failure
    • Coronary allograft vasculopathy (CAV). This is a problem with the blood vessels that carry blood to the heart muscle itself. They become thick and hard. This can cause serious heart muscle damage.
    • Failure of the donor heart
    • Death
  • The transplant evaluation process will include:

    Psychological and social evaluation. Some psychological and social issues that are involved in organ transplant include stress, financial issues, and support from family or significant others. These factors can greatly affect how you do after the transplant.

    Blood tests. You will need blood tests to help find a good donor match and help improve the chances that the donor's heart will not be rejected.

    Diagnostic tests. You will need tests to assess your lungs as well as your overall health. These tests may include X-rays, ultrasound procedures, CT scans, pulmonary function tests (PFTs), and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram.

    Other preparations. You will get several vaccines to decrease the chances of developing infections that can affect the transplanted heart.