At Mayo Clinic, doctors from many specialties work as a team to develop the most appropriate plan of care for you. They take the time to listen to your questions and concerns and provide comprehensive care, including nutritional, social, financial and spiritual issues. They follow you before, during and after your transplant, to ensure the best results and quality of care.

Before your transplant

Mayo Clinic doctors trained in heart transplantation and others will evaluate you to determine if a heart transplant will be safe and beneficial for you.

Your evaluation may last one to two weeks and may include:

• Physical examination
• Blood tests, including blood and tissue type analysis
• Imaging tests, including chest X-rays
• Cardiac catheterization
• Consultations with specialists in heart and blood vessel disease (cardiologists), transplant surgery, social services and others

A team of doctors trained in heart and blood vessel disease (cardiologists), transplant surgery, infectious diseases, mental health conditions (psychiatrists) and other areas evaluate you to determine if you're eligible for a heart transplant.

Doctors will explain what to expect after a heart transplant, including taking medications, lifestyle changes and other changes. Doctors will also discuss with you the risks and benefits of transplant surgery.

If you're approved for a heart transplant, you'll be placed on a waiting list for a donor heart. You may be on a waiting list from a few days to several years. You'll need to manage your current health condition and have regular follow-up appointments with your doctor. While waiting for a donor heart, you'll need to remain in close contact with the transplant team and notify your transplant coordinator of any significant changes in your medical or social situation. You should be prepared to get to the hospital quickly after you receive notice that a donor heart is available.

You may be eligible for a ventricular assist device or a total artificial heart to aid circulation while waiting for a heart transplant, or as a treatment instead of a heart transplant.

Transplant surgery

Once a potential donor heart is found, a transplant team member will instruct you to come to Mayo Clinic as soon as possible.

Before your transplant, you'll have a physical examination, blood tests, urine tests, a chest X-ray and other tests. Doctors also will conduct a final assessment of the donor heart to ensure it's acceptable.

Before surgery, you'll receive general anesthesia. A heart-lung bypass machine will pump blood through your lungs and body during the transplant. Surgeons will make a large incision in your chest, remove your heart and replace it with the donor heart. Surgeons then will attach your donor heart.

Sometimes surgeons may perform a heart-lung, heart-kidney, heart-liver or heart-lung-liver transplant for people who are eligible.

After your transplant, you'll usually stay in the hospital one to two weeks to recover. During your hospital stay, your transplant team will monitor your recovery process. Your treatment team will provide you with instructions on post-transplant recovery, care, lifestyle changes and medications.

After your transplant

After your transplant, you'll need to stay near Mayo Clinic for about two to three months so your doctors can closely monitor your progress and recovery, and monitor your heart for rejection.

• Follow-up care. Your doctor will update your primary health care provider about your progress and give recommendations for your care at home. In addition, a certified transplant nurse coordinator will provide follow-up care for life, and answer your questions and communicate with you and your primary health care provider.

  You'll have several follow-up appointments at Mayo Clinic for about three months. After you return home, you'll have follow-up appointments. The frequency of your appointments will be determined by your treatment team. Your follow-up appointments may include blood tests, a heart biopsy and other tests. In a heart biopsy, doctors remove very small samples of your heart tissue to test for signs of rejection. You'll also have several tests at Mayo Clinic once a year, or more often if necessary.

• Medications. You'll need to take immunosuppressant medications daily for life to keep your body from rejecting your donor heart. Your transplant team will discuss your new medications in detail.
• Returning to wellness. The transplant team considers your return to wellness after your transplant a priority. You'll be given specific guidelines to return to wellness through an exercise plan and a nutrition plan. You'll also participate in cardiac rehabilitation. Staff may give you other lifestyle guidelines, such as wearing sunscreen and not using tobacco products. Your transplant team will work with you to help you make healthy lifestyle choices to achieve the best possible transplant outcome.

Read more about heart transplant.

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July 11, 2013