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Risks
By Mayo Clinic staffAlthough receiving a donor heart can save your life, having a heart transplant has many risks. The most significant risk is your body rejecting the donor heart.
Rejection of the donor heart
Your immune system may see your donor heart as a foreign object that's not supposed to be in your body. If this happens, your immune system will try to attack your donor heart. Although all people who receive a heart transplant receive immunosuppressants — medications that suppress the activity of your immune system — nearly 25 percent of heart transplant recipients still have some signs of rejection during the first year after transplantation.
To determine whether your body is rejecting the new heart, you'll have frequent biopsy tests for several months after your transplant. During the biopsy, a tube is inserted into a vein in your neck or groin and directed to your heart. A biopsy device is run through the tube to extract a tiny sample of heart tissue, which is examined in a lab. Because rejection is most likely to occur in the early weeks and months after heart transplantation, the frequency of heart biopsies is greatest during this early period. It's possible you'd have signs or symptoms that your body is rejecting your donor heart. These signs and symptoms could include:
- Shortness of breath
- Fever
- Weight gain due to water retention
- Not urinating as much as usual
- Fatigue
Additional risks
Other risks following your heart transplant include:
- Problems with your arteries. After your transplant, it's possible the walls of the arteries in your heart could thicken and harden, leading to cardiac allograft vasculopathy (CAV). This can make blood circulation through your heart difficult and can cause a heart attack, heart failure, heart arrhythmias or sudden cardiac death.
- Medication side effects. The immunosuppressants you'll need to take for the rest of your life can cause serious kidney damage and other problems.
- Cancer. Immunosuppressants can also increase your cancer risk. Taking these medications can put you at a greater risk of skin and lip tumors and non-Hodgkin's lymphoma, among others.
- Infection. Immunosuppressants decrease your body's ability to fight infection. Many people who have heart transplants have an infection that requires them to be admitted to the hospital the first year after their transplant.
- Heart transplant. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/ht/ht_all.html. Accessed Oct. 29, 2008.
- Colucci WS, et al. Indications and contraindications for cardiac transplantation. http://www.uptodate.com/index. Accessed Oct. 27, 2008.
- Hunt SA. Taking heart — Cardiac transplantation past, present, and future. New England Journal of Medicine. 2006;355:231.
- Taylor DO, et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-fourth official adult heart transplant report — 2007. Journal of Heart and Lung Transplantation. 2007;26:769.
- Jurt U, et al. Heart transplant: What to expect. Circulation. 2002;106:1750.
- Anderson AS. Prognosis after cardiac transplantation. http://www.uptodate.com/index. Accessed Oct. 27, 2008.
- Pina IL. Rehabilitation after cardiac transplantation. http://www.uptodate.com/index. Accessed Oct. 27, 2008.
- Left ventricular assist device. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4599. Accessed Oct. 29, 2008.
