Living Donation

Heart Transplant Surgery: Preparation and Procedure

When a heart becomes available, your transplant coordinator will call you. It's very important that you get to the hospital right away.

We ask that anyone on the heart transplant waiting list be able to get to UPMC within 4 hours.

Before coming to the hospital for your heart transplant:

  • Do not eat or drink anything.
  • Pack your phone and charger.
  • Bring your medicines and also any medicines that your caregiver may need.
  • Hibiclens ® (antiseptic/antimicrobial liquid soap) shower if able.
  • If you have a ventricular assist device (VAD), bring your equipment.

Preparing for Heart Transplant Surgery

When you arrive at UPMC, we will begin to prepare you for surgery.

The donor team will inspect the heart to make sure it's good for transplant and a match for you. In the meantime, you will have a history and physical completed, blood work, and x-rays to make sure that you're in good health with no active illnesses.

Before moving you to the operating room, the anesthesiologist will speak with you about what to expect. You will receive general anesthesia and sleep through the heart transplant procedure. You will also speak to one of the surgical team members to get consent for the surgery to take place.

How Long Does a Heart Transplant Surgery Take?

The amount of time a heart transplant surgery requires depends on the complexity of your specific case and necessary procedures. 

If you do not have a heart assistive device (VAD): Surgery should take 3 or 4 hours.

If you have a ventricular assist device (LVAD) that surgeons needs to remove first, or if you have had prior chest surgeries: Surgery should take 6 or 8 hours. 

Your total time in the operating room may be longer than the actual procedure because the heart transplant team has to coordinate with the donor site.

How Do Doctors Perform a Heart Transplant?

During the procedure, your transplant surgeon will:

  • Remove your diseased heart.
  • Replace it with the donor heart.

During the heart transplant procedure, we will connect you to a heart-lung machine.

This machine performs the work of your heart and takes the strain off your lungs. It purifies and oxygenates your blood outside your body and pumps it back into your body during the operation.

How Long Will I Be in the Hospital After Heart Transplant Surgery?

After your heart transplant procedure, you will remain in the transplant intensive care unit (ICU) for 2 or 3 days. Once you are off the ventilator and recovering well, we will move you to a patient room on the transplant floor.

You will start taking anti-rejection medications immediately after surgery.

When your body detects something new, your immune system begins working to fight what it views as a threat. Anti-rejection drugs suppress your immune system's natural response to allow your body to accept the new organ.

Most people remain in the hospital for about 7 to 10 days after heart transplant surgery.

During this time, the heart transplant team will:

  • Monitor you for rejection, infection, or other complications.
  • Teach you coughing and breathing exercises that you will need to do regularly. These help keep your lungs clear and prevent pneumonia.
  • Adjust your medications to find the right combination.
  • Work with you and your caregiver to prepare for taking care of yourself at home.

The nutritionist on your care team will also create and review an eating plan for you to follow at home.

Before you leave the hospital, make sure you and your caregiver clearly understand:

  • Your medicine schedule.
  • The eating and nutrition guidelines.
  • Any other instructions for at-home care.
  • Your follow-up schedule (blood work and clinical visits)

Please feel free to ask any member of your UPMC care team for explanations or more information about any of your instructions. The heart transplant team is here for you through the transplant process. Do not hesitate to call the Cardiothoracic Transplant office at
412-648-6202 or toll free at 844-548-4591 for additional information.

For people who need more help after heart transplant surgery, we may suggest spending time in an inpatient rehabilitation program after before going home.

Fill out a Contact Form to schedule an appointment with the UPMC Heart Transplant Program, or to refer a patient.