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Why it's done
By Mayo Clinic staffHeart transplants are performed when other treatments for heart problems haven't worked, leading to heart failure. In adults, heart failure can be caused by:
- Coronary artery disease
- A weakening of the heart muscle (cardiomyopathy)
- Valvular heart disease
- Congenital heart defect — a heart problem you're born with
- Failure of a previous heart transplant
In children, heart failure is most often caused by either a congenital heart defect or a cardiomyopathy.
A heart transplant isn't the right treatment for everyone, however. Certain factors may mean you're not a good candidate for a heart transplant. While each case is considered individually by a transplant center, you could be prevented from having a heart transplant if you:
- Are age 65 or older
- Have another medical condition that could shorten your life, regardless of receiving a donor heart
- Have serious blockages in the arteries in your arms or legs (peripheral artery disease)
- Have a personal medical history of cancer
- Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking
For some people who can't have a heart transplant, another option may be a ventricular assist device (VAD). A ventricular assist device is a miniature pump implanted in your chest that helps pump blood through your body. VADs are commonly used as a temporary treatment for people waiting for a heart transplant, but are increasingly being used as a permanent treatment for heart failure.
- Heart transplant. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/ht/ht_all.html. Accessed Aug. 30, 2010.
- Colucci WS, et al. Indications and contraindications for cardiac transplantation. http://www.uptodate.com/index. Accessed Aug. 30, 2010.
- Heart transplantation in the United States, 1998-2007. U.S. Department of Health and Human Services. http://www.ustransplant.org/annual_reports/current/chapter_v_forprint.pdf. Accessed Aug. 27, 2010.
- Jessup M, et al. 2009 Focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults. Circulation. 2009;119:1977.
- Ventricular assist device. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/vad/vad_all.html. Accessed Aug. 30, 2010.
- Anderson AS. Prognosis after cardiac transplantation. http://www.uptodate.com/index. Accessed Aug. 27, 2010.
- Pina IL. Rehabilitation after cardiac transplantation. http://www.uptodate.com/index. Accessed Aug. 27, 2010.
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