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What happens after a heart transplant?

After surgery, you will regain consciousness in the open heart recovery intensive care unit (ICU). Among all the people moving around you, there will be one nurse who is assigned to caring just for you. All the cardiac ICU nurses are specially trained to care for transplant patients, and you are in expert hands. While you are in the ICU, blood tests, EKGs, and chest x-rays will be done frequently to follow your progress. Some of the drugs you will be taking affect the blood's components, and we want to be sure they remain in the normal range. One of the most important blood specimens taken daily will measure the amount of cyclosporine in your blood. We monitor this carefully to adjust your cyclosporine dosage to prevent organ rejection.

Your new heart will be supported with intravenous medications for about one to two days until it recovers from the "shock" of the transplant, but you will immediately feel the difference a healthy heart makes. Because the immune system gets activated immediately when the heart is transplanted, you will begin taking medications to prevent rejection even in the hours before your transplant and immediately afterwards. A typical stay in the intensive care unit is one to three days, and then you continue your postoperative care on a regular hospital floor. You can expect to be in the hospital 10 to14 days after your transplant.
After a heart transplant surgery you may be taken to the recovery room before being taken to the intensive care unit (ICU) to be closely monitored for several days. Alternatively, you may be taken directly to the ICU from the operating room. You will be connected to monitors that will constantly display your electrocardiogram (ECG or EKG) tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. Heart transplant surgery requires an in-hospital stay of seven to 14 days, or longer.

You will have a tube in your throat so that your breathing may be assisted with a ventilator until you are stable enough to breathe on your own. The breathing tube may remain in place for a few hours up to several days, depending on your situation.

You may have a thin, plastic tube inserted through your nose into your stomach to remove air that you swallow. The tube will be removed when your bowels resume normal function. You will not be able to eat or drink until the tube is removed.

Blood samples will be taken frequently to monitor the status of the new heart, as well as other body functions, such as the lungs, kidneys, liver, and blood system.

You may be on special intravenous (IV) drips to help your blood pressure and your heart, and to control any problems with bleeding. As your condition stabilizes, these drips will be gradually decreased and turned off as your condition allows.

After the breathing tube is out, your nurse will assist you to cough and take deep breaths every two hours. This will be uncomfortable due to soreness, but it is extremely important that you do this in order to keep mucus from collecting in your lungs and possibly causing pneumonia.

You may receive pain medication as needed, either by a nurse, or by administering it yourself through a device connected to your intravenous line.

Once the breathing and stomach tubes have been removed and your condition has stabilized, you may start liquids to drink. Your diet may be gradually advanced to more solid foods as you tolerate them.

Your immunosuppression (anti-rejection) medications will be closely monitored to make sure you are receiving the optimum dose and the best combination of medications.

Nurses, respiratory therapists, and physical therapists will work with you as you begin physical therapy and breathing exercises.

When your physician decides you are ready, you will be moved from the ICU to a private room on a post-surgical unit or transplant unit.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.