Heart transplant surgery

Find out what happens during the transplant operation

Key points

Heart transplant surgery lasts around 4-6 hours
You will be put to sleep under a general anaesthetic while the transplant takes place
Donor hearts are transplanted in the same place in your chest as your own heart
The operation can be performed a variety of ways, which will depend on your needs and the preference of the transplant surgeon

How is heart transplant surgery performed?

Donor hearts are transplanted in the same place in your chest as your own heart. This involves the removal of the diseased heart and replacement with the donor heart.

How it works

Where the heart is in the body

Your heart sits in the middle of your chest, with a slight tilt to the left. It is connected to the body through various arteries and veins, including:

The aorta - the main and largest artery in the body
Superior vena cava - a large vein that brings blood to the heart from your upper body
Inferior vena cava - a large vein that brings blood to the heart from your lower body
Pulmonary blood vessels - arteries and veins that connect to your lungs

Illustration showing the position of the heart within a body, along with the positions of the superior vena cava, inferior vena cava, aorta and pulmonary artery

A heart in close up

This is a close up of a heart showing the superior vena cava, aorta, pulmonary artery and pulmonary veins.

Arteries and veins run throughout the heart. In general, arteries take oxygenated blood away from the heart, while veins bring deoxygenated blood back to the heart. However, pulmonary blood vessels are the exception. Pulmonary arteries move deoxygenated blood from the heart to the lungs, and pulmonary veins carry oxygenated blood back to the heart from the lungs.

Close up illustration of a heart showing positions of superior vena cava, inferior vena cava, aorta and pulmonary artery

Connecting a donor heart

A donor heart is transplanted in the same place as your own heart. Your transplant surgeon will carefully join the donor arteries and veins surrounding the heart with your arteries and veins.

Illustration showing how a donated heart connects to a recipient via the pulmonary veins and coronary arteries and veins

Close up of a transplanted heart

This shows how a transplanted heart connects to your blood vessels. You can also see the position of pipes from a bypass machine. This machine takes over the function of your heart and lungs during the operation.

Close up illustration of a donated heart, showing how it would join to the recipient along blood vessels, and where the pipes from a bypass machine would go

Some things that might happen during your heart transplant surgery

You will be attached to a heart-lung bypass machine

Tubes will be inserted into your neck, arms and bladder

You will have plastic tubes (lines or catheters) inserted into your neck, arms and bladder. Before the operation, the surgical and anaesthetic teams will explain where the tubes will be placed.

What are the tubes for?

Small tubes (lines) are inserted into your arms to enable fluid and medications to be given to you during and after the surgery.

For most heart transplant operations, you’ll also have a tube inserted into the veins in your neck so that stronger medications can be given, if needed. This also lets the team looking give you extra fluid, if needed.

A tube (catheter) will be inserted into your bladder via the urethra. Most heart transplant surgeons will insert a number of large plastic tubes (up to 5) into the area around the heart transplant to drain away any tissue fluid after the surgery.

Risks

Inserting tubes into you can lead to bleeding, infection, or damage to other structures such as blood vessels or nerves. These complications are very rare.