Infections and heart transplants

This is partly due to the immunosuppressant medicine you need to take after your transplant. These medicines reduce the risks of you rejecting the donor heart, but they will also lower your immune system’s ability to fight infections.

You are likely to receive antibiotics to prevent infection at the time of surgery and for a few days after. If there is suspicion of infection or you are thought to be at higher risk the antibiotics may continue for longer.

Most infections are treated with a week or two of antibiotics

Infections can occur in your chest, urine, or around the plastic tubes inserted through your skin.

Infection of the surgical wound in your chest is also common and may require prolonged antibiotic therapy. Infection of the breastbone, which lies under the surgical wound, is less common (1 in 100 patients) but may require prolonged treatment and, sometimes, surgery.

Rarely, more serious infections can spread to your blood stream.

Thorough checks are done to prevent infections being passed on from the donated organ. However, it is impossible to be completely sure that the donor and their organ are completely free of infection. Infections that can be transmitted from the donor include bacterial, viral, fungal or other infections.

Sometimes, the transplant team know that the donor was being treated for an infection at the time of their final illness. If this is an infection that is easy to treat, it may still be reasonably safe to still transplant the donor’s heart and give the person receiving the heart the correct antibiotics to treat the infection.

Learn about risks from donated heart

It is rare to get a serious infection such as hepatitis B, hepatitis C or HIV from a transplant. This chance is less than 1 in 1,000. Serious infections like HIV or hepatitis B or hepatitis C now have effective treatments.

CMV infection

It is more common that infections such as cytomegalovirus (CMV) are passed on with the donated organ. This infection is usually fairly straightforward to diagnose, treat and monitor.

CMV is a virus that infects more than half of healthy people and, after the initial infection, remains dormant in the body for the rest of your life. Sometimes the CMV does not come from the donor organ but is dormant within the transplant patient for years, becoming active after the transplant as a result of the patient’s weakened immune system due to anti-rejection medication.

If you are at risk of suffering from CMV infection your transplant team may give you prophylactic treatment. If you develop CMV infection you will be prescribed antiviral medication for several weeks.

There are some viruses (herpes simplex virus, glandular fever virus and BK virus) that can also cause you to become ill after your transplant, but these problems are less common.

Sometimes, the transplant team know that the donor was being treated for an infection at the time of their final illness. If this is an infection that is usually straightforward to treat, it may be quite safe to still transplant the donor’s organ and give you the correct antibiotics to treat the infection.

If your transplant team believe that the chances of transmitting a serious disease with the new organ are much higher than 1 in 1,000, they will discuss this with you before the transplant.

Even serious infections like HIV or hepatitis B or hepatitis C now have effective treatments.

Antibiotics are used to treat infections.

Antibiotic treatment carries risks such as allergic reactions (rashes and breathing problems), diarrhoea, and other side effects. Your transplant team will discuss these with you.