In the hospital:
After the 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 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. Your recovery will continue to progress. Your activity will be gradually increased as you get out of bed and walk around for longer periods of time. Your diet will be advanced to solid foods as tolerated.
Nurses, pharmacists, dietitians, physical therapists, and other members of the transplant team will teach you how to take care of yourself once you are discharged from the hospital.
Once you are home, it will be important to keep the surgical area clean and dry. Your physician will give you specific bathing instructions. The sutures or surgical staples will be removed during a follow-up office visit, if they were not removed before leaving the hospital.
You should not drive until your physician tells you to. Other activity restrictions may apply.
Follow-up visits will be scheduled frequently after returning home from the hospital. These visits may include blood tests, chest x-ray, and biopsy (removal of tissue from the heart for examination under a microscope.) The transplant team will explain the schedule for these tests. The rehabilitation program will continue for many months.
Notify your physician to report any of the following:
- fever and/or chills - may be a sign of infection or rejection
- redness, swelling, or bleeding or drainage from the incision site
- increase in pain around the incision site
- difficulty breathing
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.