Heart Transplant: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Heart Transplant?
A cardiologist, a doctor who treats heart disease, usually guides care for severe heart failure and refers you to a transplant center, where a heart surgeon does the operation. There, a transplant team evaluates you. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a heart transplant?
A heart transplant is surgery to remove a damaged or diseased heart and replace it with a healthy donor heart. The donor heart comes from someone who has died. It is the last resort for people with heart failure when all other treatments have failed. Heart transplant surgery is a life-saving measure, but it has many risks.
Symptoms
People who need a transplant have severe heart failure. Most people waiting for a heart are very ill and need to be in the hospital. Many need a device, most often a ventricular assist device (VAD), to help the heart pump enough blood.
After a transplant, the body may reject the new heart. This is called rejection. Rejection can cause flu-like symptoms, such as chills, body aches, nausea, cough, and shortness of breath. People who reject a heart may have symptoms of heart failure. Shortness of breath and less ability to exercise can be signs of a failing heart transplant.
Causes and who gets it
The heart failure that leads to a transplant might be caused by coronary heart disease, damaged heart valves or heart muscles, heart defects present at birth, or viral infections of the heart. A transplant may also be done for severe heart damage after a heart attack.
Heart transplant surgery may not be used in some people, including those who:
- Are older than age 65 to 70.
- Have had cancer within the past 2 years.
- Have kidney, lung, nerve, or liver disease.
- Smoke or use excessive alcohol or drugs.
How doctors diagnose it
Once you are referred to a transplant center, the transplant team checks whether you are a good candidate. You will visit many times over several weeks or even months. You will need blood drawn and x-rays taken. Other tests include blood or skin tests for infections and tests of your kidney and liver.
Tests to evaluate your heart include an ECG, an echocardiogram, and cardiac catheterization. The team also does tests to look for cancer and an ultrasound of your neck and legs. Tissue and blood typing helps make sure your body will not reject the donated heart.
If the team believes you are a good candidate, you are put on a regional waiting list for a heart. Your place on the list depends on the type and severity of your heart disease and how sick you are. Time on the list is usually not a factor, except for children.
Treatment
Treatment is surgery to replace the heart. You are put into a deep sleep with general anesthesia, and a cut is made through the breastbone. A heart-lung bypass machine does the work of your heart and lungs during surgery. Your diseased heart is removed and the donor heart is stitched in place.
You should expect to stay in the hospital for 7 to 21 days. The first 24 to 48 hours will likely be in the intensive care unit. The recovery period is about 3 months. You will need regular check-ups with blood tests, x-rays, and echocardiograms for many years.
You must take medicines that prevent transplant rejection for the rest of your life. These medicines raise the risk of infections, and can damage the kidneys or liver. They can also cause cancer, high cholesterol levels, diabetes, and bone thinning.
When to see a doctor
If you have heart failure and treatments no longer help, ask your cardiologist about a transplant center. After a transplant, tell your transplant team about flu-like symptoms, such as chills, body aches, nausea, or cough.
Call 911 or go to the emergency room if you have chest pain or discomfort that lasts two minutes or more, you faint or lose consciousness, you have bleeding that will not stop, or you have severe trouble breathing.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Before a transplant, such a doctor can review your heart care and help coordinate a referral. After a transplant, the transplant center leads your care, and this doctor can help with routine care and keep your records in order.
Common questions
Who can get a heart transplant?
People who the transplant team believes are good candidates are put on a waiting list for a heart. A transplant may not be used in people who have had cancer within the past 2 years, or who smoke or use excessive alcohol or drugs.
Do I need medicine after a heart transplant?
Yes, you must take medicines that prevent transplant rejection for the rest of your life.
How long does recovery take after a heart transplant?
The recovery period is about 3 months. You can go back to your normal activities 3 months after the transplant as soon as you feel well enough, and after talking with your provider.
What is transplant rejection?
Rejection is when the immune system of the person who received the organ attacks the transplanted organ. Acute rejection may occur any time from the first week after the transplant to 3 months afterward. Chronic rejection can take place over many years.
Sources
- MedlinePlus - Heart transplant
- MedlinePlus - Heart Transplantation
- MedlinePlus - Transplant rejection
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
