Heart transplant

At Northwell Health, we are continuously striving to make our exceptional cardiac care even better. And that dedication to excellence shows. The Sandra Atlas Bass Heart Hospital at North Shore University Hospital is the first and only full-service destination for heart transplantation in Nassau, Suffolk, Queens, Brooklyn, Staten Island and across all of Northwell.

Led by a nationally renowned team, our Heart Hospital features one of New York’s largest cardiothoracic surgery and interventional cardiology programs, and the largest mechanical circulatory support program, that consistently achieve some of the state’s best outcomes. As a full-service transplant program, our team includes experts in cardiology, cardiac surgery, pharmacy, nutrition, psychology, social work and rehabilitation who are specialty trained in heart failure. Our expert physicians have historically performed a combined total of 500 heart transplants, and we treat more heart failure patients than any of the state's heart transplant centers.

Our lifesaving heart transplant program complements the already outstanding work of our LVAD (left ventricular assist device) and heart failure programs. It is an especially valuable resource for heart failure patients in Long Island, Queens and the outer boroughs who, until now, had to travel to Manhattan, the Bronx or beyond to ensure continuity of care. Removing the burden of extensive travel makes a huge difference for patients, who require many trips to the hospital for pre- and post-care and need a lifetime of follow-up care. It's helpful for their loved ones, too. And that's something a heart can feel good about.

The goal of a successful transplant is to help you feel better, be more active and enjoy a better quality of life. You may be considered for a heart transplant if you have advanced heart failure that cannot be controlled with medication or other kinds of heart surgery.

Other than your heart condition, you need to generally be in good health. If you have other serious medical problems, you may not be able to get a transplant. For example, if you have one of the following conditions, a heart transplant may not be a choice for you:

• Uncontrolled diabetes
• Severe lung, kidney or liver disease
• A recent diagnosis of cancer
• A bleeding disorder
• A stroke or other vascular issues

If you have an ongoing infection, it would need to be treated and cured before a transplant.

Before the surgery

As part of your pre-transplant evaluation, you'll meet with a transplant cardiologist who does a thorough physical exam. Your doctor may order X-rays, blood tests and other tests to evaluate your heart function.

If you are determined to be a candidate for heart transplant, you'll be put on a wait list for a donor heart. If your heart problems get significantly worse during this time, you may need to stay in the hospital while you wait for a transplant. This allows your care team to watch you closely and give you the care you need to keep your condition stable until a donor heart becomes available.

After you are admitted to the hospital, your transplant team does a final evaluation to make sure you can have the transplant. If you can have surgery, preparation for the transplant begins. If the evaluation shows the donor heart is not suitable for you or if you are not ready to have surgery, you may not be able to have the transplant. If that happens, talk with your transplant team about what comes next.

During the surgery

Heart transplant surgery usually lasts about six hours. It may take longer, depending on your situation. During surgery, the surgeon opens your chest and connects you to a heart-lung machine that keeps oxygen-­rich blood flowing through your body. The diseased heart is removed, and the donor heart is sewn into place.

Several monitors and tubes are put in during the surgery. The monitors record your oxygen level, blood pressure and the pressures in the chambers of your heart. These monitors are temporary. Tubes in your chest remove extra fluid from the area around where the surgery was done. A large amount of bloody drainage from these tubes is normal. A tube placed through your mouth or nose and into your stomach keeps your stomach empty and prevents nausea and vomiting. Usually, it is taken out soon after surgery.

Immediately after surgery, you are taken to the cardiac intensive care unit, or CICU. You'll get fluids and medications through several intravenous (IV) tubes. A urinary catheter will also be used to continuously empty your bladder.

While you are in the CICU, your transplant team monitors you at all times. As your condition improves, you'll move to the step-down unit. The timing of that move depends on your recovery and your response to medications.

As you progress, you will be able and encouraged to get up and move soon after transplant. In many cases, the more quickly you can get up and start moving after surgery, the less likely you are to have medical and surgical complications. Physical therapy can help prevent complications and speed up your recovery.

You will be discharged from the hospital as soon as the transplant team feels you are ready to return home. This decision is based on your rate of healing after surgery, the status of your biopsy reports, and your ability to take and tolerate your medications. People who have a heart transplant usually stay in the hospital for about two weeks; however, your hospital stay could be shorter or longer. The time depends on your situation.