Heart transplantation

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American medical researcher Simon Flexner was one of the first people to mention the possibility of heart transplantation. In 1907, he wrote the paper "Tendencies in Pathology," in which he said that it would be possible one day by surgery to replace diseased human organs – including arteries, stomach, kidneys and heart.[https://timesmachine.nytimes.com/timesmachine/1908/01/02/104713376.pdf May Transplant the Human Heart] (.PDF), The New York Times, January 2, 1908.

Not having a human donor heart available, James D. Hardy of the University of Mississippi Medical Center transplanted the heart of a chimpanzee into the chest of dying Boyd Rush in the early morning of Jan. 24, 1964. Hardy used a defibrillator to shock the heart to restart beating. This heart did beat in Rush's chest for 60 to 90 minutes (sources differ), and then Rush died without regaining consciousness.{{cite journal | doi = 10.1001/jama.1964.03060390034008 | volume=188 | issue=13 | title=Heart Transplantation in Man | year=1964 | journal=JAMA |author=Hardy James D. |author2=Chavez Carlos M. |author3=Kurrus Fred D. |author4=Neely William A. |author5=Eraslan Sadan |author6=Turner M. Don |author7=Fabian Leonard W. |author8=Labecki Thaddeus D.}}Every Second Counts: The Race to Transplant the First Human Heart, Donald McRae, New York: Penguin (Berkley/Putnam), 2006, [https://books.google.com/books?id=2Fv9dRT9TC4C&q=%22Neighbors+confirmed+that+his+name+was+Boyd+Rush.++They+described+him+as+a+retired+upholsterer%22&pg=PT109 Ch. 7 "Mississippi Gambling"], pp. 123–27. This source states the heartbeat for approximately one hour.[https://www.nytimes.com/2003/02/21/us/james-d-hardy-84-dies-paved-way-for-transplants.html James D. Hardy, 84, Dies; Paved Way for Transplants], Obituary, New York Times (Associated Press), Feb. 21, 2003. This source states the transplanted chimpanzee heartbeat for 90 minutes. Although Hardy was a respected surgeon who had performed the world's first human-to-human lung transplant a year earlier,{{cite journal | doi = 10.1001/jama.1963.63710120001010 | pmid=14061414 | volume=186 | issue=12 | pages=1065–74 | title=Lung Homotransplantation in Man | year=1963 | journal=JAMA | author=Hardy James D}} See also {{cite journal | doi = 10.1001/jama.1963.03710120070015 | pmid=14061420 | volume=186 | issue=12 | year=1963 | journal=JAMA | page=1088| title=Lung Transplantation | author1=Griscom NT }} in same issue.[https://books.google.com/books?id=FeZeAQAAQBAJ&dq=Russ%2A+pneumonia+transplant%2A+Hardy&pg=PT72 Second Wind: Oral Histories of Lung Transplant Survivors], Mary Jo Festle, Palgrave MacMillan, 2012. author Donald McRae states that Hardy could feel the "icy disdain" from fellow surgeons at the Sixth International Transplantation Conference several weeks after this attempt with the chimpanzee heart.Every Second Counts, McRae, [https://books.google.com/books?id=2Fv9dRT9TC4C&q=%22Hardy+arrived+at+the+Sixth+International+Transplantation+Conference%22&pg=PT111 page 126, top]. Hardy had been inspired by the limited success of Keith Reemtsma at Tulane University in transplanting chimpanzee kidneys into human patients with kidney failure.{{cite journal | pmc = 3246856 | pmid=22275786 | volume=25 | issue=1 | title=A brief history of cross-species organ transplantation | author=Cooper DK | journal=Proc (Bayl Univ Med Cent) | pages=49–57 | doi=10.1080/08998280.2012.11928783 | year=2012}} ' … the consent form for Hardy's operation{{snd}}which, in view of the patient's semi-comatose condition, was signed by a close relative{{snd}}stipulated that no heart transplant had ever been performed, but made no mention of the fact that an animal heart might be used for the procedure. Such was the medicolegal situation at that time that this "informed" consent was not considered in any way inadequate. . ' The consent form Hardy asked Rush's stepsister to sign did not include the possibility that a chimpanzee heart might be used, although Hardy stated that he did include this in verbal discussions.Xenotransplantation: Law and Ethics, Sheila McLean, Laura Williamson, University of Glasgow, UK, Ashgate Publishing, 2005, [https://books.google.com/books?id=J2IUYkHHezwC&q=%22Hardy+contended+that+he+had+discussed+the+procedure+in+detail+with+relatives%22&pg=PA50 p. 50]. A xenotransplantation is the technical term for the transplant of an organ or tissue from one species to another.

Dr Dhaniram Baruah of Assam, India was the first heart surgeon to transplant a pig's heart in human body.{{cite news|date=2022-01-15 |title=Pig Heart Transplanted in Human |url= https://www.thehindu.com/sci-tech/science/assam-pioneer-of-pig-heart-transplant-now-working-on-biomolecular-treatment/article38266334.ece|work=The Hindu |access-date=2022-01-16}} However the recipient died subsequently. The world's first successful pig-to-human heart transplant was performed in January 2022 by surgeon Bartley P. Griffith of USA.{{cite news|date=2022-01-15 |title=Man Gets Genetically Modified Pig Heart| url= https://www.bbc.com/news/world-us-canada-59944889|work=BBC|access-date=2022-01-16}}

The world's first human-to-human heart transplant was performed by South African cardiac surgeon Christiaan Barnard utilizing the techniques developed by American surgeons Norman Shumway and Richard Lower.McRae, D. (2006). Every Second Counts: The Race to Transplant the First Human Heart, New York: Penguin (Berkley/Putnam).[https://s//www.independent.co.uk/news/obituaries/norman-shumway-466720.html Norman Shumway: Father of heart transplantation who also performed the world's first heart-lung transplant], Obituary, The Independent [UK], 16 Feb. 2006. Patient Louis Washkansky received this transplant on December 3, 1967, at the Groote Schuur Hospital in Cape Town, South Africa. Washkansky, however, died 18 days later from pneumonia.{{cite news|date=November 29, 1987 |title=Memories of the Heart |newspaper=Daily Intelligencer |location=Doylestown, Pennsylvania |page=A–18}}{{cite news|date=1967-12-21 |title=Pneumonia Blamed in Transplant Patient's Death |url=https://www.nytimes.com/1967/12/22/archives/pneumonia-blamed-in-transplant-patients-death-new-candidate.html |work=The New York Times |access-date=2018-01-08}}

On December 6, 1967, at Maimonides Hospital in Brooklyn, New York, Adrian Kantrowitz performed the world's first pediatric heart transplant.Lyons, Richard D. [https://www.nytimes.com/1967/12/07/archives/heart-transplant-fails-to-save-2weekold-baby-in-brooklyn-heart.html "Heart Transplant Fails to Save 2-Week-old Baby in Brooklyn; Heart Transplant Fails to Save Baby Infants' Surgery Harder Working Side by Side Gives Colleague Credit"], The New York Times, December 7, 1967. Accessed November 19, 2008. The infant's new heart stopped beating after 7 hours and could not be restarted. At a following press conference, Kantrowitz emphasized that he did not consider the operation a success.Heart: An American Medical Odyssey, Dick Cheney, Richard B. Cheney, Jonathan Reiner, MD, with Liz Cheney, Scribner (division of Simon & Schuster), 2013. [https://books.google.com/books?id=LIJ1lVpfaLUC&q=%22Adrian+Kantrowitz%22+Jaime&pg=PT289 "Three days later, on December 6, 1967, Dr. Adrian Kantrowitz"]

Norman Shumway performed the first adult heart transplant in the United States on January 6, 1968, at the Stanford University Hospital. A team led by Donald Ross performed the first heart transplant in the United Kingdom on May 3, 1968.{{cite Q|Q29581627}} These were allotransplants, the technical term for a transplant from a non-genetically identical individual of the same species. Brain death is the current ethical standard for when a heart donation can be allowed.

Worldwide, more than 100 transplants were performed by various doctors during 1968.[http://dspace.ucalgary.ca/bitstream/1880/48963/1/2009_HMD_Elzinga.pdf Major Medical Milestones Leading Up To the First Human Heart Transplantation] {{Webarchive|url=https://web.archive.org/web/20160714140947/http://dspace.ucalgary.ca/bitstream/1880/48963/1/2009_HMD_Elzinga.pdf |date=2016-07-14 }}, Kate Elzinga, from Proceedings of the 18th Annual History of Medicine Days Conference 2009: The University of Calgary Faculty of Medicine, Alberta, Canada, Cambridge Scholars Publishing, 2011. " . . following Barnard's landmark heart transplantation on December 3, 1967, 107 human heart transplants were performed by 64 surgical teams in 24 countries in 1968. . " Only a third of these patients lived longer than three months.[https://profiles.nlm.nih.gov/ps/retrieve/Narrative/GN/p-nid/315 The Adrian Kantrowitz Papers, Replacing Hearts: Left Ventricle Assist Devices and Transplants, 1960–1970], National Institutes of Health, U.S. National Library of Medicine.

The next big breakthrough came in 1983 when cyclosporine entered widespread usage. This drug enabled much smaller amounts of corticosteroids to be used to prevent many cases of rejection (the "corticosteroid-sparing" effect of cyclosporine).[http://www.samj.org.za/index.php/samj/article/view/5020/4123 Transplantation of the heart: An overview of 40 years' clinical and research experience at Groote Schuur Hospital and the University of Cape Town], South African Medical Journal, "Part I. Surgical experience and clinical studies." J Hassoulas, Vol. 102, No. 6 (2012).

On June 9, 1984, "JP" Lovette IV of Denver, Colorado, became the world's first successful pediatric heart transplant. Columbia-Presbyterian Medical Center surgeons transplanted the heart of 4-year-old John Nathan Ford of Harlem into 4-year-old JP a day after the Harlem child died of injuries received in a fall from a fire escape at his home. JP was born with multiple heart defects. The transplant was done by a surgical team led by Dr. Eric A. Rose, director of cardiac transplantation at New York–Presbyterian Hospital. Drs. Keith Reemtsma and Fred Bowman also were members of the team for the six-hour operation.[http://www.nydailynews.com/archives/news/talk-guy-lot-heart-1st-kid-new-ticker-doc-article-1.664815 "Talk About a Guy With a Lot of Heart 1st kid to get new ticker wants to be doc"] NY Daily News, 13 April 2003

In 1988, the first "domino" heart transplant was performed, in which a patient in need of a lung transplant with a healthy heart would receive a heart-lung transplant, and their original heart would be transplanted into someone else.{{cite journal|last1=Raffa|first1=G.M.|last2=Pellegrini|first2=C.|last3=Viganò|first3=M.|title=Domino Heart Transplantation: Long-Term Outcome of Recipients and Their Living Donors: Single Center Experience|journal=Transplantation Proceedings|date=November 2010|volume=42|issue=9|pages=3688–93|doi=10.1016/j.transproceed.2010.09.002|pmid=21094839}}

Worldwide, about 5,000 heart transplants are performed annually, an increase of 53 percent between 2011 and 2022.{{Cite web |title=ISHLT Fast Facts |url=https://www.ishlt.org/education-and-publications/resource/ishlt-fast-facts |access-date=2025-01-22 |website=Default |language=en}} The majority of these are performed in the United States (about 4,000 annually).{{Cite journal |last=Colvin |first=Monica M. |last2=Smith |first2=Jodi M. |last3=Ahn |first3=Yoon Son |last4=Handarova |first4=Dzhuliyana K. |last5=Martinez |first5=Alina C. |last6=Lindblad |first6=Kelsi A. |last7=Israni |first7=Ajay K. |last8=Snyder |first8=Jon J. |date=February 2024 |title=OPTN/SRTR 2022 Annual Data Report: Heart |url=https://pubmed.ncbi.nlm.nih.gov/38431362/#:~:text=The%20number%20of%20heart%20transplants,85.8%25%20to%203,668%20in%202022. |journal=American Journal of Transplantation|volume=24 |issue=2S1 |pages=S305–S393 |doi=10.1016/j.ajt.2024.01.016 |issn=1600-6143 |pmid=38431362|hdl=2027.42/172019 |hdl-access=free }} Vanderbilt University Medical Center in Nashville, Tennessee currently is the largest heart transplant center in the world, having performed a world-record 174 adult and pediatric transplants in 2024 alone.{{Cite web |last=Batcheldor |first=Matt |date=2025-01-13 |title=Vanderbilt Transplant Center sets world record for heart transplants in 2024 |url=https://news.vumc.org/2025/01/13/vanderbilt-transplant-center-sets-world-record-for-heart-transplants-in-2024/ |access-date=2025-01-22 |website=VUMC News |language=en-US}}

About 800,000 people have NYHA Class IV heart failure symptoms indicating advanced heart failure.{{cite video | people = Reiner Körfer (interviewee) | title = The Heart-Makers: The Future of Transplant Medicine | medium = documentary film | publisher = LOOKS film and television | location = Germany |date = 2007}} The great disparity between the number of patients needing transplants and the number of procedures being performed spurred research into the transplantation of non-human hearts into humans after 1993. Xenografts from other species and artificial hearts are two less successful alternatives to allografts.

The ability of medical teams to perform transplants continues to expand. For example, Sri Lanka's first heart transplant was successfully performed at the Kandy General Hospital on July 7, 2017.[http://www.hirunews.lk/165445/first-ever-heart-transplant-in-sri-lanka-successful First ever heart transplant in Sri Lanka successful], Hiru News, 9 July 2017. In recent years, donor heart preservation has improved and Organ Care System is being used in some centers in order to reduce the harmful effect of cold storage.{{cite journal |last1=Verzelloni Sef |first1=A |last2=Sef |first2=D |last3=Garcia Saez |first3=D |last4=Trkulja |first4=V |last5=Walker |first5=C |last6=Mitchell |first6=J |last7=McGovern |first7=I |last8=Stock |first8=U |title=Heart Transplantation in Adult Congenital Heart Disease with the Organ Care System Use: A 4-Year Single-Center Experience. |journal=ASAIO Journal |date=1 August 2021 |volume=67 |issue=8 |pages=862–868 |doi=10.1097/MAT.0000000000001482|issn=1058-2916 |pmid=34039886|s2cid=235217756 |doi-access=free }}

During heart transplant, the vagus nerve is severed, thus removing parasympathetic influence over the myocardium. However, some limited return of sympathetic nerves has been demonstrated in humans.{{Cite journal|last1=Arrowood|first1=James A.|last2=Minisi|first2=Anthony J.|last3=Goudreau|first3=Evelyne|last4=Davis|first4=Annette B.|last5=King|first5=Anne L.|date=1997-11-18|title=Absence of Parasympathetic Control of Heart Rate After Human Orthotopic Cardiac Transplantation|url=http://circ.ahajournals.org/content/96/10/3492|journal=Circulation|language=en|volume=96|issue=10|pages=3492–98|doi=10.1161/01.CIR.96.10.3492|issn=0009-7322|pmid=9396446}}{{None}}

Recently, Australian researchers found a way to give more time for a heart to survive prior to the transplant, almost double the time.{{cite news|last=Woods|first=Emily|title=Donor hearts given longer life under trial |url=https://www.canberratimes.com.au/story/7463738/donor-hearts-given-longer-life-under-trial/ |date=2021-10-11 |work=The Canberra Times |agency=Australian Associated Press}}

Heart transplantation using donation after circulatory death (DCD) was recently adopted and can help in reducing waitlist time while increasing transplant rate.{{cite journal |last1=Kwon |first1=JH |last2=Usry |first2=B |last3=Hashmi |first3=ZA |last4=Bhandari |first4=K |last5=Carnicelli |first5=AP |last6=Tedford |first6=RJ |last7=Welch |first7=BA |last8=Shorbaji |first8=K |last9=Kilic |first9=A |title=Donor utilization in heart transplant with donation after circulatory death in the United States. |journal=American Journal of Transplantation |date=28 July 2023 |volume=24 |issue=1 |pages=70–78 |doi=10.1016/j.ajt.2023.07.019 |pmid=37517554|s2cid=260296589 |doi-access=free }} Critically ill patients that are unsuitable for heart transplantation can be rescued and optimized with mechanical circulatory support, and bridged successfully to heart transplantation afterwards with good outcomes.{{cite journal |last1=Sef |first1=D |last2=Mohite |first2=P |last3=De Robertis |first3=F |last4=Verzelloni Sef |first4=A |last5=Mahesh |first5=B |last6=Stock |first6=U |last7=Simon |first7=A |title=Bridge to heart transplantation using the Levitronix CentriMag short-term ventricular assist device. |journal=Artificial Organs |date=September 2020 |volume=44 |issue=9 |pages=1006–1008 |doi=10.1111/aor.13709 |pmid=32367538|s2cid=218506853 }}

On January 7, 2022, David Bennett, aged 57, of Maryland became the first person to receive a gene-edited pig heart in a transplant at the University of Maryland Medical Center. Before the transplant, David was unable to receive a human heart due to the patient's past conditions with heart failure and an irregular heartbeat, causing surgeons to use the pig heart that was genetically modified.{{cite web | title=In 1st, US surgeons transplant pig heart into human patient | website=Associated Press | date=2022-01-10 | url=https://apnews.com/article/pig-heart-transplant-6651614cb9d73bada8eea2ecb6449aef | access-date=2022-01-10}}{{cite web | title=In a First, Man Receives a Heart From a Genetically Altered Pig | website=The New York Times | date=2022-01-10 | url=https://www.nytimes.com/2022/01/10/health/heart-transplant-pig-bennett.html | access-date=2022-01-10}} Bennett died two months later at University of Maryland Medical Center on March 8, 2022.{{cite news |title=Man given genetically modified pig heart dies |url=https://www.bbc.co.uk/news/health-60681493 |access-date=9 March 2022 |work=BBC News |date=9 March 2022}}{{Cite news |last=Rabin |first=Roni Caryn |date=2022-03-09 |title=Patient in Groundbreaking Heart Transplant Dies |language=en-US |work=The New York Times |url=https://www.nytimes.com/2022/03/09/health/heart-transplant-pig-bennett.html |access-date=2022-03-09 |issn=0362-4331}}

On April 19, 2023 Stanford Medicine surgeons performed the first beating-heart transplants from cardiac death donors.{{cite web|url=https://med.stanford.edu/news/all-news/2023/04/beating-heart-transplant.html |title=Stanford Medicine surgeons perform first beating-heart transplants from cardiac death donors |date=29 March 2023 }}

On December 11, 2024, in Padua, Italy, the world's first heart transplant from a non-beating donor to a fully beating heart was performed.{{cite web|url=https://www.unipd.it/news/padua-worlds-first-heart-transplant-non-beating-donor-fully-beating-heart|title=In Padua, the world's first heart transplant from a non-beating donor to a fully beating heart|date=December 13, 2024|access-date=December 13, 2024}}{{cite web|url=https://corrieredelveneto.corriere.it/notizie/padova/cronaca/24_dicembre_12/il-chirurgo-del-primo-trapianto-a-cuore-battente-e-una-nuova-strada-ora-lavoriamo-a-un-cuore-artificiale-tutto-italiano-c21d82f4-5e62-4324-b2c3-9d50c4296xlk.shtml|title="Così ho eseguito il primo trapianto a cuore battente: non si ferma mai, batte tra le mani del chirurgo mentre lo sposta da chi lo dona a chi lo riceve"|author=Michela Nicolussi Moro|date=December 12, 2024|access-date=December 13, 2024|trans-title="That's how I performed the first beating-heart transplant: it never stops, beating between the surgeon's hands as he moves it from donor to recipient."|language=it|quote=In the usual transplantation, the heart is stopped at the time of retrieval from the donor, then transported up to the operating room at a temperature of 4 degrees and then transplanted, still stopped. After surgery is performed, it is restarted in the recipient. With the new technique, referred to as totally beating heart transplantation, we took the organ from the donor without stopping it and put it into the ex vivo perfusion machine, in which the heart continued to beat and never stopped, even when 'we reimplanted it into the recipient.|archive-url=https://archive.today/20241213204627/https://corrieredelveneto.corriere.it/notizie/padova/cronaca/24_dicembre_12/il-chirurgo-del-primo-trapianto-a-cuore-battente-e-una-nuova-strada-ora-lavoriamo-a-un-cuore-artificiale-tutto-italiano-c21d82f4-5e62-4324-b2c3-9d50c4296xlk.shtml#selection-3865.0-3865.559|archive-date=December 13, 2024|url-status=live}}

Some patients are less suitable for a heart transplant, especially if they have other circulatory conditions related to their heart condition. The following conditions in a patient increase the chances of complications.{{Cite journal |last1=de Jonge |first1=N. |last2=Kirkels |first2=J. H. |last3=Klöpping |first3=C. |last4=Lahpor |first4=J. R. |last5=Caliskan |first5=K. |last6=Maat |first6=A. P. W. M. |last7=Brügemann |first7=J. |last8=Erasmus |first8=M. E. |last9=Klautz |first9=R. J. M. |last10=Verwey |first10=H. F. |last11=Oomen |first11=A. |last12=Peels |first12=C. H. |last13=Golüke |first13=A. E. J. |last14=Nicastia |first14=D. |last15=Koole |first15=M. A. C. |date=2008 |title=Guidelines for heart transplantation |journal=Netherlands Heart Journal |language=en |volume=16 |issue=3 |pages=79–87 |doi=10.1007/BF03086123 |pmid=18345330 |issn=1568-5888|pmc=2266869 }}

Absolute contraindications:

• Irreversible kidney, lung, or liver disease{{citation |url=https://heart.bmj.com/content/105/3/252 |title=Cardiac transplantation: indications, eligibility and current outcomes |author1=Sai Kiran Bhagra |author2=Stephen Pettit |author3=Jayan Parameshwar |publisher=British Medical Journal |journal=Heart |year=2019 |volume=105 |number=3 |pages=252–260 |doi=10.1136/heartjnl-2018-313103|pmid=30209127 |s2cid=52194404 }}
• Active cancer if it is likely to impact the survival of the patient
• Life-threatening diseases unrelated to the cause of heart failure, including acute infection or systemic disease such as systemic lupus erythematosus, sarcoidosis, or amyloidosis
• Vascular disease of the neck and leg arteries.
• High pulmonary vascular resistance – over 5 or 6 Wood units.

Relative contraindications:

• Insulin-dependent diabetes with severe organ dysfunction
• Recent thromboembolism such as stroke
• Severe obesity
• Age over 65 years (some variation between centers) – older patients are usually evaluated on an individual basis.
• Active substance use disorder, such as alcohol, recreational drugs or tobacco smoking (which increases the chance of lung disease)

Mehra MR, Canter CE, Hannan MM, Semigran MJ, Uber PA, et al. The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: A 10-year update. J Heart Lung Transplant. 2016 Jan. 35 (1):1–23.

Patients who are in need of a heart transplant but do not qualify may be candidates for an artificial heart or a left ventricular assist device (LVAD).

Potential complications include:{{cite journal |author=Ludhwani|first1=Dipesh|last2=Fan|first2=Ji|last3=Kanmanthareddy|first3=Arun|title=Heart Transplantation Rejection|year=2020|url=https://www.ncbi.nlm.nih.gov/books/NBK537057/|access-date=25 June 2020|journal=StatPearls [Internet] |via=NCBI Bookshelf|pmid=30725742}} Last Update: December 23, 2019.

• Post-operative complications include infection and sepsis. The surgery death rate was 5–10% in 2011.{{cite journal | pmc=3082109 | pmid=21532848 | doi=10.3346/jkms.2011.26.5.599 | volume=26 | issue=5 | title=Long-term mortality in adult orthotopic heart transplant recipients | year=2011 | journal=J. Korean Med. Sci. | pages=599–603 |vauthors=Jung SH, Kim JJ, Choo SJ, Yun TJ, Chung CH, Lee JW }}
• Acute or chronic graft rejection

:*Cardiac allograft vasculopathy

• Atrial arrhythmia
• Lymphoproliferative malignancies, further worsened by immunosuppressive medication{{Verify source|date=December 2024}}
• Increased risk of secondary infections due to immunosuppressive medication
• Serum sickness due to anti-thymocyte globulin
• Tricuspid valve regurgitation
• Repeated endomyocardial biopsy can cause bleeding and thrombosisRizk J, Mehra MR. Anticoagulation management strategies in heart transplantation. Prog Cardiovasc Dis. 2020;63(3):210–18. {{doi|10.1016/j.pcad.2020.02.002}}

Since the transplanted heart originates from another organism, the recipient's immune system will attempt to reject it regardless if the donor heart matches the recipient's blood type (unless if the donor is an isograft). Like other solid organ transplants, the risk of rejection never fully goes away, and the patient will be on immunosuppressive drugs for the rest of their life. Usage of these drugs may cause unwanted side effects, such as an increased likelihood of contracting secondary infections or develop certain types of cancer. Recipients can acquire kidney disease from a heart transplant due to the side effects of immunosuppressant medications. Many recent advances in reducing complications due to tissue rejection stem from mouse heart transplant procedures.{{cite journal |vauthors= Bishay R | year = 2011 | title = The 'Mighty Mouse' Model in Experimental Cardiac Transplantation | journal = Hypothesis | volume = 9 | issue = 1| page = e5}}

People who have had heart transplants are monitored in various ways to test for possible organ rejection.{{cite journal |vauthors=Costanzo MR, Dipchand A, Starling R, Anderson A, Chan M, Desai S, Fedson S, Fisher P |display-authors=etal |title=The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients |journal=The Journal of Heart and Lung Transplantation |volume=29 |issue=8 |pages=914–56 |year=2010 |pmid=20643330 |doi=10.1016/j.healun.2010.05.034|doi-access=free }}

A 2022 pilot study{{Cite journal |last1=Killian |first1=Michael O. |last2=Clifford |first2=Stephanie |last3=Lustria |first3=Mia Liza A. |last4=Skivington |first4=Gage L. |last5=Gupta |first5=Dipankar |date=2022-04-18 |title=Directly observed therapy to promote medication adherence in adolescent heart transplant recipients |journal=Pediatric Transplantation |volume=26 |issue=5 |pages=e14288 |language=en |doi=10.1111/petr.14288 | pmid=35436376 |s2cid=248242427 |issn=1397-3142|doi-access=free }} examining the acceptability and feasibility of using video directly observed therapy to increase medication adherence in adolescent heart transplant patients showed promising results of 90.1% medication adherence compared to 40-60% typically. Higher medication variability levels can lead to greater organ rejections and other poor outcomes.

The prognosis for heart transplant patients following the orthotopic procedure has improved over the past 20 years, and as of June 5, 2009 the survival rates were:[http://circ.ahajournals.org/content/125/1/e2 Heart Disease and Stroke Statistics – 2012 Update] The American Heart Association. Retrieved 27 November 2012.

• 1 year: 88.0% (males), 86.2% (females)
• 3 years: 79.3% (males), 77.2% (females)
• 5 years: 73.2% (males), 69.0% (females)

In 2007, researchers from the Johns Hopkins University School of Medicine discovered that "men receiving female hearts had a 15% increase in the risk of adjusted cumulative mortality" over five years compared to men receiving male hearts. Survival rates for women did not significantly differ based on male or female donors.{{Cite journal | last1 = Weiss | first1 = E. S. | last2 = Allen | first2 = J. G. | last3 = Patel | first3 = N. D. | last4 = Russell | first4 = S. D. | last5 = Baumgartner | first5 = W. A. | last6 = Shah | first6 = A. S. | last7 = Conte | first7 = J. V. | doi = 10.1161/CIRCHEARTFAILURE.108.844183 | title = The Impact of Donor-Recipient Sex Matching on Survival After Orthotopic Heart Transplantation: Analysis of 18 000 Transplants in the Modern Era | journal = Circulation: Heart Failure | volume = 2 | issue = 5 | pages = 401–08 | year = 2009 | pmid = 19808369| doi-access = free }}

• Artificial heart
• Biological pacemaker
• Xenotransplantation

{{reflist|30em}}

• [https://web.archive.org/web/20160518015919/http://mmcts.oxfordjournals.org/content/2015/mmv035.full Orthotopic heart transplantation: the bicaval technique]
• [http://www.nhlbi.nih.gov/health/health-topics/topics/ht Heart Treatments - Heart Treatments | NHLBI, NIH] NIH

{{Cardiac surgery}}

{{Organ transplantation}}

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{{DEFAULTSORT:Heart Transplantation}}

Category:Cardiac surgery

Category:Organ transplantation