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Transplant Surgery

Heart Transplantation

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One of the top adult heart transplantation centers in the country, Allegheny General Hospital’s Heart Transplant Program was established in 1988. Our specialists have been on the leading edge of advanced therapies to give new hope for patients who are critically ill with end-stage disease. Thanks to enhanced operative techniques, improved anti-rejection medications, and the use of bridge-to-transplant devices, outcomes have improved dramatically for heart transplant patients. One-year patient survival after heart transplantation at AGH over the past two years is approximately 95%, exceeding the 89% national average.

 
Most patients referred to AGH’s heart transplant program have end-stage heart failure. Of these patients, close to half have heart failure as a result of coronary artery disease. Others have heart failure caused by hereditary conditions, viral infections of the heart or damaged heart valves and muscles. (Some medicines, alcohol, and pregnancy can also damage the heart muscle.)  Most patients considered for a heart transplant have been on medical treatment for many years and have endured progressive disability and frequent hospitalizations for heart failure.
 
AGH’s patient-focused, multidisciplinary team approach to patients with end-stage heart failure allows us to offer the best solution to each patient, whether it is advanced medical therapy, heart transplantation, mechanical circulatory support or complex coronary or valve surgery.
 
  • Pre-Transplantation
Depending on their current medical condition, patients undergo either an inpatient or outpatient heart transplant evaluation at Allegheny General Hospital. Members of the Transplant Team—including the transplant coordinators, transplant surgeons, transplant cardiologist, psychiatrist, social workers, dietitians and a cardiac rehab specialist—assess the patient’s medical history, current condition, physical abilities and test results. Following this evaluation, the Transplant Team will determine the best course of treatment for the patient. Patients who are accepted as transplant candidates are placed on a waiting list; AGH’s Transplant Team will continue to see the transplant candidate until a donor heart is found. In some cases, a donor heart may not become available before a patient’s heart function has deteriorated. In order to support these patients during this critical time, AGH utilizes several FDA-approved ventricular assist devices (VADS). These devices, connected to the heart during an operation, help to rest the heart by assisting the pumping process. LVADs can keep patients alive for many months, while greatly improving their quality of life.
 
  • Transplantation (Peri-Transplantation)
In most cases, if there are no complications, a transplant operation takes about 3 hours to complete. Usually, patients go directly to the Surgical Intensive Care Unit for 2 to 3 days, and stay for approximately 7 days in a private room on the transplant unit. Transplant patients undergo constant monitoring and testing, including regular heart biopsies to determine if their new heart is being accepted by their body.
 
  • Post-Transplantation
Following discharge from the hospital, patients require regular hospital checkups to watch for rejection or other complications. While routine blood work may be performed at each patient’s local hospital, all other follow-up care is done at AGH. We use a number of medications in various combinations, to decrease the risk of rejection as well as lower the side effects frequently seen with these drugs. The transplant coordinator will work with patients and their families to teach them about all of their medications, as well as facilitate the necessary care and routine follow-up that is required after transplant. Patients are carefully monitored to assess their medical status and are expected to attend a full cardiac rehabilitation program, beginning approximately six weeks after discharge. Cardiac rehab can take place at a local hospital or a rehab program.
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