11 things to know about heart transplants (from a team that has performed 500 of them)

Published October 20, 2022


The Nebraska Medicine heart transplant team is celebrating their 500th heart transplant. And wow, are their hearts full.

"Performing 500 transplants gives a second chance at life for so many people," says Brian Lowes, MD, PhD. Dr. Lowes specializes in advanced heart failure and transplant cardiology. He credits the exciting milestone to the team's advanced expertise. "We're using the next generation of technology here. And our surgeons are going farther and farther to get more organs ready for transplant."

Cardiac surgeon John Um, MD, is thrilled to be in the business of changing hearts – and lives. "To be involved in such a common problem, but at the very edge of the newest techniques, has been very gratifying to me as a professional."

Get 11 heart transplant facts from the region's leading transplant center.

1. Transport has gotten way more advanced than putting hearts on ice.

"A couple of years ago, the only option for storage and transport of a heart was static storage, meaning we arrested the heart with cardioplegia, then put it into an ice bath," says Dr. Um.

Hearts on ice have a shelf life of about four hours, which limits how far away a heart could travel – as well as the complexity of the operation. 

Recently heart transplant transportation has gotten a major upgrade, thanks to a portable box that keeps the heart warm and active. "With the Organ Care System, we can extend the amount of time a heart is outside the body," explains Dr. Um. "The heart is beating and perfused, so it can last longer during transport."

2. More hearts are available than before, thanks to DCD hearts.

Until about two years ago, all transplants were from donors who were brain dead. But it's more common for people to die from a cause where the heart stops beating. This limited how many organs were available to transplant. 

But now surgeons can also use organs from donors where the heart has stopped beating. Donation after cardiac death – or DCD organs – gives more second chances. "By some estimates, DCD has expanded the donor pool 25% to 30%. It's a rapidly evolving field because the surgery is new. Not every transplant center can offer this newer type of heart transplant," says Dr. Um.

3. You can get the COVID-19 vaccine before or after a heart transplant.

"We recommend that patients get all their vaccines before the surgery, because they respond better to vaccines prior to transplant rather than afterwards on immunosuppressant therapy," says Dr. Lowes. "But we still vaccinate people after transplantation, too. There's an increased risk of COVID-19 infection after transplant, which vaccination protects against."

In fact, Nebraska Medicine has infectious diseases doctors who specialize in transplant. "It's one more reason to come here," says Dr. Lowes.

4. The surgery can take anywhere from three to eight hours.

Some things that affect the timing include how fast the organ arrives. "If the heart gets to us quickly, and the patient has never had heart surgery before, the operation can be quite short," says Dr. Um. "On the other hand, people who have had congenital heart surgery may take longer."

5. Our surgeons can even transplant hearts from hepatitis C and COVID-19 donors.

Some centers can't handle a complexity of a heart from a hepatitis C positive donor or a COVID-19 positive donor. Our surgeons have experience safely transplanting these hearts, relieving some of the donor shortage. "We use the next generation of medical therapies and technologies to bring organs home to people, so they can live longer and have better quality of life," says Dr. Lowes.

Get help from the heart experts
Nebraska Medicine is the only medical center in the region with a nationally certified heart specialist in heart failure. Call 800.922.0000 for a heart evaluation or begin the transplant process online.

6. Can heart transplant patients have babies? It depends.

"Men can have children after a heart transplant," says Dr. Um. For women, however, it's complicated. Pregnancy puts extra strain on the heart, and anti-rejection medications a patient must take for the rest of their life can potentially harm the developing baby. 

If you want to have children, talk to your heart transplant team.

7. Recovery time after heart transplant varies.

Heart transplant patients usually spend about two and a half weeks in the hospital. Most people feel pretty good after four to six weeks, but it depends on the medical history and health of the patient.

8. Drinking alcohol or smoking weed after transplant? Not a good idea.

Because of interactions with medications, heart transplant patients shouldn't drink alcohol. 

"To some degree, the heart's life is dependent on how committed the patient is," says Dr. Lowes. "It's a lot of work. They take medicine each day, get routine surveillance for issues and be compliant with their overall follow-up and care. The good news is people can live a long time with a heart transplant if they take care of it."

Likewise, weed is not good for someone with a transplanted heart. For several health reasons, including inhalational injuries, cancer-causing chemicals, along with the risks of emphysema and chronic bronchitis, marijuana can cause lasting damage.

9. Heart transplant patients can take ED medication, under a doctor's supervision.

Under the care of a physician, patients can generally take erectile dysfunction medication like Viagra. People taking nitrates may not be able to and should check with their doctor. "In general, we want people to resume normal aspects of their life," says Dr. Um.

10. Heart transplant rejection can be reversed with early treatment.

Rejection is likely, and an expected part of recovery. Heart transplant rejection is when your immune system thinks the transplanted heart is a threat and tries to attack it.

A heart transplant patient takes powerful medications to prevent rejection from happening. It's important to take all medications as instructed.

"We have good therapies for heart transplant rejection," says Dr. Lowes. "We often can diagnose and treat it before it causes damage to the heart." Therapies work best when started early – so if you experience symptoms of rejection, including unusual fatigue and shortness of breath, contact your transplant team immediately. 

11. You can make a life-saving decision today.

People who are on an organ waiting list typically have end-stage organ disease that significantly impacts their quality of life and may be near the end of their life. Receiving an organ can become a life-changing event for these people.

Register to be an organ donor. One organ donor has the potential to save eight lives!

Becoming a donor is easy. 
When you register to renew your license, simply check the box that asks if you'd like to be a donor. You can also register at Live On Nebraska