Rehabilitation after a heart transplant

The BHF says transplant may be considered for advanced heart failure when other treatments are not working. An assessment looks at heart, lung and blood vessel tests and blood and antibody tests, and places people into one of four groups: suitable, potentially suitable, needing further investigation or unsuitable.

For those listed, the BHF says average waiting time on the routine list is 18 to 24 months, with urgent and super-urgent tiers also existing. Rehabilitation before surgery, where your team supports it, can improve strength and make recovery easier.

The BHF says surgery typically takes 4 to 6 hours. The surgeon removes the failing heart while you are connected to a heart-lung bypass machine, and implants the donor organ. You wake in intensive care on a ventilator and are gradually weaned off breathing support.

Most people get out of bed within 1 to 2 days, according to the BHF, with physiotherapists guiding the first sitting and standing.

The BHF says people usually leave hospital 2 to 3 weeks after surgery, but it may take longer. Strength returns gradually over weeks, and cardiac rehabilitation is described as important.

Until the chest wound has healed, avoid strenuous activity such as heavy lifting. The BHF also encourages regular exercise, a balanced diet, a healthy weight and not smoking as part of long-term health. Because the transplanted heart is initially disconnected from the nerves that normally speed the heart rate, warm-up and cool-down periods are emphasised in transplant exercise advice, so ask your team for specific guidance.

The BHF says you need several medicines after surgery and that immunosuppressants, which help prevent your body rejecting the donor heart, are lifelong. These medicines are tailored and monitored with blood tests, and doses may change over time.

Never skip doses, and check with the transplant team or a pharmacist before taking any new prescription, over-the-counter or herbal product, because many interact with transplant medicines.

Rejection is possible, which is why early check-ups and tests are frequent. Because immunosuppressants weaken the immune response, the BHF says infection risk is higher and advises precautions such as avoiding contact with people who are unwell, careful food handling and regular handwashing.

Contact the transplant centre promptly for fever, new breathlessness, unusual tiredness or swelling rather than waiting for the next appointment.

The BHF says that in the first year you will visit the hospital often for check-ups and tests, and that overseas travel may need to be avoided during this time. Driving and work timelines vary and are agreed with the transplant team.

Emotional adjustment matters too. People can feel gratitude, guilt, fear of rejection or low mood, sometimes together. The BHF emotional support pages describe anxiety and depression after a heart event as normal and encourage using nurses, groups and the helpline.

The BHF says around three quarters of adults who have a heart transplant in the UK live for at least 5 years. Individual outlook depends on age, the reason for transplant, other illnesses and how well rejection and infection are managed.