Risks

Besides the risks of having open-heart surgery, which include bleeding, infection and blood clots, risks of a heart transplant include:

• Rejection of the donor heart. One of the most significant risks after a heart transplant is your body rejecting the donor heart.

  Your immune system may see your donor heart as a foreign object and try to reject it, which can damage the heart. Every heart transplant recipient receives medications to prevent rejection (immunosuppressants), and as a result, the rate of rejection continues to decrease. Sometimes, a change in medications will halt rejection if it occurs.

  To help prevent rejection, it's critical that you always take your medications as prescribed and keep all your appointments with your doctor.

  Rejection often occurs without symptoms. To determine whether your body is rejecting the new heart, you'll have frequent heart biopsies during the first year after your transplant. After that, you won't need biopsies as often.

  During the biopsy, a tube is inserted into a vein in your neck or groin and directed to your heart. A biopsy device is run through the tube to take a tiny sample of heart tissue, which is examined in a lab.

• Primary graft failure. With this condition, the most frequent cause of death in the first few months after transplant, the donor heart doesn't function.
• Problems with your arteries. After your transplant, it's possible that the walls of the arteries in your heart could thicken and harden, leading to cardiac allograft vasculopathy. This can make blood circulation through your heart difficult and can cause a heart attack, heart failure, heart arrhythmias or sudden cardiac death.
• Medication side effects. The immunosuppressants you'll need to take for the rest of your life can cause serious kidney damage and other problems.
• Cancer. Immunosuppressants can also increase your risk of developing cancer. Taking these medications can put you at a greater risk of skin and lip tumors and non-Hodgkin's lymphoma, among others.
• Infection. Immunosuppressants decrease your ability to fight infection. Many people who have heart transplants have an infection that requires them to be admitted to the hospital in the first year after their transplant.