Why it's done

Heart transplants are performed when other treatments for heart problems haven't worked, leading to heart failure. In adults, heart failure can be caused by:

• A weakening of the heart muscle (cardiomyopathy)
• Coronary artery disease
• Heart valve disease
• A heart problem you're born with (congenital heart defect)
• Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
• Failure of a previous heart transplant

In children, heart failure is most often caused by either a congenital heart defect or cardiomyopathy.

Another organ transplant may be performed at the same time as a heart transplant (multiorgan transplant) in people with certain conditions at select medical centers.

Multiorgan transplants include:

• Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure.
• Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions.
• Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases if the conditions cannot be treated with only a heart transplant or a lung transplant.

A heart transplant is not right for everyone, however. You might not be a good candidate for a heart transplant if you:

• Are at an advanced age that would interfere with the ability to recover from transplant surgery
• Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
• Have an active infection
• Have a recent personal medical history of cancer
• Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking

Ventricular assist devices

For some people who cannot have a heart transplant, another option may be a ventricular assist device (VAD). A ventricular assist device is a mechanical pump implanted in your chest that helps pump blood from the lower chambers of your heart (ventricles) to the rest of your body.

VADs are commonly used as temporary treatments for people waiting for heart transplants. These devices are increasingly being used as long-term treatments for people who have heart failure but are not eligible for heart transplants. If a VAD doesn't help your heart, doctors may sometimes consider a total artificial heart — a device that replaces the ventricles of your heart — as an alternative short-term treatment while you're waiting for a heart transplant.