How Long Can You Live After a Heart Transplant? Survival Rates

Survival rates for heart transplant patients are as follows:

• 1 year: 75%
• 5 years: 64%
• 10 years: 53%
• 15 years: 40%
• 20 years: 26%

The number of heart transplant recipients who have been followed for more than 20 years is gradually increasing. The first year following the surgery is considered crucial with regard to the survival rate. 

Survival rates depend mainly on complications following surgery, as well as age, other medical issues, lifestyle, and activity level of the recipient.

A heart transplant or cardiac transplant is the gold standard treatment for end-stage heart failure. 

Heart transplantation is a surgical procedure in which a damaged heart that is beyond repair is removed and replaced with a healthy heart from a donor. Hospitals in the United States now perform over 3,000 heart transplants every year.

There are several potential risks of complications that may follow surgery. The most common complications include:

1. Rejection: One of the most serious risks is that your body will reject the donor heart. Your immune system may perceive the donor heart as foreign tissue and try to reject it, causing harm to the heart. Every heart transplant recipient is given antirejection medicine (immunosuppressants) to reduce the rate of rejection. If rejection occurs, a change in drugs can sometimes stop it. To prevent rejection, it's vital that you take medications exactly as prescribed by your doctor and keep all of your medical appointments. Rejection frequently occurs in the absence of symptoms. During the first year after your transplant, you will need to have frequent heart biopsies to determine whether your body is rejecting the new heart.
2. Infections: Mortality rate from infections is 50%. Immunosuppressive medications reduce your ability to fight infections. Many heart transplant recipients get an infection that requires hospitalization within the first year of their transplant.
3. Malignancy: Mortality rate from malignancy is 33%. Immunosuppressive medications can potentially increase your risk of cancer such as skin and lip tumors and non-lymphoma cancer.
4. Cardiac allograft vasculopathy: Mortality rate from allograft vasculopathy is 17%. Following your transplant, the walls of the arteries in your heart may thicken and stiffen, resulting in cardiac allograft vasculopathy. This can impede blood flow through your heart, resulting in a heart attack, heart failure, arrhythmias, or sudden cardiac death.
5. Graft dysfunction: This occurs when the donor heart does not function properly, which is the most common cause of mortality in the first few months following a transplant.
6. Chronic kidney disease: Immunosuppressants, which you will have to take for the rest of your life, can cause major kidney damage.

Anyone under the age of 69 diagnosed with an end-stage heart disease with a prognosis of death within 1 year is a candidate for a heart transplant.

Heart conditions that lead to a heart transplant include:

• Advanced heart failure: Occurs when your heart is unable to pump enough blood to your body
• Arrhythmia: Irregular heartbeat
• Cardiomyopathy: Occurs when the heart muscle becomes damaged, swollen, or inflexible, causing the heart to be unable to adequately pump blood
• Congenital heart disease: Congenital defect in the heart
• Coronary artery disease: Constriction of the blood arteries that provide the heart with oxygen and nourishment
• Heart valve disease: Occurs when one or more of your four heart valves do not function properly
• Failure of previous heart transplant: Occurs when heart failure occurs with a previous heart transplant

Factors that may disqualify someone from receiving a heart transplant even in the the presence of one of the debilitating conditions above include the following:

• Active infection
• Alcohol or drug abuse
• Kidney or liver disease
• Cancer

Following your heart transplant surgery, you will need to adhere to a recovery program in order to increase your chances of staying healthy.

Medications

You will need to take medications for the rest of your life after a heart transplant. They prevent your immune system from attacking your new heart. These drugs are known as immunosuppressants or antirejection drugs.

Heart-healthy diet

A balanced diet rich in fresh fruits, vegetables, and whole grains will help keep your new heart healthy and lower your risk of complications and future heart disease. 

Some of the medications that you will be given following your transplant surgery may increase your risk of high blood pressure, high cholesterol, diabetes, and weight gain, which could increase your risk of heart disease. Your diet is a critical factor in reducing these risk factors.

When it comes to food preparation, you will need to be especially cautious since your immune system may be compromised and make you more susceptible to food poisoning. Always handle and store food carefully and exercise caution when dining out.

Exercise

Exercise will help lessen some of the side effects of the medications you'll be taking, especially steroids. Another advantage of regular exercise is that it helps you maintain good blood pressure, cholesterol, and weight—all of which are critical for heart health.

As you exercise more, you will notice greater strength, flexibility, and coordination, which means simple tasks such as lifting objects and climbing stairs will become easier, you'll be able to accomplish more without feeling tired.

The most serious dangers following a heart transplant are rejection and infections. Take your medications as prescribed, live an active and healthy lifestyle, and attend your medical appointments regularly to reduce the risks.

Early detection, as well as knowing the signs and symptoms of rejection and infection, can save your life. Some signs to look out for include the following:

• Swollen ankles
• Shortness of breath
• Weight gain
• Dizziness or lightheadedness
• Heart palpitations
• Tiredness and fatigue
• Feeling less tolerant to exercise
• Loss of appetite

If you experience any of these symptoms, your transplant team will perform a cardiac biopsy to confirm whether rejection is occuring.

You may be more susceptible to infections due to the immunosuppressant medications. Common signs and symptoms of infection include:

• Fever
• Cough
• Sore throat
• Runny nose
• Fatigue
• Nausea and vomiting
• Diarrhea

If you have any of these symptoms, your transplant team will conduct blood tests, chest X-rays, computed tomography scans, and urine tests to rule out infection. Depending on the severity of the illness, oral and intravenous antibiotics may be used to treat it.

Take precautions to avoid infections, such as washing your hands and maintaining good hygiene, covering any scrapes and wounds, staying away from sick people, and keeping pets clean.