What is a heart transplant?

A heart transplant is an operation to replace a diseased and failing heart with a healthy human heart from a donor.

During the operation which normally takes three to four hours, the surgeon will remove the old heart and sew in the new organ and attach it to the major blood vessels.

In 2021, there were 112 heart transplants performed in Australia.

    Who needs a heart transplant?

    People with end-stage heart failure may be eligible for a heart transplant. Normally, these patients will have tried many other options including medications, a left ventricular assist device (LVAD) or other surgeries.

    End-stage heart failure can arise from several conditions including:

    What are the risks of having a heart transplant?

    Like any surgery, the risk of infection, bleeding, and even death is possible, but the following specific risks are more associated with having a transplant.

    1. Donor heart rejection
      Our bodies have a natural defense system in place that rejects foreign tissues or objects. Medications are given to suppress the immune system so that is does not attack the new heart. Whilst rejection rates are ever decreasing, your specialist may have to try out another immunosuppressants if rejection does occur. The risk of rejection will be monitored through frequent heart biopsies or cardiac MRI scans.

      These immune suppressants usually need to be taken for the rest of the patient’s life and can be associated with side effects that need to be monitored.

    2. Primary graft failure
      This is when the new heart fails and typically happens soon after the transplant. It is the most common form of death in the first few days and weeks after having the operation and can occur without warning. Whilst survival rates for heart transplants are high – patients still face a 5-10 percent chance of death in the first-month post-surgery.

    3. Cardiac allograft vasculopathy
      There is a chance that the walls of your arteries may become hard and thick which can affect blood circulation and heighten the risk of heart failure, although with improved therapies this risk is reducing.

    What are the survival rates for a heart transplant?

    Life expectancy and quality of life is high for people who have a heart transplant. Survival rates are 80 percent a year after surgery, 70 percent five years after, and 55 percent a decade later.

    When was the first heart transplant performed?

    The first human heart transplant took place in 1967 in South Africa. Louis Washkansky, 53, received a donor heart from a 25-year-old woman who had been in a car crash. Sadly, Louis died from pneumonia less than a month later.

    A year later an Australian patient survived for six weeks after a heart transplant at St Vincent’s Hospital, Sydney performed by Dr Harry Windsor. These early surgeries were considered the steppingstone for the establishment of the Australian Cardiac Transplant Program.

    The first successful heart transplant in Australia did not take place until 1984 and was performed by our very own Dr Victor Chang at St Vincent’s Hospital in Sydney. A month later 14-year-old Fiona Coote also underwent the operation and is still alive today.

    Heart transplant patient Fiona Coote with her surgeon Dr Victor Chang

    Our history with heart transplantation

    Dr Chang was a pioneer in the modern era of heart transplant surgery and was instrumental in Australia becoming a world leader in this field.

    Between 1984 and 1991 his team performed more than 197 heart transplants and 14 heart-lung transplants.

    Dr Chang also established the National Heart Transplant Program at St Vincent’s Hospital.

    His work came to an untimely end with his death in 1991 but researchers at the Institute have ensured his memory lives on.

    Professor Peter Macdonald's Heart-in-a-Box breakthrough from 2015 has increased the number of heart transplants by a third. He is also working on a new potential medication – derived from the venom of the funnel-web spider – which also has the potential to increase the number of donor hearts by a further third.

    Our researchers are also contributing to the artificial heart project led by BiVACOR.

    Prof Chris Hayward and Dr Sam Emmanuel working with an artficial heart

    Human trials are expected to start in 2023 at St Vincent’s Hospital, Sydney.

    The Victor Chang Cardiac Research Institute is also exploring optimisation of immunosuppression and non-invasive detection of cardiac rejection to allow patients to hopefully live longer lives with safer immunosuppression and monitoring regimes.

    Read these incredible patient stories

    True stories of some of the brave men and women, whose lives were saved by a heart transplant.

    Acknowledgement of Country

    The Victor Chang Cardiac Research Institute acknowledges Traditional Owners of Country throughout Australia and recognises the continuing connection to lands, waters and communities. We pay our respect to Aboriginal and Torres Strait Islander cultures; and to Elders past and present.

    Victor Chang Cardiac Research Institute - The Home of Heart Research for 30 Years