Heart transplantation is the most effective treatment for various end-stage heart diseases that have failed to respond to conservative treatment. It is a procedure in which a human heart that has been determined to be brain dead and successfully mated is removed in its entirety and implanted into the chest cavity of the desired patient, while the recipient’s own heart is removed (known as in situ heart transplantation) or retained to support the donor heart (known as ectopic heart transplantation). Currently, there are about 5,000 heart transplant patients worldwide each year, and in the past three years, China has completed more than 300 heart transplants each year. Data on heart transplantation in China show that the survival rate of patients after surgery is 94.8% at 1 year, 91.9% at 3 years, 88.7% at 5 years and 82.2% at 7 years. Indications for heart transplantation (which conditions require heart transplantation): End-stage heart failure that cannot be cured by regular systemic medical treatment or conventional surgery. Common conditions suitable for heart transplantation: (1) advanced primary cardiomyopathy, including dilated, hypertrophic and restrictive cardiomyopathy; (2) end-stage severe coronary artery disease that cannot be improved by surgery or other therapeutic measures; (3) end-stage valve disease that cannot be treated by valve replacement surgery; (4) complex congenital heart disease that cannot be cured by corrective surgery, such as left ventricular dysplasia; (5) post-transplantation heart disease (5) Extensive coronary atherosclerosis and myocardial fibrosis in the transplanted heart. In fact, after half a century of development, the safety of heart transplantation has been significantly improved. The development of new immunosuppressive drugs has greatly reduced the incidence of immune rejection and adverse drug reactions, and the quality of life of patients after surgery has been greatly improved, and many patients can obtain long-term survival. The cost of surgery is directly related to the patient’s physical condition when hospitalized, and generally costs around 200,000. With the reduction of the price of immunosuppressive drugs and the coverage of the national medical insurance policy, the burden of medical expenses that patients need to bear is significantly reduced, and the long-term post-operative maintenance medication only needs to be borne by the patients themselves for about a thousand yuan per month. 3. Waiting time for donor Given that heart transplantation has higher requirements for donor compared with liver transplantation and kidney transplantation, the waiting time for donor is difficult to estimate, ranging from a few weeks to several months. Our hospital, as one of the largest organ transplant centers in China, has the highest number of liver transplants and kidney transplants in recent years, and has a mature system and process in organ transplantation, especially a perfect organ donation network established earlier in the province and even in neighboring provinces and cities, so we believe we can get the maximum benefit for organ transplant recipients in this aspect. Admission examination and comprehensive pre-operative assessment The doctor will conduct a series of necessary examinations according to your condition and the needs of the operation. These examinations are very important to assess your condition, the feasibility of the operation and the risks of the operation; these examinations will be conducted in order, led by the doctor or nursing staff, and patients with serious conditions will be arranged for trolley or direct bed-pushing examinations, and accompanied by a person. The tests include blood tests (e.g. routine blood, liver and kidney functions, hepatitis B and HBV-DNA, EBV, etc.) and routine radiographs (chest X-ray, ECG, ultrasound, pulmonary vascular resistance measurement, etc.). After all the tests are completed, the heart transplant team will call the relevant departments to organize a multidisciplinary discussion in which all the departments related to the disease will participate to conduct a comprehensive discussion and evaluation for you, and finally communicate the results to the patient and his family. What you need to do while waiting for your transplant 1. Communicate regularly with the doctor in charge of your transplant team. Patients who need a heart transplant have severe long-term heart disease and are in poor physical condition. It is recommended that you follow your doctor’s instructions to keep your entire body in a good condition in preparation for the transplant surgery. 2. Pre-operative waiting requires avoiding heart failure as much as possible. Take your medication according to the instructions of your cardiac surgeon, live in a comfortable environment, do slow walking and other activities in moderation, avoid strenuous physical activities, and recommend a high-protein diet to enhance your physical fitness. 3. Firm belief in surgery. The time between the notification of the organ donor and the start of transplantation is usually very short, so patients who decide to have a heart transplant should have a firm belief and come to the hospital to prepare for the surgery as soon as a matching donor heart is found and notified by the doctor. 4. Identify and treat potential infections. Because postoperative patients need immunosuppressive treatment and are relatively prone to infection, it is very important to detect and actively treat potential infections before surgery. The common sites that need attention are oral caries, repeated oral inflammation; sinus inflammation; urinary system infection; female patients also need to undergo gynecological examination. 5. Treatment to reduce pulmonary artery pressure. Pulmonary artery pressure has a great impact on the surgically implanted heart, and patients with severe pulmonary hypertension and very high pulmonary resistance cannot even undergo heart transplantation. If the pulmonary artery pressure is high before surgery, it is necessary to lower the pulmonary artery pressure treatment first.