How do Doctors Prevent a Heart Transplant Rejection?

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  • Written By: Marco Sumayao
  • Edited By: Lauren Fritsky
  • Last Modified Date: 13 September 2019
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A heart transplant rejection is when a patient's immune system recognizes a donor's heart as a foreign body and attacks it. It is considered one of the most serious complications of a heart transplant, as rejection can prove to be fatal if left unnoticed. Doctors take great care to prevent heart transplant rejection through heavy testing before the surgery and by prescribing drugs that suppress the patient's immune system. Regular diagnostic tests, such as x-rays and heart biopsies, allow doctors to monitor for any signs of rejection. Despite these measures, roughly 20 percent of heart transplant patients die within two years due to organ transplant rejection or other complications.

Prior to the heart transplant procedure, a patient undergoes a rigorous screening process to determine whether or not surgery is the best option. Along with evaluating the patient's emotional and psychological capacity for the operation, doctors test his and the donor's blood types for compatibility. The blood is also tested for certain antibodies that could lead to heart transplant rejection. Depending on the urgency of the situation, preparing for a heart transplant can take a few days to several weeks. If the patient is cleared, he can go on with the procedure.


After the surgery, the patient will need to go through periodic testing with his doctor. For the first six to 12 months, he will have to undergo monthly heart biopsies to check for any signs of rejection. These procedures can be paired with x-rays for confirmation.

The doctor will also be on the lookout for several signs of heart transplant rejection, such as high fever, abnormal blood pressure levels, and poor healing. Other symptoms of heart transplant rejection include chest pains, difficulty in breathing, and unexplainable fatigue. Any of these signs of rejection must be taken seriously, as any form of organ transplant rejection can be fatal if left unattended. Regular monitoring of these symptoms should continue well after the first 12 months.

The patient will also need to make several lifelong adjustments to his new heart. Aside from heart-friendly lifestyle changes like quitting smoking and cutting down on alcohol intake, he will have to take immunosuppressant drugs on a regular basis. These drugs weaken the immune system, lowering the risk of a heart transplant rejection. Since these drugs suppress the immune system, the patient will also need to take great care in maintaining his overall health. This entails getting regular exercise, proper nutrition, and lessening the stressors in his life.


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