Waiting for a Heart Transplant

Step Two: How to Prepare for a Heart Transplant

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A heart transplant is a life-changing surgery, but waiting for a donor heart may be a stressful -- and sometimes lengthy -- process. Patients awaiting a transplant must meet waitlist requirements, attend regular medical appointments, and be available at any time to report to the hospital for a transplant. Keeping track of these details can be difficult, but patients and families don’t have to do this on their own. As one of the largest heart transplant programs in the country, we provide you and your loved ones with the resources and assistance you need as you prepare for your heart transplant.

Call for a Heart Transplant Evaluation

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The Donor Heart Match Process

After you are approved for a heart transplant, your name is placed on the United Network of Organ Sharing (UNOS) national waitlist and is ranked according to medical urgency statuses. (Status 1 is the most urgent, and Status 6 is the least urgent.) UNOS matches potential donors with people waiting for a transplant. When a donor heart becomes available, it is first offered to the person with the most urgent medical status who best matches the donor’s characteristics, like blood type and body size, and is geographically closest to the donor. If the heart is not a good match for that person, the donor heart is offered to the next person on the list, moving to less urgent and more distant patients until it is accepted.

Staying Healthy

As a candidate for a heart transplant, it is important to stay healthy in preparation for surgery. Establishing good habits now can also help you make the most of life with your new heart.

Avoid nicotine in all forms, including cigarettes, patches, and gum.
Do not use alcohol or other drugs.
Maintain physical fitness and stamina by exercising regularly, as your health condition allows.
Maintain a healthy weight and follow dietary recommendations, such as limiting salt.
Keep regular appointments with your transplant team.

Be Prepared for the Call

You and your caregiver should always be prepared to receive a call that a donor heart has been matched to you. Once you are notified, you should arrive at the hospital within four hours. Depending on how far you live from Duke, you may need to relocate closer to the hospital while you wait for a donor heart. Your transplant coordinator will discuss this with you and can help you make short- or long-term lodging arrangements if needed.

Request a Referral from Your Doctor

If you are interested in making an appointment for an evaluation, please ask your cardiologist to submit a referral.

Heart Support While You Wait

We provide the support your heart needs while you wait for a donor. We offer the full range of medications and devices to help slow your heart disease, manage symptoms, and optimize your heart function until you’re ready for transplant. These devices may include:

Ventricular Assist Devices (VADs)

Surgically implanted devices that help the heart pump blood to the rest of the body. In most cases, patients can go home with these devices in place. VADs can serve as a bridge to transplant or as a long-term solution for those who are not eligible for a heart transplant.

Intra-Aortic Balloon Pumps (IABPs)

Devices placed during a minimally invasive catheterization procedure. They help the heart pump more blood and reduce its workload. An IABP requires patients to stay in the ICU until they are ready for a VAD or heart transplant.

Extracorporeal Membrane Oxygenation (ECMO)

A machine that pumps and oxygenates blood outside of your body, supporting the work of both the heart and lungs. Like an IABP, it is a short-term bridge to a VAD or transplant and requires the person to stay in an ICU.

Total Artificial Hearts

Duke works to pioneer new technologies that make heart transplantation accessible to more people. In 2021, Duke became the first center in the world to place the CARMAT total artificial heart as part of a clinical trial. In 2024, Duke's heart transplant team was the second in the world to implant the BiVACOR total artificial heart. Both devices help support patients until a donor heart is available.

Best Heart Hospital in North Carolina

When it comes to your heart care, you want the very best. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cardiology and heart surgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Why Choose Duke

Shorter Wait Times

Wait times for a donor heart can range from days (for people on ECMO) to years (for those doing well at home with a VAD). Duke has some of the shortest wait times in the region. We use innovative techniques that allow us to use donor hearts that other centers may not be able to transplant, and that means there are more hearts to go around.

Expanded Heart Donor Pool

One reason why Duke can offer more hearts to more people is our participation in a clinical trial studying Donation after Circulatory Death (DCD). In fact, Duke surgeons performed the first DCD heart transplant in the U.S. in December 2019. We are one of only five centers in the U.S. approved to use this process. The DCD program could expand the donor pool by 30%, reducing wait times.

A Dedicated Transplant Coordinator

Preparing for heart transplant can be overwhelming. As a patient at Duke, you have around-the-clock access to your transplant coordinator who can help you manage appointments, help you arrange lodging, organize medication, and more. The transplant coordinator also provides training and education before and after your transplant.

Step 3: Transplant Surgery

This page was medically reviewed on 01/24/2023 by

Joseph B. Lerman, MD | Internal Medicine Doctor