One major risk is rejection. Rejection is your body's natural response to the new heart.

Your immune system protects you from infection, but it also identifies your new heart as foreign tissue. Special white blood cells invade the tissue in an attempt to destroy it. The immunosuppressive medicines you are taking work against this response.

More than one half of all patients have a rejection episode during the first three months after surgery.

Signs and symptoms of rejection

Rejection can happen even if you don't have symptoms. Signs and symptoms of a rejection episode can include:

  • heart palpitations (abnormal or irregular heartbeats, unusually fast or slow)
  • shortness of breath
  • increased weight gain or swelling (edema)
  • flu-like symptoms (chills, aches, headache, dizziness, upset stomach or vomiting)
  • temperature of 100.5 or higher
  • difficulty sleeping while lying on your back
  • decreased appetite, abdominal "bloating"
  • any heart failure symptoms

Call the transplant office if you have any of the above symptoms.

How to prevent rejection

  • Take all of your medicines as directed.
  • Keep all lab appointments and checkups.
  • Check your vital signs.
  • Call your regular doctor when you are not feeling well, such as a cold, allergy or the flu.
  • Call the transplant office if you have any medicine changes or new prescriptions. Even over-the-counter medicines can weaken your immunosuppression medicines. This includes vitamin and herbal supplements.

Your chance of a rejection episodes decreases over time, but it is a lifelong risk. Severe rejection can weaken your heart, cause disease in your blood vessels, and cause death.

It is important to take your immunosuppressive medicines as directed for the rest of your life.

How to treat rejection

Treating an episode of rejection includes increasing anti-rejection medicine. You may also need to stay in the hospital for a few days. Your doctor will prescribe a treatment plan based on the biopsy, your history of rejection episodes, and if you have any symptoms.

Medicine treatments

Your cardiologist will choose one of the treatments below to treat the rejection:

  • intravenous (IV) prednisone (Solu-MedrolĀ®) This requires a three-day hospital stay so the medicine can be given directly into the vein. After the IV course is finished, you will take prednisone by mouth. You will be given a taper schedule.
  • change in your immunosuppressive medicines.
  • other treatment options, if needed

Source: Allina Health's Patient Education Department, Care After Heart Transplant, cvs-ah-95405 (1/18)
First Published: 01/06/2013
Last Reviewed: 01/19/2018