Vanderbilt Transplant

The Transplanted Heart

The transplanted heart fills with blood and pumps as any other normal heart. However, the transplanted heart is "denervated." This means that the nerves from the central nervous system that supplied connections to your other heart do not supply connections to your transplanted heart. These nerves were divided upon removal of your own heart.

The heart does not need these nervous system connections to pump effectively. However, the rate at which the transplanted heart pumps at rest and in response to activity (for example, exercise) will be different. Before your operation, your heart would respond to exertion by quickly increasing its rate after the central nervous system told it to. Following your heart transplant, the heart increases its rate only after substances called catecholamines (adrenalin, for example) are released from a gland on the kidney and circulated through the blood to the heart. After exertion, it takes a while for this effect to decrease. Therefore, the transplanted heart increases its rate more gradually with exertion and slows more gradually with rest. To avoid extreme fatigue it is important that you allow time for your heart to increase its rate during exercise and other activity. Your physical therapist and exercise physiologist will provide directions for you to follow.

Loss of central nervous system connections to the heart also means that you will be unable to feel chest pain (angina pectoris) that occurs if coronary artery disease develops in the heart. If you notice chest discomfort, it is probably related to chest wall irritation, tissue healing, or strain from exercise.