Having a heart transplant can be a life-saving option. You may be able to live for years with a donated heart, but its durability can be difficult to predict.

A heart transplant is a surgical procedure that involves the removal of a diseased, poorly functioning heart that’s replaced with the heart from a deceased donor. More than 4,000 such procedures are performed annually in the United States, according to the U.S. Health Resources and Services Administration.

How long a transplanted heart will function and how long a transplant recipient will live depend on many factors. In general, the survival rates of people who receive heart transplants are improving. Some people outlive their transplants, making them eligible to receive a second donated heart.

Read on for more detail about this type of transplant and what you may need to know in preparing for this heart procedure.

Since the first successful human heart transplant in 1967, survival rates have steadily improved. In the short term, most studies suggest that at least 9 out of 10 individuals who receive a transplanted heart will be alive a year later.

A 2020 study of more than 30,000 people who received a heart transplant and who were older than 50 years of age suggests that the overall 1-year survival rate is about 89%. About half of those individuals lived for at least 12 years after their surgery.

Other research, including a 2020 report, suggests that the median survival rate internationally is closer to 10 years. But figures can differ significantly from one nation to another.

Predicting how long a transplanted heart will keep pumping is difficult. While severe heart failure is the main reason a person might need a heart transplant, there may be other complications, such as pulmonary hypertension, that can go on to affect the donated heart.

The donor heart may have a pre-existing heart disease that worsens after transplantation.

But one of the most common reasons a transplanted heart fails is rejection by the recipient’s immune system, which attacks the new heart as a foreign object. Immunosuppressant drugs can reduce the risk of rejection, but they can’t always prevent it.

As the number of organ transplants performed each year rises, so too do the survival rates of recipients and the durability of the donor organs.

While there are examples of individuals living for 20 or 30 years or more with a transplanted organ, the average life spans are shorter.

A 2019 report suggests the following survival rates for some of the more common organ transplants:

  • Heart: 9.4 years
  • Kidney: 12.4 years
  • Liver: 11.1 years

There’s no official limit to how many heart transplants a person can have, though having more than one (retransplantation) is uncommon.

A 2020 study suggests that retransplantation represents only about 2–4% of adult heart transplant procedures and about 5% of pediatric heart transplants.

Your age when you have a heart transplant is one of several important factors affecting your life expectancy. Other factors include conditions such as diabetes, a history of smoking, and other health and lifestyle considerations.

A 2016 study looked at survival rates by age group. The findings suggest the following 5-year post-transplant mortality rates by age group:

  • 18–59 years: 26.9%
  • 60–69 years: 29.3%
  • 70 years and older: 30.8%

In other words, the lower the better for mortality rates. A lower percentage means the heart transplant procedure is largely successful over the course of the next 5 years.

The list of people who have lived more than 20 or 30 years with a heart transplant is growing.

But the person who has lived the longest with a heart transplant is believed to be Sandy Shaw of the United Kingdom. She received her first heart transplant at the age of 27 years old in 1982 and her second in 2005.

There are other reports in the United States of people living longer than that, such as Lizzy Craze in California. She received a heart transplant in 1984 due to a genetic condition that caused her heart to fail. After her transplant, she was still going strong in 2022 at nearly 40 years since that initial transplant.

A full recovery from a heart transplant can take at least 3 months.

During those first few months, it’s important to avoid putting excess strain on your heart and the incision in your chest. That means avoiding lifting anything heavy for 6 weeks after surgery and avoiding driving a car for 6–8 weeks after the procedure.

Because you’ll be on medications that suppress your body’s immune system response, you’ll need to take precautions to avoid infections. This means keeping up with vaccinations and taking steps to reduce your risk of infection, such as regular handwashing and avoiding spending time around people who are sick.

Receiving a heart transplant can offer a new lease on life, but it does present a new set of health concerns. Because you will be on immunosuppressant medications, you’ll be at higher risk of infections. Your risk of kidney conditions also increases with a heart transplant.

If you’re willing to work closely with your healthcare team and keep to a strict heart-healthy lifestyle that includes taking medications as prescribed and keeping up with doctors’ appointments and health screenings, you may be able to live a long and active life with your new heart.