Heart transplantation involves removing the diseased heart and replacing it with a healthy heart from an organ donor. In order to remove the donor heart from the donor, the donor must be declared brain-dead.

Once a patient has been approved for transplant, then he/she is placed on a waiting list. This list is a national data base and includes information that will help to identify the most closely-matched organ possible for the recipient. Waiting time may be only a few days or a few weeks, but sometimes it may take months or longer before an acceptable organ is found. While waiting, the patient will be closely followed by his/her physician.

The patient will remain out of the hospital for as long as his/her condition allows. If the condition worsens, the patient may be admitted to the hospital for more intensive therapy. Sometimes, a few days in the hospital is sufficient to improve the patient's condition and the patient may return home. However, it is possible that the heart's condition may worsen to the point that the patient is unable to leave the hospital. At this point, the patient's condition may be changed on the waiting list to indicate a worsening condition, thus giving that patient a higher priority for suitable organs that become available.

Once a suitable heart has been found, a team of physicians will go to the location of the donor and will examine the heart (and other organs) to make sure it is appropriate to use for transplant. If the heart is acceptable, the physicians will remove the heart from the donor, place it in a special solution to help preserve it, place it in a cooler, then return to the hospital to perform the transplant operation.

While the team of physicians is obtaining the donor heart, the recipient is prepared for the heart transplant operation. Once the hospital receives notification that the donor organ is acceptable, the patient is given final preparation for surgery and is taken to the operating room. The diseased heart is removed, and the donor heart is attached. The patient is then taken to the intensive care unit (ICU) to recover from the surgery.