Watching for rejection

Although your doctor will work to prevent rejection, it can still occur—even years after transplant surgery. That is why it is important to have a good sense about your day-to-day health and stay in tune with your body.

There are usually no obvious symptoms that you can feel when rejection of the transplanted heart is occurring. That is why people with heart transplants must be monitored regularly by their transplant team. Heart biopsy—which is when a portion of the heart is removed and examined by the transplant team—is the best way to diagnose rejection. Heart biopsies will be done frequently during the first year post-transplant and will decrease in frequency thereafter.

When? How often?
Weeks 1–6 Weekly
Weeks 7–16 Twice a month
Months 5–6 Monthly
Months 7–12 Every month and a half
Years 1–2 Every 3 months
Years 3–5 Every 6 months
After year 5 Only if you have symptoms


Call your transplant team right away if you experience any of the following events as they could signal a problem:

  • Fever over 100°F (38°C)
  • Flu-like symptoms such as chills, nausea, vomiting, diarrhea, headache, dizziness, or body aches and pains
  • Retaining fluids or having sudden weight gain
  • Tiredness
  • Shortness of breath
  • Blue or pale nail beds
  • Change in heart rate
  • Decreased urine output

Because rejection can occur without producing any signs or symptoms and may only be found during a regular office visit, it is important that you remember to keep all of your scheduled appointments and complete needed lab work.

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