Patients waiting for a donor heart will generally carry a pager and be “on call.” When a suitable donor heart becomes available, the patient will be paged and told to come to the hospital immediately.

If the donor heart is in the same hospital as the recipient, then the surgery will be done as soon as all preparations have been made. If the donor heart is being transported by ambulance or by air, then the surgical team responsible for the transfer will keep the hospital team informed of its progress.

The hospital team will require about 20 minutes to prepare the donor for removal of the heart. Time is critical, because the donor heart can survive for only four to six hours outside the body.

After arriving at the hospital, the patient will be given specific preoperative medications and prepped for surgery. First, the chest area is shaved (if necessary). Next, the surgical team creates a sterile environment by swabbing the patient's chest with an antiseptic solution and covering the area in sterile surgical drapes. An intravenous (IV) line will be started, usually in the forearm or back of the hand.

When the time is right, the patient is given general anesthesia through the IV line. The patient will continue to breathe a mixture of oxygen and anesthetic gas to remain asleep throughout the surgery.