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You would be surprised just how well a transplanted heart can hold up. My daughter has been through 3 bouts of CongestiveHeart failure Left-sided heart failure Right-sided heart failure Heart Failure with her heart and she's still alive. One of her BNPs reached almost 8000 with a normalNormal saline flush of 0-100! An EF% of 45 really isn't too bad, normalNormal saline flush is 50-70%. What does your transplant team say about all of this? Are you in any rejection? From what I can gather, having CHFHeart failure with a transplanted heart isn't commonCommon cold. No one in our therepy group has had this happen and when I questioed the group (of about 20 patients) everyone looked pretty stunned at the idea that that could even happen. I've even posted this question here on the transplant forum and got no replies, so I don't think it's really common. Take care