The biggest problem with an organ transplant in the immune system reaction to the organ. Your immune system will identify the new organ as a foreign object and will attack it causing rejection which will destroy the organ.
Now, rejection can be avoided by immunosuppressions medications : They lower the activity of the immune system and thus it will attack less the transplanted organ.
Problem tho is that you can’t completely prevent the immune system from attacking the transplant, even with good medication. And immunosupressors can induce long term complications on other organs and increase the overall risk of getting cancer. So usually after a few years, the transplant will start to get rejected.
However, everyone is different and some people are luckier than others. While a heart transplant give you an average life expectancy of 9 years, some people have managed to live with a transplanted heart for more than 25 years.
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