"The longer out you get, the better off you are," said Dr. Brett Sheridan, a heart transplant surgeon at UNC-Chapel Hill School of Medicine.

Sheridan was not involved in Richardson's transplant, which took place late Sunday and early Monday at Carolinas Medical Center. But he agreed to talk in general about transplant recovery.

For the first three to five days, Sheridan said, patients are in bed, perhaps on ventilators to help them breathe, getting "a great deal of intensive care therapy. ... It takes some time for that heart to get used to its new environment."

CMC doctors declined to talk Monday about their high-profile patient. Panthers and National Football League officials, including league commissioner Roger Goodell, said Richardson's transplant was successful, but hospital officials would not even confirm he is a patient.

Richardson, 72, had coronary bypass surgery in October 2002. After not feeling well this past fall, he received a pacemaker/defibrillator in November and went on a waiting list for a heart in December.

Organ recipients don't usually find out the identity of their donors, but for CMC patients, the donors would have to come from the eastern United States or the Midwest. Transplant teams have only about four hours to take the heart from a donor and get it transplanted inside a recipient. Donors and recipients also have to be about the same size, and they must have compatible blood types.

Transplant patients usually stay in the hospital two to four weeks, Sheridan said. Normal recovery time is three to six months. But patients get moving as soon as possible.

Before patients leave the hospital, they start getting regular biopsies of their new hearts to watch for rejection, one of the biggest risks. Doctors guide a catheter through a large vein in the neck and into the right ventricle of the heart, where they "take a nibble out of the septum," Sheridan said. The piece is examined for inflammation that would suggest rejection.

At Chapel Hill, Sheridan said the first biopsy is done seven days after surgery. Biopsies are performed weekly at first and gradually less often until they become annual.

While in the hospital, patients are weaned off of some of the medicines that initially supported their new hearts. But when they leave, they still could be taking 15 to 20 drugs a day, Sheridan said.

"That's probably the biggest limitation to heart transplants," Sheridan said. "The intensive medical therapy that patients have to adhere to."

Still, heart transplants are "terrific therapy," he said. "These patients are looking at a high probability of being dead in six weeks to six months. ... It's a remarkable reversal of a problem."

Good news, Goodell says

While watching the first half of Super Bowl XLIII on Sunday night, NFL Commissioner Roger Goodell received a phone call telling him his friend Jerry Richardson, the Carolina Panthers' owner, was en route to Carolinas Medical Center in Charlotte.

The commissioner stayed up very late and rose a couple of hours later to receive reports.

By the time Goodell appeared at a post-Super Bowl news conference early Monday, Richardson had received a strong prognosis from doctors.

"It's positive news," Goodell told the Charlotte Observer, saying he had been told the transplant process was "very successful."

"We're very optimistic," he said.

CHARLES CHANDLER