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Anime And Manga
- Angel Beats! has the rare heroic example of Otonashi donating his heart to Tenshi after dying.
- This is the premise of Angel Heart: receiving a heart transplant changes the life of an assassin.
- Happens very early in Area no Kishi: While Kakeru Aizawa is talented at soccer, he has an inferiority complex over his older brother Suguru who is the top player representing Japan in international U-15 championship, effectively reducing his performances in the field. After receiving heart transplant from his dead older brother after thei both had an accident, he re-embraces his love for soccer and inherits his brother's spirit.
- In Blue Submarine No. 6, it turns out that the doctor everyone blamed the world's problems on removed his own heart and used it to power the Earth's destabilizing magnetic field. So, in this case, the one who received his heart was the planet.
- In Busou Renkin, the villain Victor's Start of Darkness began when he had his heart replaced by the experimental Black Kakugane.
- In Science Ninja Team Gatchaman the Condor has to have his heart replaced.
- Happens in Seven Mortal Sins, when Lucifer switches her heart with Maria's.
- In Mega Man: Defender of the Human Race, to cement his character development, ProtoMan offers his own internal regulator/heart to save Mega Man.
- Dragonheart: Draco gave half his heart to the prince hoping it might redeem the prince from the ways of his wicked family. It didn't work because he was always a jerkass, but due to this trope the hero assumes that Draco is at fault for corrupting him.
- A sort of example, Tony Stark from Iron Man; though the heart didn't actually come from someone (or something) else, getting the arc generator put in his chest did symbolically represent his assumption of the role of Iron Man, thus fitting the trope.
- In the movie Heart Condition, a heart transplant patient ends up stuck with the ghost of the donor, a black man whom the recipient hated because he was racist, and because the recipient a cop and the other guy a lawyer. This of course brings about an emotional change of heart as the movie progresses.
- In Repo Men, the main character only acts like a decent human being after losing his heart and having it replaced with a mechanical heart.
- In Return to Me, Grace receives a transplanted heart that previously belonged to Bob's late wife. Although the movie is mostly not supernatural, there is one brief moment which suggests a connection between Grace and Bob due to the transplanted heart.
- A heroic version occurs in Terminator Salvation. John Conner gets mortally wounded and Marcus makes a Heroic Sacrifice giving him his own heart.
- In Clockwork, by Philip Pullman, a character's mechanical heart is winding down, threatening his life.
- In Howl's Moving Castle (both the anime and the novel) Calcifer had swallowed Howl's heart as part of an old contract between them. The ending involves the heart being returned to its original owner, with some improvement of said owner's character.
- In Meredith Ann Pierce's book The Darkangel, two characters switch hearts in an attempt to save one of them at the expense of the other's life. They both live, because as it turned out, there was a way to revive the vampyre's heart without Aeriel giving up hers.
- The titular warlock in the Harry Potter fairy tale The Warlock's Hairy Heart attempts this. It doesn't go well for anyone.
- One of the older print examples is the Tin Man from The Wonderful Wizard of Oz. Because of the curse on him and the Emergency Transformation he underwent to survive it, he does not have a proper heart. He wants to ask the Wizard for a replacement so he can return to his girlfriend and become a proper husband for her. He succeeds in his task and gets a sawdust and silk one. Too bad his girlfriend was seeing someone else on the side, and got married when he was rusted by the roadside.
- In How the Grinch Stole Christmas!, the Grinch has a change of heart about stealing the Christmas gifts from Who-Ville after he heard the Whos celebrate anyway and his heart grows three times as large as it was before.
- In Three Fat Man by Yuri Olesha, the titular villains demanded from a scientist to replace the heart of their future heir with a heart of iron in order for him to grow up the way they wanted. When the scientist tried to explain it cannot be done, they put him in a cage. A rumor eventually spread among the population that the Fat Men did replace the boy's heart (a completely false one - the boy was shown as kind, although rather misinformed).
- In the Magic: The Gathering Scar of Mirrodin block novel, Venser gave his heart to Karn, whose original Heartstone was full of Phyrexian Glistening Oil. This allowed Karn to leave New Phyrexia and begin work in removing their evil once again.
- Wilhelm Hauff's story "The Marble Heart" is a about some giant (or perhaps a devil) who offers people wealth, but in return, they must have their hearts replaced with marble.
Live Action TV
- Highway to Heaven: Totally reversed in the late Season 2 episode "The Torch," where Everett Soloman, a Nazi death camp survivor whose parents were killed during World War II, is speaking against the growing Neo Nazi movement needs a heart transplant. Meanwhile, one of the Neo Nazi groups, led by Jan Baltic, is determined to silence Soloman and eventually they kill his son. While Baltic and his group — engaged in a campaign to convince the public that the Holocaust was mere propogandalized fiction — are planning their next move, his son accidentally sets off a machine gun, mortally wounding Baltic and killing two others. The change of heart comes when Baltic's heart is a biological match for Soloman. The transplant is successful ... but when Soloman learns the heart of his sworn enemy now beats inside him, he suddenly becomes ill and wants to die. While in his coma, Soloman has a dream where he is visited by his son and his parents, convincing him that this literal change of heart came for a reason and that he needs to continue his public speeches before a new Neo Nazi group is able to take root. He agrees and, once well, he resumes his (presumably ultimately successful) public speaking tour.
- In a cruel case of irony, Herschel Bernardi, the actor who played Everett Soloman, died of a heart attack in May 1986, less than six months after this episode was filmed.
- In the series finale of Smallville, Darkseid takes Lionel's heart out and plants it in the Lex clone's body.
- Occurs in the "Brown Betty" episode of Fringe.
- In Star Trek: The Next Generation, Captain Picard got in a fight with some surly Naussicans as a youth and got stabbed right through the chest. Now he's got an artificial heart. During a near-death experience in a later episode, he was asked by Q if he would like to change that part of his past that lead up to that (and the subsequent malfunction of the artificial heart years later); however, by doing so, he wound up becoming a person who never developed any guts or took any risks.
- Played with in an episode of The Ricky Gervais Show. In the episode, Karl talks about a made-up TV show he came up with called "Look What We Can Do With Science" and has him explaining how he thinks human organs can just be either removed or replaced. He then states that they could replace a person's heart with a pacemaker, but Ricky is quick to point out that they don't really replace the heart with a pacemaker in real life.
- Occurs in Kingdom Hospital. A shady, sleazy, overweight lawyer needs a heart transplant. Otto's dog finds a suitable heart, and Antubis transplants it.
Antubis: Out with the old...and in with the new.Lawyer: AAAAAAAAAAAAAAAHHHHHHHHHHHHHHHH!
- This trope is in one origin story for Xuanwu (Genbu) of The Four Gods: as a mere mortal, he was a ruthlessly brutal butcher until he had a vision where he saw his horrifically disgusting insides being swapped out for much nicer ones. This resulted in him getting religion and becoming a saint, then going back to battle his old insides (which had become monstrous).
- In Dungeons & Dragons, ancient red dragon Ashardalon was already a arrogant monster of greed and violence when his heart was badly damaged in battle. But after he replaced it with a literal demon, Ammet the Eater of Souls, it got worse as Ashardalon basically became pure evil incarnate.
- In Kingdom Hearts, this is how a Grand Theft Me by Big Bad Xehanort is preformed.
- In Brütal Legend, Demon Emperor Doviculus keeps his defeated enemies' (including Drowned Ophelia's) hearts in his chest. It doesn't influence his Neutral Evil morality much.
- Legacy of Kain features the Heart of Darkness, which is heart of the last ancient vampire Janos Audron, ripped still-beating from his chest by Sarafan vampire hunters and christened as such. In the first game, the Heart simply acts as a healing item, but eventually it's revealed that the same heart was used by Mortanius the Necromancer to resurrect Kain, and it's also the only thing that can resurrect Janos himself.
- In Team Fortress 2's "Meet the Medic" video, the Medic accidentally destroys the Heavy's heart when trying to attach the Ubercharge device to it. He substitutes a larger heart from a "Mega Baboon" for it instead.
- Tales of Vesperia: Raven's heart was replaced with a modified blastia after he died during the Great War, which took place 10 years prior to the events of the game itself. It not only sustains his life, it allows him to unleash the very same power as an offensive weapon; as seen during his Mystic Arte.
- During the Old World Blues DLC for Fallout: New Vegas, the player has his/her heart (and brain, and spine) removed and replaced by a synthetic one. Later on, you have the choice of keeping your powerful synthetic organs or putting your old ones back in (upgraded with a bit of tech, of course). Your upgraded original organs give better boosts to your SPECIAL stats and Damage Threshold, while the synthetic ones give smaller boosts but will also make you immune to poison and being crippled in the head and torso.
- The Elder Scrolls
- From the series' backstory comes Pelinal Whitestrake, the legendary 1st Era hero of mankind/racist berserker. Believed to have been a Shezarrine, physical incarnations of the spirit of the "dead" creator god Lorkhan (known to the Imperials as "Shezarr"), Pelinal came to St. Alessia to serve as her divine champion in the war against the Ayleids. He had a hole in his chest and a red diamond instead of a heart, symbolizing his connection with the "heartless" Lorkhan. He killed those who spoke of such things to him, though.
- In Skyrim, Forsworn Briarhearts are warriors who have had their hearts replaced with magical briar seeds. They are the mightiest warriors in the Forsworn's ranks, but the ritual deprives them of free will and makes them of little use as anything other than berserkers or battlemages. Also, if you can pickpocket the Briar Heart from them, it will kill them instantly.
- One mission in the Sega Shadowrun game has you stealing a cybernetic heart in order to save the life of one of your brother's friends, because he's installed so much cyberware on his body that his biological heart can't sustain him anymore.
- In Metal Gear Rising: Revengeance, Senator Armstrong's nanomachines (son) are controlled/powered by his artificial heart that you must cut out of him in order to put him down for good.
- In The Legend of Heroes: Trails of Cold Steel III, it's revealed that the reason why Rean has his powers is because his father used his own heart to transplant it to his son. He can survive easily because he is a Divergent being. It's also the reason why survives his assassination back in the first game.