From the date you are referred to our program for transplant consideration, it is our goal to have you seen in our transplant office within seven days of the referral, if not sooner. The first phase involves us obtaining as many of your records as possible to have them reviewed prior to your first appointment. During your first appointment, you will meet with the heart transplant coordinator and transplant cardiologist and/or transplant surgeon who will review your medical history. During this first appointment, they provide information regarding transplantation, including potential risks and benefits of having a transplant, as well as an overview of the evaluation process. While not required, many patients find it helpful to bring someone with them to the initial consultation to listen and take notes.
After the review of your records, additional testing will be necessary to determine the best treatment path for your individual case. Based on the condition of a patient's advanced heart failure, same day testing in our Advanced Heart Failure Clinic might be discussed.
- Blood tests: You will need blood tests to help find a good donor match and help improve the chances that the donor heart will not be rejected.
- Diagnostic tests: You will need tests to assess your lungs as well as your overall health. These tests may include X-rays, ultrasound procedures, CT scan, pulmonary function tests (PFTs), and dental exams.
Meeting the Heart Team
- Surgeon: Evaluate the degree of your heart failure with the transplant team to ensure the best path is chosen for your care. The transplant surgeon will perform your transplant surgery and/or ventricular assist device (VAD) implant, if that option is the best choice for you.
- Cardiologist: Manages your heart failure treatment and evaluates you for transplantation. Following transplant, the cardiologist monitors your health and immunosuppressive medication regimen.
- Coordinator: Organize all aspects of your care before and after the transplant. They educate you about the entire process, coordinate diagnostic testing and help make sure you receive all necessary follow-up care.
- Social Worker: Evaluates your social history and discusses social issues related to cardiac transplant.
- Social worker: Some psychological and social issues that are involved in organ transplant include stress, financial issues, and support from family or significant others. These factors can greatly affect how you do after the transplant. Your social worker can help support your psychosocial needs and address them appropriately throughout the transplant process.
- Registered Dietician: You will meet with a dietician, who will assess your daily diet. The goal is for you to be as strong as possible for surgery.
- Other consults may also be required
Outline of Transplant Evaluation
On this testing day, you will be moving from department to department, and most patients bring someone along to help assist them. Plan on spending several hours on our campus for testing.
Tests may include:
- Chest CT scan
- Myocardial oxygenation tests: These tests are performed to measure the amount of oxygen the heart consumes during exercise. You will walk on a treadmill for approximately one hour while breathing into a plastic tube attached to a machine that measures oxygen consumption.
- Pulmonary function tests These tests, which take about one hour and involve blowing into a plastic tube, are used to detect lung disease. Specifically, pulmonary function studies detect and measure respiratory function abnormalities
- EKG (electrocardiogram)
- Ultrasound of abdomen
- Heart catheterization: A heart catheterization enables physicians to measure pressures in all four chambers of the heart through the insertion of a thin plastic tube or catheter into a vein in your neck. Patients receive a local anesthetic before undergoing the 30-45 minute catheterization procedure
- Cardiovascular surgery clinic appointment
- Additional imaging/lab tests
- Social work evaluation
- Registered dietitian evaluation
- Transplant education with the transplant coordinator – It is required and very important to bring your support people to this appointment.
Following the evaluation process, results from your medical tests and physical are compiled along with the medical and psychosocial history. A selection committee comprised of heart transplant team members reviews your information and makes recommendations based on your overall health and test results. If treatment options, such as surgery or conventional medical therapy, are not suitable for you based on physical condition, you will be placed on the transplant waiting list.
If our heart transplant team determines a heart transplant is the best option for you, we add you to the current wait list that is maintained by the United Network for Organ Sharing (UNOS).