The decision to proceed with heart transplant is considered when no other medical or surgical options are available. A heart transplant offers an improved quality of life but it also comes with many new responsibilities.
Anyone considered for transplant will have an extensive evaluation by the heart transplant team. Evaluation and testing can take 2-3 days. This includes:
Cardiac Catheterization: used to evaluate the function and anatomy of the heart. Also looks at the blood pressures in the chambers of the heart and the blood pressure of the lung arteries.
Echocardiogram (ECHO): an ultrasound of the heart that measures the size, anatomy and function of the heart.
Electrocardiogram (EKG): shows the heart rhythm and heart rate.
Chest X-ray: an X-ray image of heart and lungs
Blood Tests: blood will be drawn to check the function of the kidneys, thyroid, pancreas, liver, immune system and blood type
Dental Evaluation: check for any dental cavities
Nutrition Evaluation: provides support in making healthy diet choices
Social Work Evaluation: identifies needs and social support system
Heart Transplant is not available for everyone. There are specific criteria for eligibility that are published and supported by the Ohio Solid Organ Transplant Consortium (OSOTC). Our program is a member of OSOTC and information (without identifiers) is sent to the OSOTC for review prior to listing a patient.
Once the evaluation is complete, the next step is listing. Listing is done through the national transplant list managed by the United Network for Organ Sharing (UNOS). UNOS works with our local procurement agency, Lifeline of Ohio, to recover organs.
Organs are distributed to the most critically ill patients. Once a person is listed for heart transplant, they are given a listing status based on the severity of heart failure. This status is determined by UNOS. UNOS ensures fair distribution of organs.
Status 1A often involves the critically ill. These patients are usually in the intensive care unit. They may require special medical equipment to support breathing and/or require certain high dose intravenous (IV) medication(s) to help the heart work better.
Status 1B patients require the same medications to help their heart work better but at lower doses. They do not need care in the intensive care unit but will be hospitalized on the step-down heart floor. Infants and children who can not gain weight appropriate for their age due to their heart problem can be listed as 1B.
Status 2 patients do not meet status 1A or 1B criteria. They are well enough to wait at home. They will be called at home or given a pager to carry and will be notified by the Transplant Coordinator when a new heart is available.
A suitable organ donor is a person who is a match to the patient’s blood type and is of similar body size. The average waiting time for a new heart can be weeks to months.
When the appropriate donor heart is found, we will begin the process of preparing for the surgery of heart transplant. This surgery is very similar to any other type of open heart surgery. The average length of surgery is approximately 6-8 hours. You may wait with your family and friends in the surgical waiting room in the main hospital on the second floor. Here you will receive updates from the surgical team and the surgeon will meet you here once the surgery is complete.
After the transplant operation, the hospital recovery time is variable but may be several weeks. After the heart transplant surgery the patient is cared for in the Cardiothoracic Intensive Care Unit (CTICU) for close monitoring. Once able, the patient will be moved to the cardiac step-down unit (H4A) with the next transition to be discharged to home.