You will first be seen by one of our heart failure specialists to determine if you are a transplant candidate. If you are, you will then be scheduled for a full outpatient clinic evaluation. There we will determine if there is a need for additional medical or surgical therapy before transplant evaluation testing is initiated.
You will next meet the transplant coordinator and be scheduled for evaluation testing. The evaluation includes extensive cardiovascular testing, in addition to other tests that evaluate your health. Transplant candidates should be in good overall health since immunosuppressant medications taken after transplant are hard on bones, kidneys and liver.
Heart transplant candidates are classified into four categories, depending on the severity of illness:
- Status 1A: Critically ill, must have one of the following: on ventilator, a ventricular assist device or VAD (good for 30 days useable at any time post-VAD), VAD-related complication, intra-aortic balloon pump or multiple inotropic medications with a hemodynamic monitoring device placed
- Status 1B: May be in the hospital or at home on continuous inotropic support (single inotrope)
- Status 2: Stable patient at home on oral therapy
- Status 7: Temporarily inactive (not accruing time, not able to be transplanted for multiple reasons, such as infection, recent surgery, personal issues, etc.)
Priority for donor hearts is given to the “sickest” patients first, starting with Status 1A.
As part of your evaluation, you will also have consultations with our social worker, infectious disease specialists and the transplant psychologist. Every patient being evaluated for a heart transplant will have a psychosocial assessment to help determine if you have the psychological stability, motivation and personal support to meet the challenges of transplantation.
Additionally, all patients must meet the chemical dependency requirements of the Ohio Solid Organ Transplantation Consortium. The use of tobacco, alcohol or illicit drugs is carefully examined. Patients who are dependent on alcohol or drugs must undergo at least six months of rehabilitation and demonstrate a minimum of six months of abstinence before being put on the heart recipient list.
Finally, the patient’s track record of compliance with medical appointments and medications will be assessed.