Heart Transplantation

Your own cardiologist will make a referral for you to be evaluated for transplantation appropriateness at Ohio State’s Ross Heart Hospital. You will need to notify your insurance company before making your initial evaluation appointment. Our pre-transplant office and hospital business office will work with you to determine insurance availability and precertification requirements. Heart transplant coordinators and business office staff then work together to meet insurance company requirements for evaluation and transplant procedure approval.

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:

Once your testing has been completed, your case is presented to the Heart Transplant Patient Selection Committee, which comprises cardiothoracic surgeons, transplant cardiologists, transplant coordinators, a social worker, an infectious disease specialist and a psychologist. This committee will determine if a heart transplant is the best course of action for you.

If the Heart Transplant Patient Selection Committee approves you for transplant listing, the final step involves approval by the Ohio Solid Organ Transplantation Consortium (OSOTC). When approved by the OSOTC, you are then listed for heart transplantation on the United Network for Organ Sharing national waiting list.

It is important to note that you are not on the waiting list for transplant until you are told so by your heart transplant coordinator. A letter is sent to your insurance company providing recommendations for transplantation and requesting approval.

Donors are matched to recipients according to blood type, size, severity of illness and geographic location. Your wait time could be from days to years. 

Our heart failure physicians will continue to follow up with you while you are waiting. You must submit to random drug, nicotine and alcohol screenings.

You must be reachable by phone at all times. Your transplant team is receiving offers of hearts from organ procurement organizations and then relaying that information to your transplant surgeon and cardiologist. If an organ is a good match for you, you will be contacted immediately. You should always be within a two-hour drive of Columbus, due to tight time constraints of a transplant.

You should not eat or drink anything from the moment you are notified that a heart has been matched to you. You will be instructed to immediately come to The Ohio State University Wexner Medical Center for admission to the Ross Heart Hospital.

At the same time, one team of OSU surgeons will be traveling to the donor hospital to recover the donor heart. If the heart is found to not be suitable for you, we may decline it and you may be sent home. If the donor heart is found to be acceptable, the team will recover the organ and transport it back to Columbus. The heart needs to be transplanted within four to six hours after donor recovery.

At the same time, the recipient surgical team is preparing you for the heart’s arrival. You will undergo lab tests, receive an x-ray and begin immunosuppression medications. You will then go to surgery. You will be in the operating room for approximately six hours.

Upon completion of the surgery, you will be taken to the intensive care unit and closely monitored for complications. You will be on a ventilator, with multiple IVs and monitoring devices. Usually, you will be removed from the ventilator and out of bed within 24-48 hours post-operation.

The average length of a hospital stay for a heart transplant patient is seven to 14 days. Post-transplant success depends on your ability to take multiple medications daily (up to 40 pills a day) and to maintain a rigorous follow-up schedule, especially early on. Exercising and eating a heart-healthy diet are also important.

Endomyocardial biopsies, used to diagnose rejection within the heart, are done weekly in the early post-transplant phase. They are done as an outpatient procedure and last about a half-hour.

Some degree of rejection is normal and expected. To treat rejection, your medication may be adjusted or you may receive an IV treatment. Rejection is very treatable if detected early.

After clearance by your doctor, we encourage you to return to work. A licensed independent social worker specially trained in transplant will assist you in adjusting to lifestyle changes brought on by your disease and its treatment. A registered dietitian will individualize your nutritional care and teach you about your dietary needs.

You will be followed and evaluated annually by our transplant team. Your transplant coordinator will be an important part of your recovery.

Although patients are ultimately responsible for the costs associated with a transplant, financial resources are not the determining factor in selection for the transplant program. A transplant financial counselor, business office staff and transplant social workers assist you and your family with questions about insurance coverage for your transplant and post-transplant medications.

This doctor specializes in heart care and will follow you before, during and after your lung transplant to ensure your heart stays healthy throughout the process.

This doctor will perform your lung transplant surgery and help take care of you after the transplant. They will discuss the operation and responsibilities after transplant. 

These doctors, who specialize in infectious diseases, will follow you before and after your transplant (if needed) to reduce risk of infection.

The advanced practice providers include physician assistants and nurse practitioners who work closely with your physician to ensure continuity of care throughout your stay at the hospital and your transition to outpatient care. They order and monitor diagnostic tests and treatments, respond to urgent needs, diagnose and treat problems if they arise and provide the educational tools and resources necessary to continue success with your transplant once you are discharged.

These are the nurses who will be your primary contact from the time you are referred for a transplant evaluation throughout your care at Ohio State’s Wexner Medical Center. They will help answer any questions you may have and assist you throughout your transplant experience.

These are the nurses who will be your primary contact from the time you are referred for a mechanical device throughout your care at Ohio State’s Wexner Medical Center. They will help educate you and your family as well as answer any questions you may have and assist you throughout your experience.

These professionals meet with you to evaluate your psychological readiness for transplantation.

A transplant pharmacist is a pharmacist who specifically works with patients who have received a transplanted organ. This pharmacist has been trained to understand details about anti-rejection medications, works closely with your transplant physician to help manage your medications and helps answer medication questions you may have.

This professional offers assessment, linkage and referrals for assistance to patients who need certain medications and have high co-pays or no prescription drug coverage.

Contact: 800-626-2538

The list of accepted insurances for heart transplant can often change. Please contact your health care insurance provider to confirm your coverage for transplant at Ohio State’s Comprehensive Transplant Center.

Ohio State's Tissue Typing Laboratory ensures that an organ is compatible with its recipient. The process involves matching a person's unique configuration of six human leukocyte antigen (HLA) molecules with a potential pool of approximately 100 different varieties.

Cross-match testing helps prevent some types of organ rejection. The testing involves mixing cells from the donor's and recipient's serum to determine whether rejection-promoting antibodies will occur. This information helps your physicians plan for the right medication strategy to best control organ rejection.

Transplant support testing includes monitoring new drugs that patients use, testing to determine a patient's overall ability to maintain a recipient's organ and developing new tests to support many of the clinical aspects of transplantation.

Organ transplant affects a person’s body, spirit and life in numerous ways. Adjusting to these changes can often be easier with the assistance of others with similar experiences.

Open to all Ohio State’s LVAD and heart  transplant patients, Ohio State’s Heart Failure Support Group offers an emotionally supportive community before and after the transplant journey and is one of many additional, optional resources offered to benefit our heart failure patients. 

• Date: Meetings will be held weekly on Wednesdays
• Time: 3 – 4 p.m.
• Location: Ohio State Ross Heart Hospital, 6th floor conference room

For any questions or concerns, please call the heart failure office at 614-293-4748.