Since completing our first heart transplant in 1986, The Ohio State University Wexner Medical Center has been the only adult heart transplant center in central Ohio.
Why choose Ohio State for heart transplant?
Experience: Our Comprehensive Transplant Center has one of the largest organ transplant programs in the nation. We perform more than 350 kidney, liver, pancreas, combined kidney-pancreas, heart and lung transplants each year. Since our program started in 1967, we have performed more than 9,250 lifesaving transplants including nearly 500 heart transplants.
Heart Transplant Candidates
Heart transplant candidates
- Ischemic cardiomyopathy: happens when an artery leading to the heart becomes narrowed or blocked for a short time and oxygen-rich blood cannot reach your heart. In most cases of ischemia, this temporary blood shortage to the heart causes pain in the chest (called angina pectoris). In certain other cases, there is no pain. These cases are called silent ischemia
- Non-ischemic cardiomyopathy: predominately involves the heart's abnormal structure and function. It does not involve the hardening of arteries on the heart surface typically associated with ischemic cardiomyopathy
- Post-partum cardiomyopathy: a rare type of heart failure that is diagnosed in women during the last month of pregnancy or within five months following delivery. The damage weakens the heart muscle and causes the heart to become enlarged. As a result, the heart can’t pump blood properly throughout the rest of the body
- Malignant arrhythmias: abnormal electrical signals in the heart that cause impairment, preventing the heart from beating in an organized rhythm and may cause sudden cardiac death
- Intractable angina: debilitating chest pain or discomfort that occurs during exercise and exertion that prevents living a meaningful quality of life and is not treatable by opening up more blood flow to the heart
Clinic Evaluation Phase
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.
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.
Active Wait List Phase
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.
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.
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.
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.
Infectious Disease Physician
These doctors, who specialize in infectious diseases, will follow you before and after your transplant (if needed) to reduce risk of infection.
Advanced Practice Provider
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.
Heart Transplant Coordinator
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.
- Erin Bumgardner, BSN, RN, CCTC
- Emily Jarvis, BSN, RN, CCTC
- Susan Montgomery, BSN, RN, CCTC
Ventricular Assist Device Coordinator
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.
- Nicole Albright, RN, BSN
- Abby Bergman, RN, BC, BSN
- Kelly MacBrair, RN, BSN
- Stacie Osborn, RN, BSN
Heart transplant office associate:
- Laura Cook
- Kristin Kuntz, PhD, Transplant Psychologist
- Laura Newman, LISW
- Pam Burcham, RPh
- Kevin Kissling, RPh
Pharmacy Patient Assistance Coordinator
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.
- Emily Snow
- David Williams
Frequently Asked Questions
Which health insurance are accepted?
The list of accepted insurances for heart transplant can often change. Please contact your healthcare insurance provider to confirm your coverage for transplant at Ohio State’s Comprehensive Transplant Center.
What is tissue typing?
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.
Are there any support groups to join?
As the local organ, eye and tissue recovery agency, Lifeline of Ohio does not have a formal support group, but does have a volunteer program that brings organ transplant recipients together in the effort to promote organ, eye and tissue donation awareness, and the need for registered donors. Volunteer trainings and promotional events are held periodically throughout the year.
More information can be obtained by calling 614-384-7375 or visiting www.lifelineofohio.org/volunteers.