The most common conditions leading to heart transplantation are coronary artery disease coupled with multiple heart attacks, and cardiomyopathy, a disease of the heart muscle. Heart transplantation may be considered when patients develop end-stage heart disease as a result of these conditions, have no other medical or surgical options, and have a high risk of dying from heart disease within one or two years.
Evaluating physicians consider the following questions to determine a patient's eligibility for heart transplantation:
During the evaluation process, candidates undergo many tests. These include:
If the transplant team determines that transplantation is a viable option, the patient is placed on the wait list for a donor organ.
Some patients eligible for transplantation may also be candidates for a left ventricular assist device (LVAD), an implantable device that takes over the function of the heart's left ventricle. LVADs are often used for a period of time to sustain patients until the time of heart transplantation, known as bridge-to-transplantation. On average, patients use an LVAD for four to six months prior to transplantation. During this time the device allows their hearts to rest, heal, and grow stronger.
If a patient is not eligible for transplantation due to age, other health problems, or complications, and medical therapy is no longer effective, surgeons may implant an LVAD indefinitely. This is known as "destination therapy."
Waiting for a suitable donor heart may take many months. Transplant recipients and their families often describe this waiting period as the most difficult part of the entire transplant process. Because fear and anxiety are normal reactions during this period of uncertainty, doctors here often suggest that transplant candidates and their families attend support groups and avail themselves of the many support services available at the Hospital. These resources are available to assist patients and their families with the multi-faceted challenges associated with the organ transplantation process, and are helpful in providing encouragement, confidence, support, and practical information.
Heart Failure and Transplantation Program