Preparations for a heart transplant often begin long before the surgery to place a transplanted heart. You may begin preparing for a heart transplant weeks, months or years before you receive a donor heart, depending upon the waiting time for transplant.
Taking the first steps
If your doctor recommends that you consider a heart transplant, you'll likely be referred to a heart transplant center for an evaluation. You're also free to select a transplant center on your own. Check with your health insurance provider to see which transplant centers are covered under your insurance plan.
When evaluating a heart transplant center, consider the number of heart transplants a center performs each year and transplant recipient survival rates. You can compare transplant center statistics on the web using a database maintained by the Scientific Registry of Transplant Recipients.
Also consider additional services that may be provided by a transplant center. Many centers may coordinate support groups, assist with travel arrangements, help you find local housing for your recovery period or direct you to organizations that can help with these concerns.
Once you decide where you would like to have your heart transplant, you'll need to have an evaluation to see if you're eligible for a transplant. During an evaluation, your doctors and transplant team will conduct a physical examination, order several tests, and evaluate your mental and emotional health. The evaluation will check to see if you:
- Have a heart condition that would benefit from transplantation
- Might benefit from other less aggressive treatment options
- Are healthy enough to undergo surgery and post-transplant treatments
- Will agree to quit smoking, if you smoke
- Are willing and able to follow the medical program outlined by the transplant team
- Can emotionally handle the wait for a donor heart
- Have a supportive network of family and friends to help you during this stressful time
Your transplant team will also discuss with you the benefits and risks of a transplant and what to expect before, during and after a transplant.
Waiting for a donor organ
If the transplant team determines that you're a candidate for a heart transplant, the transplant center will register you on a waiting list. At any given time, there are about 3,000 people in the U.S. waiting for heart transplants. Unfortunately, there aren't enough hearts for every person in need, and some people die while waiting for a transplant.
While you're on the waiting list, your medical team will closely monitor your condition and alter your treatment as needed. Your transplant team may temporarily remove your name from the waiting list if you develop a significant medical condition, such as a severe infection or stroke, which makes you temporarily unable to have a transplant while you recover.
Your doctors may recommend that you participate in a cardiac rehabilitation program while you wait for a donor heart. Cardiac rehabilitation is a program of exercise and education designed to help improve your health before and after your heart transplant.
If medical therapy fails to support your vital organs as you wait for a donor heart, your doctors may recommend you have a device implanted to support your heart while you wait for a donor organ, such as a ventricular assist device (VAD). These devices are also referred to as a bridge to transplant because they stabilize your condition until a donor heart is available.
When a donor heart becomes available, the donor-recipient matching system considers several factors to make a match, including:
- Medical urgency of potential recipients
- Blood type (A, B, AB or O)
- Antibodies the recipients may have developed
- Size of the donor
- Time spent on the waiting list
Immediately before your transplant surgery
A heart transplant usually needs to occur within four hours of organ removal for the donor organ to remain usable. As a result, hearts are offered first to a transplant center close by, then to centers within certain distances of the donor hospital.
Transporting donor organs for transplant
Mayo doctors and staff can receive donor organs from other locations and transport them to prepare them for transplantation.
You'll need to remain in close contact with the transplant team and let them know if you have any changes to your health. Make sure the transplant center has phone numbers to be able to contact you anytime. The transplant center needs to be able to reach you 24 hours a day.
When you're notified that a potential organ is available, you and your transplant team have a limited amount of time to consider whether to accept the donation. You'll be expected to travel to the transplant hospital immediately after being notified of the potential donation. You'll usually need to be prepared to get to the hospital within three hours.
As much as possible, you should generally make travel plans ahead of time. Some heart transplant centers provide private air transportation or other travel arrangements. Have a suitcase packed with everything you'll need for your hospital stay, as well as an extra 24-hour supply of your medications.
Once you arrive at the hospital, your doctors and transplant team will conduct a final evaluation to determine if the donor heart is suitable for you and if you're ready to have surgery. If your doctors and transplant team decide that the donor heart isn't appropriate for you or surgery isn't appropriate for you, you may not be able to have the transplant.
Sept. 19, 2017