Becoming a Candidate for a Heart Transplant

In general, people who qualify for heart transplants have a severe, life-threatening heart disease that has not responded to surgery or other medical treatments. You will need a referral to The University Hospital from your physician to be evaluated as a possible candidate for a heart transplant. 

At The University Hospital, you will have a thorough evaluation to determine whether a heart transplant is a viable option for you. In performing this evaluation, we look carefully at your overall medical condition, and we make certain that you meet specific criteria established by the Ohio Solid Organ Transplantation Consortium. Consortium criteria may change as new information and findings become available.

The guidelines are as follows:

• You must be age 60 or younger.

• You must have severe, life-threatening heart disease that has not responded to other treatments.

• You must not have any other life-threatening illness, such as cancer; severe kidney, liver, or lung disease; or diabetes with circulatory or kidney problems.

• You must not have an active alcohol or drug addiction.

There are other specific health conditions that may make you ineligible for heart transplantation. These will be discussed in detail with you at the time of your evaluation.
 

What happens during the pre-transplant evaluation?

The pre-transplant evaluation includes a number of tests and will require more than one visit to complete. The average time for the first visit is three to four hours. If your doctor has referred you to us for evaluation, we ask that you sign a release of information form in your doctor's office before your first visit so your complete medical records can be sent to us ahead of time. This gives us time to review your medical history before your first evaluation appointment.

Please notify us before your appointment if you need oxygen, a wheelchair, or if you have other special needs. You may reach us at 513-584-7217.

Your pre-transplant evaluation may include testing of your heart function with echocardiogram and MUGA (multigated acquisition) scans, and possibly a cardiac catheterization.

An echocardiogram is a painless test that uses sound waves to examine the size, shape and movement of the heart's valves and chambers; and to determine the heart's function. There is no special preparation for this test. The test will probably only take 20 to 30 minutes.

An electrocardiogram (ECG) is done at the same time as an echocardiogram to compare the heart movement to the contraction and relaxation phases of the heartbeat. There is no evidence that sound waves produce any harmful effects. No radiation is used in performing this test.

In the MUGA test, a detector over your chest measures the movement of a radioactive tracer chemical through the left ventricle of your heart. Like the echocardiogram, this is a nonsurgical test. You will remain awake during the test.

For this test, you will be injected with a non-radioactive, tin-containing compound. Twenty minutes later, you will be injected with a tracer. A detector is placed over your chest during the test to measure the ability of your heart to pump blood. You will have less exposure to radiation during this test than you would from a series of lower-back x-rays.

A heart catheterization may also be performed at a later date. A cardiac catheterization lets the cardiologist actually see how the blood flows through your heart and arteries. You will go to the cardiac cath lab where a cardiac cath team will perform this test.

For the test, a doctor inserts a catheter tube into an artery in your leg and guides it to your heart. From the catheter, the doctor can release a special dye which shows up on the monitor screens in the room and on x-ray films. You will be awake but sedated during the procedure, which lasts about an hour. For more information about cardiac catheterization, see the section Coronary Artery Procedures.

You will also have blood tests, x-rays and electrocardiograms, and other tests, which will provide us with information about your body and your health. Over the course of your pre-transplant evaluation, you will meet with The University Hospital cardiologists and cardiac surgeons, as well as our nurses, a social worker, a financial counselor and other staff members, as needed.

We will provide you and your family with as much information as possible about heart transplantation to make certain that you are well-prepared for the transplant process. It is important that you and your family understand that following medical instructions is essential both before and after your transplant for healthy recovery and long-term survival.