Heart Transplant Journey
A heart transplantation truly is a journey, with distinct steps before, during and after the surgical procedure. Though each patient case is unique, the three key steps in the transplant process typically include patient evaluation, preparation for transplant surgery and post-surgical care.
Read Donor Facts
How are you evaluated?
As a potential transplant candidate, you will be invited to Piedmont for an evaluation and to meet our transplant team. During the first visit, you will be seen by our heart transplant coordinator and our transplant cardiologist. Before your arrival, we will try to review all of your old records, including.
- Echocardiogram
- Heart catheterization
- Stress tests
- Carotid ultrasounds (neck arteries)
- Ultrasound of the leg arteries
- Blood work
During this visit, our transplant coordinator will teach you about the transplant evaluation process. Your family is encouraged to attend with you.
Our transplant cardiologist will review your information to ensure that you are a good transplant candidate. This assessment confirms that your CHF severity is bad enough to think about transplantation, VAD, or other advanced CHF therapy. We will ensure that all other therapies have been tried or been considered. Patients are closely screened for any issues that may not make them a good candidate for transplant or VAD surgery. This screening is continued as the work-up process for surgery continues.
You will be seen and evaluated by an entire team, which includes:
- Transplant surgeon
- CHF/transplant cardiologist
- Transplant/VAD coordinator
- Social worker
- Psychiatrist
- Financial coordinator
- Palliative care/spiritual care.
There are many tests and studies needed to make sure you are a good candidate for heart transplantation or VAD surgery. Some of these are listed below.
Heart Tests
- Left and right heart catheterization
- Cardiopulmonary stress test
- Echocardiogram
- EKG
- Exercise stress tests
Infectious disease
- PPD
- Vaccinations such as pneumonia, Hepatitis B and Tetanus
Miscellaneous tests
- Urinalysis
- PAP Smear, mammogram in all females once a year
- Colonoscopy (patients over the age of 50)
- Abdominal ultrasound
- Dental evaluation
Laboratory Tests
- CBC with differential
- Fasting lipid panel (LDL, HDL, cholesterol, and triglycerides)
- Thyroid function tests
- PSA in all males over the age of 50
- Blood type
- Panel reactive antibody screen (antibody screen)
After you are selected
United Network for Organ Sharing (UNOS)
If you are accepted for transplantation and insurance approval is obtained, you will be listed with UNOS. This is the national listing organization that matches transplant recipients with available donor organs. Once an organ donor becomes available, the UNOS computer then generates a list of patients who match the donor organ.
Matches are based on the following criteria, and include:
- Where the patient is listed
- Time spent on the waiting list
- Blood type
- Size
- Severity of heart failure
Waiting period
As a transplant candidate accepted for the wait list, you must either have a pager or mobile telephone so we may reach you away from home. It is your responsibility to be available at all times. We recommend that you give our transplant coordinator all of the numbers we can use to reach you. You need to tell the transplant coordinator when:
- You are sick or hospitalized
- You will be unreachable or unavailable
- You travel outside of a defined radius from Piedmont Hospital
Donated organs always are utilized locally first. If a local donor match does not exist, the organ is then offered to a larger region, and then finally it is offered nationally.
Things to know when you are at home
Once you are home, it will be important to keep the surgical area clean and dry. You will be given specific bathing instructions. The sutures or surgical staples will be removed during a follow-up office visit, if they were not removed before you left the hospital. You should not drive until your physicians give you permission. Other activity restrictions may apply. Ask questions to make sure you know what you can and cannot do at home.
It is important for you to monitor your own progress and recognize if there is something that might be an early problem.
Call the transplant team if you have any of the following:
- Fever and/or chills
- Redness, swelling, or bleeding or drainage from the incision site
- Increase in pain around the incision site
- Difficulty breathing
Follow-up visits will be scheduled frequently after you go home from the hospital. These visits will include blood tests, chest x-rays, and heart biopsy (removal of tissue from the heart for examination under a microscope.) The transplant team will explain the schedule for these tests.