Because of the wide range of information necessary to determine eligibility for transplant, the evaluation process is carried out by a transplant team. The team includes a transplant surgeon, a transplant cardiologist (physician specializing in the treatment of the heart), one or more transplant nurses, a social worker, and a psychiatrist or psychologist. Additional team members may include a dietitian, a chaplain, and/or an anesthesiologist.
Components of the transplant evaluation process include, but are not limited to, the following:
- psychological and social evaluation: Psychological and social issues involved in organ transplantation, such as stress, financial issues, and support by family and/or significant others are assessed. These issues can significantly impact the outcome of a transplant.
- blood tests: Blood tests are performed to help determine a good donor match and to help improve the chances that the donor organ will not be rejected.
- diagnostic tests: Diagnostic tests may be performed to assess your lungs as well as your overall health status. These tests may include X-rays, ultrasound procedures, computed tomography (CT scan), pulmonary function tests, and dental examinations. Women may receive a Pap test, gynecology evaluation, and a mammogram.
- other preparations: Several immunizations will be given to decrease the chances of developing infections that can affect the transplanted heart.
The transplant team will consider all information from interviews, your medical history, physical examination, and diagnostic tests in determining your eligibility for heart transplantation.
Once you have been accepted as a transplant candidate, you will be placed on the United Network for Organ Sharing (UNOS) list. When a donor organ becomes available, heart recipients are selected based on the severity of their condition and their blood type. You will be notified and told to come to the hospital immediately so you can be prepared for the transplant.
The following steps will precede the transplant:
- Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
- You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if something is not clear.
- You should begin to fast once you are notified that a heart has become available.
- You may receive a sedative prior to the procedure to help you relax.
- The area around the surgical site may be shaved.
- Based upon your medical condition, your physician may request other specific preparation.