While a complex organ, the heart is basically a muscle that contracts and relaxes to pump blood through the body. When this muscle becomes damaged or weakened to the point where it cannot pump an adequate amount of oxygenated blood, a heart transplant may be the only treatment available.
During a heart transplant, the patient’s heart is removed and the pumping of blood is rerouted through a bypass machine. A healthy heart from a deceased donor is transplanted into the patient and blood flow is again rerouted, this time into the transplanted heart.
Who Qualifies for a Heart Transplant?
To determine if a patient is a good candidate for a heart transplant, he or she will undergo a comprehensive series of medical and psychological tests and procedures. Information learned during these tests is used to match patients with donor hearts. Because donor organs are scarce, this process also screens for the likelihood of organ rejection. Patients whose bodies are more likely to reject a transplanted heart may be considered ineligible for transplant without additional treatments.
- Other conditions or factors that may take a patient out of consideration for a heart transplant include:
- Current or recurring infection that is not treatable
- Cancer that has metasticized (spread) from its primary site to another location in the body
- Medical problems that would prevent the patient from tolerating the surgical procedure
- Serious non-cardiac-related conditions that will not improve after the transplant
- A patient’s refusal or inability to adhere to a very rigid treatment regimen
How are Donor Hearts Found?
In the United States, the United Network for Organ Sharing (UNOS) is the organization responsible for distributing transplant organs. UNOS has a database system that works 24/7, collecting and analyzing every piece of information related to a heart transplant waiting list, organ matching and transplant surgeries. Every heart transplant candidate’s data is entered in this system and continually updated with new or relevant information from the patient’s medical team. The conditions of patients needing a heart are ranked according to the urgency of their need with those most in need receiving first priority for donor hearts.
When a heart becomes available, its tissue characteristics are analyzed in the database to find a heart transplant candidate with a matching tissue type, starting with those with the most urgent need. If a candidate with a more urgent status isn’t a tissue match for the donor heart, the database then checks for candidates ranked lower on the urgency scale.
How Does a Patient Get on a Waiting List?
Potential heart transplant candidates undergo a series of tests and procedures. This screening process not only determines whether a heart transplant is an appropriate treatment based on patient condition and likelihood of organ rejection, but also gathers the information needed for the UNOS database. Testing includes:
- Psychological and social evaluation
- Diagnostic tests, including:
o Sonography (ultrasound)
o Computed tomography scan (CT or CAT scan)
o Pulmonary function test
o Dental exam
o Pap smear
o Gynecological evaluation
- Blood tests