HEART
Transplant
A heart transplant can replace a failing heart that no longer pumps enough to meet the demands of the body. The goal of the Heart Transplant Program at Methodist Heart Hospital is to exhaust all medical therapies before resorting to a heart transplant, which is reserved as a final life-saving option. Transplantation is only considered for patients with severe heart failure who meet transplant criteria and otherwise have healthy organs.
Pre-Transplant Expectations
If your doctor feels you may be a candidate for heart transplant evaluation, you will have to undergo multiple diagnostic tests and medical evaluations. You will also participate in various consultations with members of our heart transplant Inter-disciplinary team including our surgeons, dietitian, social worker, psychiatrist, financial advisor, and other consulting physicians as necessary. The patient’s referring physician is considered part of the team and will be involved in all facets of the transplantation process.The heart transplant team meets on a regular basis to discuss patients who have been evaluated for transplantation. If the transplant team determines that you are a good candidate for transplantation, your name is placed on the UNOS waiting list for a donor heart. Your place on the list is determined by the severity of your illness and how long you have been waiting. You may move up or down the list as your condition declines or improves.
Private insurance, as well as Medicare and Medicaid, provides coverage for heart transplants. Our financial coordinators verify transplant benefits from insurance and/or Medicare and Medicaid, assists patients with information and planning, help you understand what your insurance will and will not cover, estimate transplant costs, and estimate what medicines will cost.
Transplant Surgery
When a donor heart becomes available, the transplant team determines if the donated heart is a good match for you. If this is the case, the Transplant Program Coordinator contacts you immediately and instructions are provided. As the donor heart is being transported to the hospital, you will be prepared for surgery. The transplant operation lasts four to six hours. During the procedure, the patient is placed on a heart-lung bypass machine keeping the blood circulating and oxygenated. The diseased heart is removed, and the donor heart is reconnected to major blood vessels and surrounding tissues.After surgery, the patient is taken to the Surgical Intensive Care Unit (SICU), and then transferred to a regular room in the hospital’s transplant unit when appropriate. Most transplant patients spend approximately 10 days in the hospital following operation. However, each individual recovery course varies and some patients may require a prolonged hospital stay.
While hospitalized, the transplant program Inter-disciplinary team of physicians, nurses, dietitians, and social workers provide post-transplant education and support services. The patient is informed about diet, exercise, cardiac rehabilitation, and medications. Classes and cardiac rehabilitation is planned accordingly. Discharge arrangements are also planned and may include home care, resumption of daily activities, and scheduling of follow-up visits.
Post Transplantation
After discharge, activity will be limited for six to eight weeks. The patient must keep a daily record of blood pressure, pulse, temperature, and dosages and times medication is taken. Patients are watched closely for signs of rejection of the transplanted heart. Rejection may occur because your body perceives the heart as foreign, and your immune system attacks the heart. To check signs of rejection, the transplant team will perform periodic heart biopsies; these involve inserting a tube through a vein in your neck or groin into the heart, from which a small sample of tissue is removed. The tissue is examined for signs of rejection. To prevent rejection, you must take immunosuppressants or anti-rejection medications the rest of your life.Because post-transplant medications are designed to suppress the immune system to reduce the risk of rejection, they also increase the risk of infection. Immediately following discharge, it is imperative that patients avoid large crowds or become in contact with unhealthy individuals.
Your transplant team will do their best to reduce your chance of having complications and to treat any problems or difficulties right away. Following instructions carefully and keeping your transplant team informed of any problems you think you may be having or are concerned about, will help you return to a normal, active life.