Who Needs a Heart Transplant?

Who Is Referred to a Heart Transplant Center?

Most patients referred to a heart transplant center have end-stage heart failure. Of these patients, close to half have heart failure as a result of coronary artery disease. Others have heart failure caused by hereditary conditions, viral infections of the heart, or damaged heart valves and muscles due to factors such as the use of certain medicines and alcohol, and pregnancy.

Most patients considered for a heart transplant have exhausted attempts at less invasive treatments and have been hospitalized a number of times for heart failure.

Who Is Eligible for a Heart Transplant?

The heart transplant specialists at the heart transplant center will determine whether a patient is eligible for a transplant. Specialists often include a:

• Cardiologist (a doctor who specializes in treating heart problems)
• Cardiovascular surgeon (a doctor who performs the surgery)
• Transplant coordinator (a person who makes arrangements for the surgery, such as transportation of the donor heart)
• Social worker
• Dietitian
• Psychiatrist

In general, patients selected for heart transplant have severe end-stage heart failure, but are healthy enough to receive a heart transplant. Heart failure is considered end stage when all possible treatments—such as medicine, implanted devices, and surgery—have failed.

Patients who have the following conditions might not be candidates for heart transplant surgery, because the procedure is less likely to be successful.

• Advanced age. Although there is no widely accepted upper age limit for a heart transplant, most transplant surgery isn't performed on patients older than 70 years.
• Poor blood circulation throughout the body, including the brain.
• Diseases of the kidney, lungs, or liver that can't be reversed.
• History of cancer or malignant tumors.
• Inability or unwillingness to follow lifelong medical instructions after a transplant.
• Pulmonary arterial hypertension (high blood pressure in the lungs) that can't be reversed.
• Active infection throughout the body.