If a heart transplant is thought to be an option for you, you will be referred for an assessment. Tests are carried out to find out whether a transplant really is the best treatment for you.
Transplant assessment
You will need to stay in hospital for three to five days for the assessment. Tests may include:
- blood tests
- urine tests
- tests to find out how efficiently your lungs work
- electrocardiogram (ECG), which records the electrical activity of your heart
- echocardiogram, which checks how well your heart is pumping
- cardiac catheterisation and an exercise test (these determine how severely your heart is affected and whether any other treatments might be helpful)
During the assessment, you will have the chance to meet members of the transplant team and to ask any questions. The transplant co-ordinator (your main point of contact) will talk to you and your family about what happens and the risks involved in a heart transplant.
When the assessment is complete, it will be decided whether a heart transplant is suitable for you and is the best option.
It may be decided that:
- You should go on the active waiting list (which means you could be called for a transplant at any time).
- A transplant is suitable for you, but your condition is not severe enough. You will be put on a provisional waiting list, and if your condition worsens, you will then be put on the active waiting list.
- You need more investigations or treatment before a decision can be reached.
- A transplant is not suitable for you. In this case, the assessment team will explain why and offer you other options, such as drug therapy or alternative cardiac surgery.
- You need a second opinion from a different transplant centre.
Why you might be unsuitable for a heart transplant
You may be considered unsuitable if:
- Your heart failure is not severe enough. There are only enough donor hearts to treat people who are the most sick.
- You have poor kidney function. One of the drugs given after a transplant is poisonous to the kidneys, so your kidneys need to be in good condition at the start.
- You have not complied with previous advice or been reliable. For example, you have not given up smoking despite being advised to do so, you have a poor history of taking prescribed medication or you have missed hospital appointments.
The waiting list
Once you are on the active waiting list, the transplant centre may give you a pager so that you can be contacted at short notice.
The right heart may be available within a few days or it could take years. The length of time you will have to wait will depend on your blood group, donor availability and how many other patients are on the list (and how urgent their cases are).
Around one in three patients on the transplant list is too ill to go home and needs to stay in hospital while they wait for a donor heart. Priority is usually given to these patients.
While you wait, you will be cared for by the doctor who referred you to the transplant centre. Your doctor will keep the transplant team updated with changes to your condition. Sometimes, another assessment is necessary to make sure you are still suitable for transplant.
