Acceptance into our program as a heart transplant candidate means the transplant team believes:
- Your heart condition is severe enough to warrant this aggressive therapy;
- The transplant surgery will make you feel better, keep you out of the hospital, and prolong your life, and;
- There are no conditions that would prevent a successful surgery and recovery.
Each case is different and every effort is made to make this decision based on the risk/benefit ratio of your particular case. Any alternatives to transplantation will be considered. In certain cases, the risks of transplant will be greater than others. This is discussed in detail with each patient accepted to the program.
Once accepted as a transplant candidate, you are listed in the United Network of Organ Sharing (UNOS) computer. This is a nationwide computer list of all people in the country who are awaiting transplant. Once you are listed, you are re-evaluated every six months. If your condition improves, you may be removed from the list.
Each listed patient is assigned one of four status ratings based on clinical status. Your status may change as your condition changes.
Status Ratings for Patients Awaiting Transplant
This is the highest priority. Status 1A patients must require at least one of the following:
- Use of a life support ventricular assist device (such as a left ventricular assist device) for 30 days or less
Mechanical ventilation (breathing machine)
- Continuous use of high-dose intravenous inotropes (i.e. dobutamine or milrinone) in the intensive care setting with a right heart catheter for 7 days
- An intensive care setting and a life expectancy of less than 7 days without a heart transplant
- A patient listed in this category requires continuous use of intravenous inotropes (either at home or in the non-intensive care unit) or has a life support ventricular assist device (such as a left ventricular assist device) in place for over 30 days.
- Most patients are listed as Status 2. They are waiting at home or in a non-acute hospital.
- If hospitalized, patients are not on continuous IV inotrope medication.
- This status describes someone who is on the list but "inactive" for various reasons. A problem may have developed that makes transplantation unwise at that time. Often it means that patients have improved and might do well without transplant. Time accrued before being taken off the list as "inactive" will be counted if you should ever need to be placed on the list again or if your status changes from "inactive" to "active".
- It is impossible to tell exactly how long you will wait for your new heart. Some people wait only a few days while others wait for a month or a year or longer.
- Allocation of organs is based on rules established by UNOS and is related to many factors, including blood type, body size, status and waiting time