Heart Transplant Evaluation & Process

What is the evaluation process?

Once we have a signed consent form for your evaluation, a nurse coordinator will review the form with you and answer any questions you have at that time, or at any other point in the process. Depending on your medical history, there may be additional physician visits and tests required. Our extensive heart transplant evaluation process includes health, financial and psychological evaluations.

Upon completion of the evaluations, our transplant team will review your case to determine if transplantation is a treatment option for you. We will review the results of all tests and carefully consider all factors before a final decision is made. The nurse coordinator or cardiologist will notify you following a selection meeting, and the cardiologist will discuss the results and next steps with your primary care physician.

Health Evaluation

  • Blood testing
  • Blood and tissue typing
  • Possible drug or tobacco screen
  • Heart studies, which may include any or all of the following:
    • Echocardiogram
    • Electrocardiogram, also called EKG
    • Holter monitor
  • Heart
    • Cardiopulmonary stress test
    • Pulmonary function tests
    • Urinary system evaluation
    • Abdominal ultrasound
    • Chest x-ray
    • Vascular doppler studies
  • Dental exam, including x-ray
  • Complete physical exam

You may be discharged from the hospital before all the results are available, and some of the testing may be done as an outpatient. You will be updated with your results as frequently as possible.

Financial Evaluation

A heart transplant evaluation process includes much more than physical health. A Financial Counselor will meet with you as a part of your evaluation to provide you with additional information and comfort. You will also meet with a Pharmacy Financial Counselor to discuss your insurance coverage and benefits, learn about potential medications and their costs, and review any concerns you and your family may have.

Psychological Evaluation

We also include a psychological evaluation as part of this process to ensure a heart transplant is the right treatment option available. This will help determine whether you will be able to comply with the necessary treatment regimen before and after the transplant.

When am I placed on a waiting list for a heart transplant?

Before we place you on a waiting list for a heart transplant, we want to make sure there is not another treatment option available for your condition and we must be fully confident that you're capable of enduring the transplant process.

You will be notified when you are placed on the heart transplant list. The following is an example of a listing on the heart transplant list. Status is based on medical urgency with three main classifications:

  • Status 1A: This is the most urgent; these people are often in the hospital with mechanical support and multiple IV medications.
  • Status 1B: This is less urgent; these people could be at home with a Left Ventricular Assist Device or on IV medications.
  • Status 2: This is the least urgent; these patients are the healthiest.

Your status can vary based on your health and will be monitored closely by the transplant team. For more information on these statuses and the wait list, you can visit www.unos.org or ask your Transplant Coordinator.

What happens when your healthy heart arrives?

As soon as we are notified that a healthy heart is on it's way to Nebraska Medicine, our transplant surgeons begin preparing for the removal of your diseased heart. When the new heart arrives, you will be connected to the heart-lung machine, which will take over the function of the heart and lungs for the rest of the procedure.

After the diseased heart is removed and your healthy heart is attached, surgeons connect the blood vessels, allowing blood to flow through the heart and lungs. Surgeons check all the connected blood vessels and heart chambers for leaks before removing you from the heart-lung machine. The heart-lung machine is turned off, leaving the new heart to work by itself.

Keep in mind there are always risks and potential complications with surgery. A patient may bleed more than usual, get an infection, have trouble breathing, get blood clots, or the body may reject the heart. Our team will monitor you closely following surgery and treat any of these complications.