Heart Transplant Qualifications
Receiving a heart transplant is both a happy and sad occasion. On one hand, the recipient was given a new lease on life, but on the other hand, another person had to pass away in order for the recipient to receive their transplant. You hear about people going in for evaluations for transplants, but you never really hear about what qualifications they had to meet in order to get to that point. We are going to discuss some of the things that can help qualify you for one, and some things that will exclude you from one. This list is not all-inclusive and could have changed after it was written.
Acceptable conditions for a transplant
According to Johns Hopkins, some acceptable patient conditions for transplant are "severe ischemia consistently limiting routine activity not resolved with revascularization and recurrent symptomatic ventricular arrhythmia refractory to all acceptable therapeutic modalities."1 It is also considered an acceptable patient condition if you have a maximal VO2<10 ml/kg/min with the achievement of anaerobic metabolism.
A few conditions that will give you the best chance of ending up on the transplant list are recurrent unstable angina not amenable to revascularization, no underlying pulmonary disease, end-stage heart disease that doesn’t respond to other medical or surgical therapy with irreversible pulmonary hypertension, and unstable fluid balance/renal function not due to patient noncompliance with a regimen of weight monitoring, diuretics, and salt restrictions.1 There are more, but as you can see, you need to be compliant with your medications and other therapies or instructions your doctor gives. Starting a good routine now will help you make the list if needed one day.
Conditions that prevent a transplant
Now to the ugly part, the stuff that will guarantee you don’t get on the list. These include, but are not limited to major systemic diseases, age, most types of cancer in the last 5 years, smoker or less than 6 months since quitting, HIV, current substance abuse, and severe infection. I do hope that HIV changes because there are treatments that are very successful these days unless those medications interact with transplant medications. The others, for the most part, you can start working on or changing about yourself. Not only for this but for your overall health as well.1
A few things that may cause you to not get on the list, but aren’t absolute disqualifiers are acute pulmonary thromboembolism, morbid obesity, documented severe peripheral or cerebrovascular disease, active peptic ulcer disease, current or recent diverticulitis, inability to make a strong commitment to transplant, and absence of adequate external psychosocial supports for either short-term or long-term basis.1
The healthiest you can be
When it comes time to discuss a transplant, your doctor and team will go over everything you need to know and what will help you get on the list. As I said, this list could change and may have already changed. If nothing else, it might help you have a better chance of getting a transplant if needed. Remember, there are new technologies and medications coming out all the time. Keep your head up high and work on being the healthiest you can be. That is all anyone can do.
What type of heart failure have you been diagnosed with?