What are the indications for a heart transplant? Why do I need a heart transplant?

Patients who are suffering from advanced (end-stage) heart failure but are otherwise healthy may be considered for a transplant. When a patient’s heart disease and heart failure becomes advanced and very severe, sometimes it can no longer be improved by medications, implanted devices, or corrective cardiac surgery (valve surgery or bypass of the coronary arteries).

Generally speaking, a patient is referred for a cardiac transplant evaluation once his or her heart failure has progressed and has become so severe that the patient’s prognosis has become very poor. When your condition becomes refractory to all standard therapy, heart transplantation can offer you the potential of living an independent and normal, active life once again. If you are eligible, a heart transplant can drastically improve your functional capacity, quality of life, and long-term survival.

Because of advances in surgical techniques and the improved medical management of transplant recipients, an increasing number of people can now have a heart transplant. Currently, the choice is mainly limited by the availability of a donor heart that is suitable for transplantation. Your candidacy is determined on an individual basis and involves many different factors.

After all your tests have been completed, your pretransplant cardiologist presents your case to a heart transplant selection committee. This is a team that meets weekly and is composed of heart surgeons, cardiologists, transplant nurses, infection experts, and a social worker.

Your case is reviewed, and the committee discusses recommendations for the best course of treatment for you. In some cases you may be “too well” for listing at this time and may continue on medications. Other times a patient may need to be listed for transplant immediately. In other cases a patient may be determined not to be a candidate who will benefit from a heart transplant, because of one of several possible reasons.