After I am on the heart transplant waiting list, how long will I have to wait to receive a new heart? Will I have to wait in the hospital?

Once you have been accepted as a candidate for a heart transplant, the wait for a new heart begins. At any given time about 3,100 people are on the national patient waiting list for a new heart, but only about 2,200 donor hearts become available for transplantation each year.

The average waiting time for a donor heart is about 6 months, but the wait can be much shorter or much longer, depending on the availability of a heart. The wait can sometimes be for several years. In addition to organ availability, the duration of the waiting period can be influenced by your blood group and how sick you are.

Some patients may have a serious medical event (such as a stroke, severe infection, kidney failure, etc.) while waiting for a heart transplant. If these are temporary, the patient may be temporarily removed (“inactivated”)  from the active list of patients awaiting a transplant. After they recover from this medical event, they may be “reactivated” on the list and return to their same place on the waiting list (and will not lose credit for the time they have already accumulated). Rarely, if it is a very severe and permanent problem, that patient may then no longer be considered as a candidate for a heart transplant, and other options are then considered.

At least one-third of patients on the transplant list are too sick to be discharged from the hospital and must remain in the hospital until the transplant is performed. Of course, these patients are given the highest priority, because some of them require intensive care unit monitoring and powerful intravenous cardiac medications or mechanical heart pumps (VADs) to keep them alive. That being said, over 50% of patients on the waiting list are at home when they are called to receive their heart transplant.

If at all possible, every effort is made to improve a patient’s condition so that they can enjoy time at home while they wait for a new heart. To get some patients home for the long wait, a continuous infusion of special intravenous heart medication (dobutamine or milrinone) may be instituted, administered by a long-term intravenous (IV) line from a portable medicine infusion pack. As discussed earlier, some patients go home with a special heart pump (ventricular assist device).