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Heart transplant evaluation process
You
can call (352) 265-0751 to make a referral to the heart
transplant program at the Shands Transplant Center at the
University of Florida.
In
order to be considered for a heart transplant you must be
evaluated by the physicians and other health care providers
at Shands Transplant Center at UF. Evaluation for transplantation
involves taking a series of tests and being examined by
a variety of specialists. The overall goal of this evaluation
is to be sure that a heart transplant is the best treatment
for your heart problem and to be sure that you don't have
any other problems that would prevent you from getting the
best results. During the evaluation period we encourage
you to ask questions about anything you don't understand.
Generally,
the evaluation phase will require you to be hospitalized
for three to five days. One reason for the hospitalization
is so that we can adjust your medications - if needed -
in a safe and monitored environment. Another reason is to
have adequate time for all the tests to be performed in
a coordinated manner that does not tire you out. In some
cases, tests will need to be done early in the morning and
others at various times throughout the day.
The
tests you undergo during evaluation are listed below. Some
of the tests will be conducted in your hospital room while
others will take place within various departments of the
Shands at UF medical center.
Heart
tests
- Electrocardiogram
(EKG)
- Echocardiogram
- Cardiac
Catheterization
Lung
(Pulmonary) function tests
- Chest
X-Ray
- Lung
function studies
Kidney
and liver test
- Complete
blood count
- Kidney
function tests (from blood samples)
- Lipid
or fat profile in your blood
- 24
urine collections
- Blood
coagulation profile
- Liver
function studies (from blood samples)
Nutritional
status
- Calorie
count
- Skin
fold measurements
- Weight/diet
evaluation
- Body
protein evaluation
Immune
system (from blood samples)
- Blood
type and grouping
- Antigen/antibody
reactions
- HIV
virus test
- Thyroid
function
- Viral
illness tests (such as hepatitis)
Psychological
profile
- Personality
inventory
- Vocabulary
test
- Memory
tests
- Medical
coping questionnaire
Social
Support
-
Family structure and support
-
Coping mechanisms
-
Living arrangements for you/family
-
Financial resources evaluation
Financial
planning
Early in
the evaluation period you will meet with a heart transplant
coordinator. The coordinator is a registered nurse who will
care for you throughout all phases of the transplantation
process. As the name implies, the transplant coordinator "coordinates"
the care provided to you and your family to provide information,
answer questions and help you solve problems.
During
the evaluation period cardiology physicians are in charge
of your care. The cardiologists will have your health records
from your local physician and will discuss with your personal
physician any changes in your condition and medications.
Patient
and Family Services - social services
Social workers are an integral part of the healthcare team
who work closely with patients and their families to help
them solve many kinds of problems. A social worker is assigned
to all heart transplant patients and is available throughout
the transplant process. Prior to any transplant procedure
the social worker will help arrange things such as lodging
and transportation for those needing assistance. The social
worker is available to assist with financial matters and
coordination with hospital financial counselors.
A primary
function of the social worker is assistance with emotional
issues that may accompany transplantation. Anxiety, fear
and frustration are common and normal. You can also expect
the social worker to be available after the transplant.
Home health home care referrals, follow-up appointments
and any additional services will be reviewed to assure you
of continued support. Your social worker can address many
of your about your transplant recovery process, lifestyle
changes and needs.
Complications
of heart transplantation
A heart transplant is not a "cure" for your sick
heart. It is a trade of one set of health needs for another.
Potential
"complications" of your heart after transplant
include:
-
Rejection of your new heart
- Infection
-
High blood pressure
-
Weight gain
-
Increased risk for cancer
-
Risk of developing diabetes (insulin or non-insulin dependent)
due to medications
-
Coronary Allograft Vasculopathy (CAV)
- Osteoporosis
(reduced strength of the bones) due to the medications
-
Potential need for a permanent pacemaker insertion
-
Kidney and liver damage due to the medications
Becoming
a heart transplant candidate
After the evaluation is complete, the transplant team will
meet to discuss all the information gathered. The purpose
of this meeting is to discuss your options and your need
for a heart transplant. The team also discusses potential
problems that could make transplantation too risky for you.
You may need additional tests to confirm your candidacy
for transplantation. We will make all the arrangements to
complete these additional tests as quickly as possible.
Waiting
for your new heart
Waiting for a suitable heart to become available may be
the toughest part of the transplantation process. It is
natural to wonder whether you will get your heart in time.
Our team will do everything possible to help you get your
new heart quickly. However, the average wait at home can
be one to two years. If you are sick enough to be hospitalized
while you wait for your transplant the wait may still be
one to three months.
Some
tips to lower your anxiety while waiting:
- Talk
about your feelings with your family and friends
-
Keep the transplant team informed of your condition
-
Be accessible by phone or pager
-
See your doctor(s) regularly
- Maintain
good eating habits and watch your weight
-
Let your transplant coordinator, social worker and others
help you adjust
If you
are at home during the waiting period it is a good idea
to plan for the day you are called to come to the hospital
for the transplant. We suggest that you keep a packed suitcase
ready in preparation for the day (or night) of your surgery.
When preparing your bag, think about what clothes and personal
articles you would like to have with you in the hospital
(reading material, music, photographs, etc.).
If your
local physician hospitalizes you during the waiting period,
please contact your coordinator and keep them informed of
how you are doing. If you will be on vacation please notify
your coordinator of when you may be unavailable.
Statistics
Success rate and various other statistics regarding the
Shands Transplant Center at UF are available from the Scientific
Registry of Transplant Recipients at ustransplant.org.
Related Links
CHF
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