When it is decided that you must have a heart and or lung transplant you will be required to undergo a range of testing.
What is involved in the Work up for listing
If your cardiologist decides initial screening was acceptable, you may be a candidate for listing, they will refer you to the Heart Transplant Clinic near you or in your state. Initially you may attend the Heart / Lung Transplant Unit regularly to determine if alternative interventions and medications could prevent or delay a heart / lung transplant. When it is decided that you must have a heart and or lung transplant you will be required to undergo a heart transplant assessment, which involves a range of tests to ensure the transplant has the greatest opportunity for success.
Eligibility Tests for a Heart Transplant
Eligibility tests usually include:
Blood screening for: drug and alcohol addiction; Liver and Kidney function, HIV, Hepatitis, life threatening infections
Tuberculosis (Mantoux) screening
Urine Samples for culture (e.g. kidney function)
Urine for drug screening
MRSA (methicillin-resistant Staphylococcus aureus) Swabs
Skin Cancer screening
Bone Mineral Density Screening
Dental X Ray and examination Screening
Body scans – X RAY, CT Scan, MRI, PET, ECG, ECHO
Mammogram / Cervical Screening
Psychiatric Screening
Frailty Assessment
Palliative Care Assessment
Occupational Therapy Assessment
Speech Pathology Assessment
Dietician consultation
Right Heart Catheter (more on this later)
Weighing up your options pros and cons of Heart / Lung Transplant
Signing the consent form
Complete the online information sessions and achieve 100% accuracy in the quizzes for each section. You are given an individual login to access patient only Online Resources.
In October 2021, I was referred to St Vincent’s Hospital Heart / Lung Transplant Team in NSW, Australia. I did not meet with the team until February 2022. Fate blessed me with a cardiologist who was doing her PHD research within the St Vincent’s Hospital Heart / Lung Transplant Clinic. Despite my complicated medical conditions, she referred me immediately to get the process for heart transplant listing started. Her attitude was that we could overcome the comorbidities while going through the screening and vaccination protocols. This early referral surely saved my life as my health continued to rapidly free fall.
Feeling Overwhelmed?
This list seems overwhelming, however, there is a team of transplant specialists around you to support and guide you through this screening process. My attitude was to get through it as soon as possible. From the outset, I was told it would take up to 3 months to complete the screening tests. Due to my terminal status, I was running out of runway or time. I was able to complete the screening and vaccination protocols within 8 weeks. The strategy that worked for me was to complete the screening and immunisations concurrently rather than waiting for one process to be completed.
Regular screening while on the active list
You should be aware, these screenings need to be updated every 12 months prior to listing and while on the active transplant waiting list. The decision to remove you temporarily or permanently from the list is determined by continued screening. From my previous post you might be aware that I had a lot of comorbidities and required multiple surgeries. I was grateful that I had completed the screening and vaccinations before I became terminally ill as it made the process more streamlined and at the time I felt like the transplant team viewed it as an advantage.
Once you are listed you will have monthly blood tests for tissue typing, (matching you against potential donors) and antibody testing and regular blood and urine tests to screen for smoking, drug and alcohol usage.
Patients who drink, smoke and or use drugs will not be activated on the transplant list for 6 months or until they meet 3 negative tests over 6 months. Patients can be removed from the active transplant list if they relapse. The transplant team is insistent about ceasing substance use, however, they are very supportive and non critical. They will refer patients to drug/alcohol counselling.
You are welcome to share your story by leaving a message in the comment section below.
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