Not all people who need a heart transplant are suitable candidates for a heart or organ transplant.
A cardiologist does the initial screening process for a heart transplant referral.
What initial criteria do you have to meet for a heart transplant?
There are many reasons why a heart transplant is needed. Heart failure is commonly the main reason for heart transplant. A heart transplant is a last resort where all other interventions have been attempted. Not all people who need a new heart are suitable candidates for an organ transplant. The screening process for listing (getting on the organ transplant list) is extremely rigid and intensive. There is strict inclusion and exclusion criteria. A cardiologist does the initial screening process.
To read about the work up for transplant visit: What are the eligibility requirements for a heart transplant? Another post unpacks What is it like to have a Heart Transplant.
Heart Transplant Exclusion Criteria
During the initial screening process the cardiologist considers:
Body Mass Index (BMI). Usually the requirement is a BMI under 30.
Comorbidities such as diabetes, infection, addictions, mental health, age, level of fitness, and level of frailty are all considered during the initial screening process.
For more information on the Heart Transplant Screening and Work Up process please follow the link: Heart Transplant Assessment.
Potential transplant patients
Potential transplant patients are assessed for their ability and commitment to comply with medical therapy pre and post transplant. If you have active malignant cancer, life threatening uncontrolled infection, complicated diabetes, drug and alcohol addictions, failing organs which prevent recovery, a high BMI (above 30) or have any other comorbidities it becomes more difficult to be referred to the Transplant Team and ultimately being listed for transplant.
Transplant Recipient
There is hope, do not give up. I was in this position. Over a period of 18 months I had an Aspergilloma (mould) infection in my right lung. The mould infection activated an autoimmune response called Sarcoidosis. The Sarcoidosis is like having tumours (called Granulomas) spreading through parts of your body. In my case the Granulomas spread from my voice box to the diaphragm. It spread throughout my right lung where the mould was and then pretty much ate away at my heart. Half way through the screening process, I was diagnosed with breast cancer in June 2022. These were all comorbidities that excluded me from immediate listing for an organ transplant. Each one needed to be dealt with individually before I qualified for the Heart Transplant List.
From August 2022 to May 2023, I endured four heart ablations, an EPS (electrophysiology study), four defibrillator surgeries, aggressive bilateral breast cancer surgery, 5 weeks of radiation therapy, a top right lung lobectomy and various medication therapies and related surgical procedures.
After all of this by January 2023, I was told I had end stage heart failure and was terminal without a heart transplant. The reality was I was running out of runway. It still took until May 2023 (another 5 months) to get on the heart transplant list. Then you are on the active list and you wait for the call.
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