Q. What if I am having concerns about how to pay for the transplant?
A..Although patients are ultimately responsible for the costs associated with a transplant, financial resources are not the determining factor in selection for the transplant program. A transplant financial counselor, business office staff and transplant social workers assist you and your family with questions about insurance coverage for your transplant and posttransplant medications.
Q. What is involved in evaluation testing prior to the transplant?
A. There is extensive cardiovascular testing, in addition to multiple tests that evaluate one’s general health. Transplant candidates should be in good overall health, since immunosuppressant medications taken after transplant are very hard on several body systems such as the bones, kidneys and liver. The goal of pretransplant testing is to ensure that a transplant will enhance your quality of life.
You also have appointments with our social worker, infectious disease specialists and the transplant psychologist.
Q. How do I get on the heart transplant waiting list?
A. Once your testing has been completed, your case is presented to the Heart Patient Transplant Selection Committee, which includes cardiothoracic surgeons, transplant cardiologists, transplant coordinators, transplant social workers, infectious disease specialist and a transplant psychologist. This committee reviews the evaluation testing and determines if a heart transplant is the best course of action for you.
If you are approved for transplant listing by the Heart Transplant Selection Committee, the final step involves approval by the Ohio Solid Organ Transplantation Consortium (OSOTC). The OSOTC has a committee comprised of representatives from other transplant programs and other members who approve all patients for heart transplant listing in the state of Ohio.
When approved by the OSOTC, you are then listed for heart transplantation on the UNOS (United Network for Organ Sharing) national waiting list. It is important to note that you are not “on the waiting list” for transplant until you are told so by the heart transplant coordinator. A letter is sent to your insurance company providing recommendations for transplantation and requesting approval.
Donors are matched to recipients according to blood type, size, severity of illness and geographic location. Heart transplant candidates are classed into four categories, depending on the severity of illness.
Q. What happens during the waiting period before transplant?
A. During the waiting period, you continue to follow up with heart failure physicians at The Ohio State University Medical Center. You must submit to random drug, nicotine and alcohol screening. You must be reachable at all times, usually with a cell phone. If drug or nicotine screens are positive after listing, patients will be taken off the waitlist.
Also after listing, you meet with the transplant social worker and transplant coordinator, as does your family and any support persons identified for an orientation. You sign a contract which details patient expectations and outlines expectations patients can have of the Ohio State's heart transplant team.
During the orientation meeting, you take part in a comprehensive education program that details the surgical procedure, medications, recovery and rehabilitation associated with the transplant process.
Q. What happens when a suitable heart is found?
A. If an organ is a good match for you, you will immediately be contacted. Once you receive the call, you should not eat or drink anything from that time on, and you are instructed to come to The Ohio State University Medical Center for admission to Ohio State’s Richard M. Ross Heart Hospital. You should always be within a two-hour drive of Columbus, due to tight time constraints before the transplant procedure.
Once you are admitted, you undergo multiple laboratory tests, receive an X-ray, and begin your immunosupression medications. You go to surgery, usually within a few hours of admission.
One team of Ohio State's surgeons travels to the donor hospital to recover the donor heart. If the heart is found to not be suitable for you, OSU may decline the heart, and you may be sent home. If the donor heart is found to be acceptable, the team will recover the organ and transport it back to Columbus.
At the same time, the recipient surgical team is preparing you for the heart’s arrival. Timing is critical to success of the transplant. The heart needs to be transplanted within four to six hours after donor recovery.
You are in the operating room for approximately six hours, depending on individual circumstances.
Upon completion of the surgery, you are closely monitored for complications.
Q. How long will my hospital stay be?
A. The average length of stay for a heart transplant patient is seven to 14 days in the hospital. After discharge, frequent follow-up will be necessary, especially during the first three months post transplant.
Q. How will I adjust to the lifestyle and nutritional changes I’ll need to make after surgery?
A. A Licensed Independent Social Worker (LISW) specially trained in transplant, assists you in adjusting to lifestyle changes brought on by your disease and its treatment. A registered dietitian specializing in the care of transplant patients assists you by individualizing your nutritional care and educating you about your dietary needs.