Newark Beth Israel Medical Center Heart Transplant Criteria
A heart transplant is a treatment option for end-stage heart failure. It is recommended by the Newark Beth Israel Heart Transplant Program when patients remain symptomatic despite optimal medical treatment options. For select patients, a heart transplant can drastically improve their quality of life, especially when compared to untreated patients.
Newark Beth Israel continues to expand access to care and is now offering heart transplants to HIV-positive patients, the only center in New Jersey to offer this care. The program also offers bloodless surgery for patients who require this option.
Heart failure (HF) is a serious problem nationally and worldwide. HF symptoms often mimic those of aging, including:
- Shortness of breath
- Swelling
- Fatigue
- Difficulty sleeping
- Coughing
- Decreased appetite
- Increased urinary frequency
- Racing heartbeat
- Anxiety
In most cases, and especially when diagnosed early, treatment options like medications and sometimes medical devices can alleviate symptoms and decrease the chances of HF advancing to more serious stages. When conservative treatment options no longer control HF, end-stage heart failure may be diagnosed and a heart transplant may be recommended.
The following heart transplant criteria are considered in the decision-making process:
- Severe symptoms, including shortness of breath at rest or with minimal exertion
- Fluid retention episodes
- Reduced cardiac output at rest
- Objective evidence of severe cardiac dysfunction, including echocardiogram and 6-minute walk test results
- One or more hospitalizations because of HF in the last 6 months
The number of patients who meet heart transplant criteria and could benefit from a heart transplant greatly exceeds the amount of available donor hearts. Thus, the heart transplant waiting list at hospitals is usually long.
Heart transplant contraindications
A heart transplant is not always the appropriate treatment option for every patient. The Newark Beth Israel Heart Transplant Team notes, that in addition to heart transplant criteria, there are absolute heart transplant contraindications, conditions that render a person ineligible for transplant, including advanced and irreversible:
- Renal failure
- Liver disease
- Pulmonary parenchymal disease
- Pulmonary artery hypertension
- Cancer
Relative or non-absolute contraindications include:
- Severe peripheral vascular disease
- Severe cerebrovascular disease
- Severe osteoporosis
- Severe obesity (BMI greater than 35 kg/ m2)
- Acute pulmonary embolism
- Active infection
- Age greater than 70
- Psychological instability
- Substance abuse, active or acute
- Diabetes mellitus with organ damage
- Lack of social support or sufficient resources for consistent medication management and follow-up appointments
Heart transplant waiting list
Newark Beth Israel heart transplant candidates are placed on the national transplant waiting list. The list is a computer database that contains medical information for every person who is waiting for any type of organ transplant in the U.S. and Puerto Rico. It is run by the United Network for Organ Sharing (UNOS), a private, non-profit organization that manages the nation’s organ transplant system under contract with the federal government.
There is no way of knowing how long it will take to find a donor's heart. Some of the heart transplant criteria that are evaluated when selecting a new heart include:
- Blood type
- Height and weight
- Geographic area
While on the heart transplant waiting list, Newark Beth Israel heart transplant patients:
- Regularly attend follow-up appointments with their cardiologist
- Regularly communicate with their heart transplant coordinator
- Meet with their heart surgeon
- Have access to ongoing heart transplant education and support
Patients are encouraged to maintain their health while on the heart transplant waiting list. They are also advised to:
- Stay up to date regarding necessary routine medical testing
-
Notify their Newark Beth Israel heart transplant coordinator if they develop new health problems
-
Carefully follow the treatment plan provided by the Newark Beth Israel heart transplant team
Patients are asked to stay within 4 hours of the hospital at all times. When a donor's heart is found, a heart transplant coordinator calls the patient right away. Patients are instructed to arrive at the hospital as soon as possible. While patients wait for their donor heart, the heart transplant team:
- Makes sure the heart is a good match for the patient
- Begins to prepare the donor heart for transplant
Patient’s families can accompany them until they go into surgery. Once the donor's heart is prepared and the patient is ready, surgery begins.
