Heart Transplant Program
Physicians at Aurora St. Luke's have been performing heart transplants since 1968, giving them the most experience in the Midwest.
Upon referral to the Heart Transplant Program at Aurora St. Luke's Medical Center, a transplant coordinator will contact you to discuss the heart transplant process. During the referral phase of a heart transplant, the Transplant Clinic team will perform several diagnostic tests to help determine if a heart transplant is the right treatment for you. The testing insures that, other then your heart, you are in good physical health and can undergo the heart transplant. The diagnostic tests may include:
- Cardiac Catheterization: This test will determine the status of your heart's function and the pressures in the pulmonary artery (the artery that connects the right side of the heart to the lungs). If a cardiac catheterization is necessary, the Transplant Clinic staff will provide you with more information on the procedure.
- Echocardiogram: This test will determine the status of your heart's function. It also looks at how effective the muscle contracts, the size of the four chambers of the heart and if the valves are working properly.
- Exercise Oxygen Evaluation (MVO2): A low-level stress test is performed to determine heart function during exercise.
- Antibody Screening: Blood samples are analyzed to determine if you have antibodies that might make it difficult to match a donor.
- Blood and Tissue Typing: Blood samples are tested to determine an individual's blood type and tissue type, to match donors to recipients.
- Infectious Disease Screening: Following transplant surgery, drugs used to prevent rejection of the heart can increase the chances of infection. An infectious disease doctor will interview you and order a number of tests to identify any current infections and treat any active infections before surgery.
- Kidney Function Tests: Since your kidneys play a vital role in recovery from surgery, it is important to know if they can tolerate the stress of surgery and drug therapy. Blood and urine samples will be used to detect any kidney problems.
- Liver Function Tests: Blood samples are also analyzed to determine liver function.
- Pulmonary Function Tests: These tests measure your lung function and determine whether any lung disease is present.
- Dental Evaluation: A dentist will check for any infection on the mouth and that your teeth are in good repair to prevent future infection.
- Bone Mineral Density: Following transplant surgery, drugs used to prevent rejection of the heart can decrease the density of your bones, so a base line study is done.
The patient and family also participate in interviews and consultations with other members of the transplant team to discuss all aspects of transplantation and how it will affect their life.
After obtaining the needed information, a multi-disciplinary selection committee meets to decide if transplantation is the best option. If the committee determines that the candidate is qualified, the patient is registered with the United Network of Organ Sharing (UNOS), the national computerized list that matches transplant recipients with available organs.
How long the patient waits for a heart is based on various medical factors such as blood type, clinical status and length of time on the list.
Pre-transplant candidates are treated by the transplant team to keep them as healthy as possible while awaiting transplantation. They are regularly scheduled for visits with their transplant physician and transplant nurse coordinator to monitor their health status and to receive the emotional and practical support that often is needed during the difficult waiting period.
The wait for a matching heart can vary from a few days to a few years. As patients move to the top of the UNOS list, they are provided with an electronic pager and specific instructions to prepare for their surgery.
The call to come to the Medical Center for a heart transplant can come at any time. As St. Luke's Procurement Team facilitates the recovery of the heart from the donor hospital, the transplant patient is prepared for surgery at St. Luke's.
Following surgery, time spent in one of St. Luke's specialized Intensive Care Units varies for each patient. The total length of hospitalization generally depends on how sick patients were before their transplant and how well they are recovering after the surgery.
During the hospital stay, the transplant team monitors the function of the new heart and closely watches for signs of infection, rejection and medication side effects. Patients also are educated about their immunosuppressive medication program, which begins with the transplant, and what to look for and expect when they return home.
Physical therapy usually begins in the hospital and continues at home with an individualized exercise program planned by a rehabilitation specialist.
Post-discharge and Follow-up Care
Immunosuppressive medications must be taken daily for the rest of the patient's life to prevent rejection of the heart. These are powerful drugs with many possible side effects. Patients begin taking immunosuppressives in the hospital just before surgery, and their course of therapy is fine-tuned in the weeks and months to follow.
During the transplant follow-up phase, which continues for life, patients visit the Transplant Clinic regularly to keep them free of infection and rejection. Visits are more frequent during the first year of the transplant and gradually decrease in subsequent years. Follow-up care may include blood tests, radiological studies and biopsies to check for signs of potential problems.
Visits with the transplant physician and transplant nurse coordinator involve physical exams, medication management, patient education and support. To avoid unnecessary travel, patients who live in another community can arrange to have their blood and lab work done through their primary care physician and sent to St. Luke's.
Patients also need to continue to see their primary care doctor for medical concerns that are unrelated to the transplant.
Since the first organ transplant at St. Luke's more than 30 years ago, doctors have gained a better understanding of the body's immune system and how to prevent organ rejection. Significant advancements in immunosuppressive therapy and transplant technology have resulted in dramatic improvements not only in the length of life following transplant but also in the quality of life.
Following recovery from transplant surgery, most patients regain their health and strength and are able to resume everyday activities, including work and driving, within a few months.
Your transplant clinic physician and team will provide more detailed information on the safest time for you to regain normal activity.
To learn more, click here or call 414-646-5410.