The purpose of the transplant evaluation is to determine your level of heart function, to identify if any medical or surgical therapies may improve your heart function and to rule out any health problems that may interfere with a successful transplant.
The pre-heart transplant evaluation tests can be done at Sharp HealthCare if you haven't already had them done. Please inform the Sharp heart transplant team if you think some of these tests were already done.
This is an ultrasound of the organs in the abdomen, liver, gallbladder, pancreas, spleen and kidneys. This test looks for any abnormality that might interfere with a successful heart transplant surgery and outcome.
Carotid Doppler Studies
This is an ultrasound of the carotid arteries in the neck, which carry the blood to your brain. If blockages are present, the patient could suffer a stroke during surgery.
An X-ray of the chest will be obtained to determine the size of the heart and any abnormalities seen on the lungs.
A 12-lead EKG will be obtained to determine if you have any abnormal heart rhythm disturbances that can or may need to be corrected.
This test provides information on heart wall motion, how the valves work and the size of the different chambers of the heart. It describes the pumping function of the heart and is usually called the "ejection fraction" and is stated as a percentage. Normal ejection fraction is 60 to 80 percent while patients with cardiomyopathy may have an ejection fraction of 5 to 35 percent. The lower the ejection fraction, the worse the heart failure.
Several tubes of blood will be drawn to obtain blood and tissue typing. Tests will be run to rule out exposure to hepatitis, HIV and other disease processes as well as anemia, bleeding problems, kidney and liver studies.
Left Heart Catheterization (Angiogram)
This is an invasive test where dye is injected into one of the large arteries in the groin to find out if there are any blockages in the coronary arteries of the heart. Left ventricular heart function can also be determined.
Peripheral Doppler Studies
This is an ultrasound of the legs. The surgeon needs to know if there are blockages in the arteries to the legs since large catheters are put into the large veins and arteries in the groin for the heart-lung machine that is used during the heart transplant operation.
Pulmonary Function Tests
This tests the ability of your lungs to carry oxygen to the rest of your body.
Right Heart Catheterization
This can be done at the same time as the left heart catheterization or separately. This gives the physician information on the pressures in the heart and lungs. These measurements help the physician make recommendations and suggestions on medications you may be taking and whether you are a heart transplant candidate.
This includes tuberculosis (TB) skin testing and immunizations for influenza, pneumonia and hepatitis.
- Females: Mammogram and Pap smear, flexible sigmoidoscopy or colonoscopy
- Males: Prostate exam, flexible sigmoidoscopy or colonoscopy
- Other testing: Additional testing may be necessary depending on patient’s other diseases (i.e., diabetes mellitus, history of cancer)
Summarizing and Assessing the Evaluation
Assessing optimal heart failure management is a key component in the evaluation for heart transplant. Heart transplantation is considered a final option in the treatment of heart failure and should be restricted to patients who have failed optimal medical and electrical therapies.
Heart failure therapy has accomplished major breakthroughs in medical therapeutic interventions. It is also important to consider high-risk surgical options such as revascularization or valvular repairs. Additionally, ventricular assist devices can be used as destination therapy for patients in whom transplantation is not an option.
For More Information
To learn more about Sharp's heart transplant services or to find a Sharp-affiliated doctor, search for a San Diego cardiologist or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm. To find general information about transplant, visit Transplantation in Adult Health or read the Transplant News archive.