Heart Transplant Frequently Asked Questions

What are the different wait list statuses for heart transplantation?
There are four statutes for patients on the heart transplant waiting list, which are:

  • Status 1A — These patients are at the top of the waiting list. They usually include patients in the intensive care unit, on life support and/or high-dose intravenous (IV) medications to support their heart function. Or, they have had a ventricular assist device (VAD) or extracorporeal membrane oxygenation (ECMO) to support their heart function.
  • Status 1B — These patients have end-stage heart failure and are at home on a ventricular assist device (VAD) or continuous IV heart medications (inotrope medication) that makes the heart beat stronger.
  • Status 2 — These patients do not meet the criteria for Status 1A or 1B. Most often, these patients are waiting at home for a donor heart and are taking oral heart failure medication.
  • Status 7 — These patients are temporarily inactive on the heart transplant waiting list. This might include patients who develop an infection and cannot undergo transplant surgery until the infection has cleared, have left the area and cannot return within two hours, insurance has changed and need a new authorization or loss of insurance coverage.

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Can I be on more than one waiting list?
Yes, this is called a multiple listing and is permitted by the United Network for Organ Sharing (UNOS). You may increase your chances of getting a heart sooner if you are listed at another center in another location. To do so, you will need to be evaluated, accepted by that center and provide verification that your insurance company will pay for another evaluation at another center.

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What if I want to go to another center?

Debbie Kinney, Heart Transplant Survivor
Debbie lived with a heart pump until she underwent heart transplant surgery.
Changes can occur, be it your insurance changes, you need to move or you want to receive your transplant elsewhere. Your “time on the list” can be transferred to another center. Please discuss this with your transplant coordinator who will explain the process if this becomes necessary.

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How long will I have to wait for a donor heart?
It is not possible to predict how long you will have to wait for a donor heart. Some patients wait days while others wait weeks, months or years. Organ offers are made on the basis of: 

  • Blood type (the donor heart must come from a donor with the same or compatible blood type as you)
  • Heart size
  • UNOS status (1A, 1B or 2)
  • Waiting time (how long you’ve been on the waiting list)

While you are waiting for your donor heart, it is important to stay healthy so that when a donor heart does become available, you are in the best possible condition to undergo transplant surgery.

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What are my responsibilities once I am placed on the waiting list?
As a transplant candidate, you must notify the transplant team if:

  • There are any changes in your medical condition (for example, you start to feel worse)
  • You become sick with an illness (common cold, etc.)
  • You leave the county for any reason 
  • Your automatic implantable cardioverter defibrillator (AICD) generator has been changed (if you have one)
  • Your contact information changes
  • You receive a blood transfusion at another hospital
  • Your insurance changes   

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Why do I have to let you know if my insurance changes?
If your health insurance changes while you are on the list, approval for heart transplantation must be obtained from your new insurance provider.

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How does UNOS find donors?
Once a physician identifies a hospitalized patient with a devastating brain injury, the patient will undergo extensive neurological testing. If the result of this testing is irreversible brain death with no chance of recovery, the local organ procurement organization (OPO) will be called. An OPO professional trained in discussing organ donation will speak to the family about possible organ donation. Procurement coordinators also work for the OPO and are well-trained individuals who work in hospitals with the donor patient to ensure the patient is in good condition for organ donation. The procurement coordinator also ensures the fair and equitable distribution of acceptable donor organs to transplant candidates. 

San Diego’s local OPO is called Lifesharing. Most donors come from the local and regional OPOs located in Northern California, Arizona, Washington, Oregon, Nevada and New Mexico.

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What do I do if my transplant beeper goes off?
When a donor heart becomes available, you will called at home and/or paged on a beeper provided by the heart transplant team that will display Sharp's heart transplant program phone number so patients can quickly and easily return the phone call.

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Are there any donor-related factors that could affect the success of the transplant surgery or my health following surgery?
Yes. These factors could include, but are not limited to:

  • Infection in the donor that is not detected by pretransplant screening (e.g., HIV, hepatitis or other infectious disease)
  • The condition of the donor heart
  • The donor’s history  

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What medicines will I have to take after transplant?

Michael McFadden, Heart Transplant Survivor
Michael suffered from congestive heart failure before he received a new heart.
You will need to take medications for the rest of your life to prevent your body from rejecting your new heart. In addition to looking for rejection, your blood work will be evaluated to determine if the medications are too strong for you and need to be adjusted.

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How will I know if I’m having a rejection?
We will teach you the symptoms of rejection so you will know when to call us. We will schedule you for biopsies and echocardiograms after you receive your new heart. The biopsy can tell us about rejection when it is in your cells. The echocardiogram will show any decrease in heart function. If the biopsy or echocardiogram shows you are having a rejection, your medication doses may be increased or new medications may be given to you.

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Are there any other risk factors after I have a heart transplant?
The medications we give you to decrease the risk of rejection also increase the risk of infection. Your body knows that the new heart does not have your special identification marks; it thinks the new heart is an invader. Therefore, we have to suppress the body’s urge to reject the new heart, which can also suppress its reaction to bacteria, viruses and other sources of infection.

Organ transplantation can also impact your psychological well being. You should be aware that this impact can cause depression, anxiety, post-traumatic stress disorder, sleep disorders and guilt.

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Whom should I call when I have a problem or concern?
The transplant coordinators and doctors are on call 24 hours a day, 7 days a week. You may call the heart transplant program office at 858-939-3831 during business hours (7 am to 3:30 pm) or after hours at 858-939-3400 and asking for the on-call heart transplant coordinator.  

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Can I return to work after a heart transplant?
Many heart recipients return to work within several months after their transplant. When you return to work depends on how you feel and the type of work you will be doing. Our transplant team of doctors, nurses and social workers can help you with deciding when you can return to work.

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What if I decide not to have a heart transplant?
Transplant is not for everyone and everyone who is referred for a transplant may not need one. If you do not think you want to have a transplant, we will respect that decision and assist you with other options.

Even if you are listed for a transplant, you may not get one if you become too sick. We would like for you and your family to consider what you would like to do, or have done, if that happens. It is important that your family and caregivers know your wishes.

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Where can I find additional heart transplant information?
You can find more heart transplant information by visiting the Organ Procurement and Transplantation Network (OPTN).

We hope you find the above websites helpful, but please remember that Sharp HealthCare does not control or endorse the information presented on this website, nor does this site endorse the information found on www.sharp.com.

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For More Information
To learn more about Sharp's heart transplant services or to find a Sharp-affiliated doctor, search for a San Diego heart surgeon 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 Heart Transplantation in Adult Health or read the Transplant News archive.