Before a person can be put on a waiting list for a heart transplant, the determination has to be made that there is no other treatment option available for the person's heart failure. In addition, it must be determined that your body, your emotions, and your family/support system are capable of enduring the transplant process. Once those determinations have been made, there are other steps in the evaluation process. Those steps include, but are not limited to, the following:

Exclusion Criteria

Because of a shortage of donor organs, criteria have been established to ensure that those who will benefit the most from transplant are most likely to receive a donor organ. Your physician will discuss these criteria with you to determine if you are a possible candidate for transplantation. Criteria for automatic exclusion include the following:

• patients with active cancer or infection
• patients who are overweight
• patients who are actively smoking
• patients who are actively using drugs and/or alcohol

Smokers will be considered for transplant, provided they are otherwise eligible, only if they remain smoke-free for a minimum of three months. Random nicotine screening may be utilized if necessary.

Blood and Tissue Typing

Because of the body's immune system, any tissue or organ introduced into a human body that is not a part of that body will cause a natural process to start that will ultimately damage or destroy the foreign tissue or organ. Thus, a potential organ recipient must have blood and tissue-typing tests done so that a donor organ that most closely matches the recipient can be found.

Other evaluation procedures include:

• blood chemistries
• hepatitis and HIV testing
• 24 hour urine specimen (to evaluate kidney function)
• chest x-ray (to assess for lung infection, other pulmonary diseases, and heart size)
• abdominal ultrasound (to assess for gallstones and/or other abdominal conditions or diseases)
• EKG (to assess the heart's electrical conduction system)
• Holter monitor (to assess the heart's electrical conduction system in further detail than a regular electrocardiogram or EKG)
• Panorex or a type of x-ray of the teeth and jaws (to assess teeth for cavities and abscesses that might cause infection after transplant; your dentist will be required to clear you for a transplant)
• pulmonary function tests (to evaluate lung function)
• right heart catheterization (to assess the pressures inside the heart, which helps your physician to determine your heart's functioning capability)

Financial Evaluation

Unfortunately, transplantation is a very expensive procedure. In addition, the medications, follow-up visits, and additional post-transplant care are also expensive, and will be necessary for the remainder of the heart recipient's life. Insurance may cover the cost of the transplant procedure itself but may not pay for post-transplant care and medications after a certain period of time. All available assistance will be provided.

Family Situation

It must be established that any potential heart recipients have an adequate and stable support system.

Psychological Evaluation

This is done to assist in determining whether a potential heart recipient will be able to comply with the necessary treatment regimen before and after transplant.