Transplant evaluation is carried out to decide whether heart transplant is the right option for a cardiac patient. A heart transplant is a procedure that removes a damaged or diseased heart and replaces it with a healthy one. If you need a heart transplant, your doctor will refer you for a transplant evaluation. To decide if you will benefit from a heart transplant, the following assessments are carried out:
Assessment of cardiovascular system: This includes chest X-ray or CT scan, electrocardiogram, echocardiogram, exercise stress test and right heart catheterization. It is done to confirm the availability of any other treatment for this condition.
General health assessment: This includes pulmonary function test, TB test, blood test, urine analysis, peripheral vascular/ carotid artery studies, abdominal ultrasound and cancer screening test. Cancer screening test may include colonoscopy or prostate-specific antigen test, and a Pap smear and mammogram for women. These tests determine certain conditions that would make transplantation too difficult or dangerous. Presence of a co-morbid condition such as an active infection in the body, high pressure in the lungs, severe thickening of the arteries or any condition that contraindicates the use of steroid drugs may make a heart patient unfit to be considered for a transplant.
Full Dental examination with X-ray: This is carried out to rule out any hidden infections in the mouth that could be a source of infection after the transplant.
Psychological evaluation by a psychiatrist: This determines whether the patient is emotionally and mentally strong to cope with the stress of transplantation surgery and recovery.
Physical evaluation by a physical therapist: This assesses whether the patient can participate in the routine exercise program after the surgery.
Social worker evaluation: A social worker meets the patient and their family to evaluate whether the patient has adequate social support network that is essential during and after the heart transplant. The social worker also analyzes the feelings of the patient and the family members related to the illness, and the possibility of the transplant.
Financial evaluation by a financial counselor: A financial counselor discusses the financial aspect of the transplant related to insurance coverage, potential medications and their cost.
A transplant evaluation thus includes a series of testing and consultations. These usually take a few days and are done on an outpatient basis unless the patient is very sick. Before the evaluation, the patient is also required to fill the evaluation consent form. You will be seen and evaluated by the transplant team to make sure that you are a good candidate for heart transplant. The patient is then notified and given a status based on the medical urgency to receive the implant. Depending on medical urgency, the patient may be put on the waiting list for transplant.
The evaluation process provides information necessary to determine eligibility for transplant.