When the primary cardiologist who knows the medical history and has followed up the patient decides that a heart transplant is necessary for the treatment of the disease, s/he shall applies to the council of heart transplant and prosthetic heart support systems.A provisional assessment is made after patient’s medical history, all past treatments, current health status, most recent examinations, physical capacity and other details are discussed.Next, patient’s status is assessed in detail by the council which meets regularly.Other necessary tests and consultations (psychiatry, endocrinology, nephrology, dentistry) are planned.The patient is accepted to the heart transplant program, depending on severity of the patient’s condition, and recorded in the waiting list, if the council of heart transplant and prosthetic heart support systems deems the patient is a good candidate for heart transplant in the light of all these assessments.Estimated waiting period for a heart transplant is approximately 6.5 to 7 months for the patients with a medical emergency and 1 year for others.
Patients who are accepted to heart transplant program;
Irrespective of the underlying cause (ischemic cardiomyopathy, dilated cardiomyopathy, valve diseases, myocarditis, congenital diseases, heart tumors etc.), all patients with an end-stage (Stage D) heart failure and the life expectancy shorter than 1 year, who are younger than 65, are accepted to the program.
Patients with refractory and life threatening rhythm disorders persisting despite all medication options and rhythm regulating treatments (for example, ventricular fibrillation) are accepted to the program even if the disease is not in the end-stage.
Moreover, it is important that the heart transplant candidates are very compliant to the treatment, have no drug/illicit substance and supported by the family and the social circle.All co-morbidities which can affect success of the treatment and patient’s quality of life adversely are carefully reviewed and assessed.Patients are accepted to the program after above mentioned medical, psychological and social features are addressed by specialists of our heart transplant team.
Among the patient’s who are found eligible for heart transplant by the council of heart transplant and prosthetic heart support systems and recorded in the waiting list, those who are able to stay at home present for outpatient follow-up visits at certain intervals, while others with severe heart failure should stay at the hospital until a donor heart is found.
Patients who meet criteria of heart transplant in the Heart Failure Council are recorded to the Heart Waiting List of the Ministry of Health afterwards.A patient can only be recorded to the heart waiting list of one center.Health status of the patients in the heart waiting list is constantly updated by the centers where they are followed up and treated.National and Regional Coordination Centers match the donors with appropriate patients and inform the center, where the patient is recorded, about the donor heart when the brain death is verified for a person who had donated his/her heart.The match is approved after the center reviews details of the donor and relevant characteristics of the recipient and verifies the compatibility.
Artificial heart support systems are implanted to keep patients alive until a donor organ is found, if the condition of the patient progresses into a clinical stage in the waiting period.This is called “bridging to heart transplant”.Depending on various factors, the waiting period until the appropriate heart is found can last as short as several hours to a day or it can take many years.This way, many patients with heart failure can survive while waiting for a donor heart and conserve their physical and mental health.
Patients who are waiting for heart transplant should always be physically and mentally ready for the transplantat.Prescribed medications should be used strictly as advised by doctors.Smoking and alcohol consumption should be avoided at all costs; and diets and water-salt consumption require very close attention.Patients with heart failure should avoid crowded places, pay attention to personal hygiene and visit their doctors at regular intervals, as they are prone to infections.As it is not possible to make appointments for a heart transplant surgery; patients who are waiting for a heart transplant at home should always be reached whenever called and the family should also be ready to immediately reach the hospital.