Indications Patients with end-stage cardiac disease including but not limited to the following will be considered for heart transplant:
- Cardiomyopathy
- Ischemic Heart Disease
- Hypertrophic Heart Disease
- Severe decompensated inoperable valvular heart disease
- Congenital heart disease
- Any other cardiac abnormalities that severely limit normal function and/or have a mortality risk of greater than 50% at two years
Absolute & Relative Contraindications The list of absolute and relative contraindications for Heart Transplant is continually evolving as our experience with certain pre-existing conditions and diseases grows. At present, the only absolute contraindications for Heart Transplant appear to be:
- Chronologic age greater than 70 or physiologic age greater than 65
- Life threatening illness that despite transplant will limit survival to less than 5 years despite therapy
- High risk or severely symptomatic carotid or peripheral vascular disease that is not amenable to correction
- HIV infection
- Severe pulmonary disease that will likely result in the patient being ventilator dependent after transplant
Relative contraindications include the following:
- Uncontrolled diabetes mellitus with significant neuropathy, nephropathy, or retinopathy
- Severe asymptomatic peripheral vascular disease
- Patients with body mass index > or = 35
- Psychological impairment
- Drug dependency that is felt to limit the allograft survival or limit the patient's chance for meaningful recovery
- Active alcohol
- Evidence of noncompliance with accepted medical practices
- Lack of social support network that can make long term commitment for patient's welfare
- Cigarette smoking when the patient makes no attempt to stop
- Unrealistic expectations by the patient or family regarding transplant, its risks, and benefits
