Referral The transplant process begins with a referral. Your physician can refer you to Ochsner's heart transplant program by phone, fax, or mail. You may also call to refer yourself. We will then contact you to gather initial information over the phone. We will need medical records faxed or mailed to us prior to your appointment. An initial consultation appointment will be scheduled.
Initial Appointments The initial appointment will consist of a review of your medical history from records provided. We will schedule you for lab work and echocardiogram. You will meet with a Transplant Cardiologist, a physician who specializes in heart disease, and a Transplant Nurse Coordinator, the nurse who will be coordinating elements needed to complete your workup and follow-up care. A Financial Coordinator will discuss the costs associated with your transplant and with the medications you will require after transplant and will work with you to help you understand your insurance coverage. It is important that you understand the costs that may not be covered by insurance. Once your initial appointments have been completed, you will be scheduled for more in-depth medical tests.
Work-up During the work-up phase, you will meet with members of the Heart Transplant Team to include the Cardiologists, Nurse Practitioner, and Physician Assistants that will monitor your heart function and discuss the significance of undertaking a heart transplant and mange your medical regimen. The Transplant Nurse Coordinator will provide education regarding the transplant evaluation process, the listing process, and patient responsibilities before and after transplant. You will meet with a Social Worker to evaluate your ability to cope with the stress of transplantation and will also help to identify your support network. Many different tests are done to determine if you are a suitable transplant recipient.
The following tests will be included in your evaluation process. Remember, other tests may need to be done based on the results of these tests or on your medical history.
- Laboratory studies of blood and urine
- Diagnostic tests, including but not limited to: chest x-ray, abdominal ultrasound, echocardiogram, cardiopulmonary treadmill, right heart catheterization, electrocardiogram, pulmonary function tests, vascular studies, and pulmonary studies
- You will need to be up to date on you dental and eye care check ups
- Additionally, women will need to have an up to date mammogram and gynecologist evaluation to include PAP testing
- Consults with other specialists, including but not limited to: infectious disease doctor and colon-rectal doctor, psychiatrist
- Diabetic patients will be required to meet with an endocrine specialist and opthamologist
Listing Once all medical tests have been completed, your case is presented in front of a committee to discuss your eligibility for a transplant. If it is decided that you meet the requirements, you will placed on the list for transplant. The median waitlist time for heart recipients on our waitlist is 39 days, much less than the national average of 146 days. During your waiting time, you will be required to come in every one to two months to meet with a physician and have updated testing.
Transplant When a donor organ becomes available, you will be called and evaluated to decide if you are suitable for transplant at that time. A blood test will then be performed to determine if you are a match with this particular organ. It is at this time you will be asked to come to the hospital. During the transplant surgery you will be put under general anesthesia, which means you will be given medications to put you to sleep, block pain and paralyze parts of your body. You will also be placed on a machine to help you breathe. As with any major surgery, there are risks involved. The Heart Transplant Surgeon will explain the risks of surgery to you. After the surgery you will be taken to the intensive care unit where you will be closely monitored. You will be on a machine to help you breathe and you will have many tubes and drains in place. Immediately following the surgery, you will experience pain. This will be carefully monitored and controlled. Most transplant recipients have a significant reduction in the pain two to three weeks after surgery. When your medical condition has stabilized you will be transferred to the TSU, the transplant stepdown floor. Your length of stay in the hospital will depend on the rate of your recovery. You will remain in the hospital as long as your physicians feel hospitalization is necessary. Most patients stay in the hospital for approximately two weeks.
Post-Transplant After you leave the hospital you will still be recovering. You will have some restrictions on your daily activities for at least six weeks. During the recovery period the transplant team will follow your progress. You will need to be monitored on a long-term basis and you must make yourself available for examinations, laboratory and other tests to see how well your transplanted heart is working. You will be required to stay close to our medical center if you live out of town for several weeks. During the first four weeks after you are discharged from the hospital you are required to have someone stay with you 24 hours every day. The transplant team will see you weekly for the first month, every two weeks for the second month and monthly for the first year. Every effort is made to transition your routine medical care to your primary care physician. You will be followed in the transplant clinic for life. For most patients this involves frequent lab work and at least yearly clinic visit.
