Who is a candidate for heart transplant?
Eligibility for a heart transplant
Your child is only eligible for a heart transplant if s/he has a heart problem that cannot be treated and his/her survival expectancy is less than a year. Consideration for transplantation requires that your child has no significant abnormalities of his/her other organs.
The timing of the decision about a heart transplant is different for every person.
Heart transplant donors
Currently there are more people waiting for heart transplantation than there are available donor hearts. A person can only donate a heart when his/her brain is injured in death, but the heart and other organs are not injured.
Match between donor and recipient
When a donor heart becomes available, the child waiting on the transplant list who is the best possible match is identified on a national computer list. There are several considered in selecting the best recipient including blood type, size/weight, distance (miles) between the donor and potential recipient, how ill the child is, and how long the child has been waiting on the transplant list. The donor and recipient must have compatible blood types, and match according to size and weight. However these factors alone do not determine the best match.
Your child may wait on a transplant list for months, or it could be less than a day. It is impossible to predict how long any person will need to wait on a transplant list before receiving a donor. It is not uncommon to wait for more than a year.
What happens at the evaluation visit for heart transplant
When your child is referred to Cincinnati Children’s for consideration for a heart transplant, a comprehensive evaluation is scheduled by the heart transplant team. The purpose of this evaluation is to:
- Provide information to your child and family about Cincinnati Children’s and the Heart Transplant Program;
- Discuss implications of heart transplant and treatment options with your child and family;
- Assess your child's health status and determine the need for further tests or information, if any;
- Assess your child and family's support system and resources for coping with the anticipated stress of a heart transplant; and
- Establish communication and a relationship between your child, family and the Heart Transplant team, all of whom will be actively involved in your child's care and treatment once accepted for transplant.
Your child and family will meet with the following people as part of the transplant evaluation process:
- Transplant Cardiologists
- Transplant Nurse Practitioners/Coordinators
- Transplant Surgeons
- Transplant Social Workers
- Transplant Pharmacists
The following people are available as needed to your child and family throughout the transplant process:
- Financial counselors
- Hospital chaplain
- Public relations
- Pediatric dentist
- Child Life specialists
- Psychology/psychiatry specialist
- Neurodevelopmental specialist
During the evaluation process, you are encouraged to ask questions and learn as much as possible about the short- and long-term implications of heart transplantation. You are given as much time as possible, as determined by your child's current health and need for treatment, to make a decision about pursuing heart transplantation.
Upon completion of the evaluation, the heart transplant team will meet to share information and make a decision about the suitability of a heart transplant for your child. This decision will be communicated to the referring cardiologist and to you. If the team feels that transplantation is suitable and you agree to proceed with a transplant, a member of the transplant team will talk with your child and family to review the next steps in the transplant process.
Not every child who may need a transplant is acceptable for transplantation. Reasons that some children are not listed for transplantation include:
- Medical contraindications
The goal of heart transplantation is to return your child to a functional state with the least amount of limitations and to improve quality of life.