When you’re walking through something medical, people have questions. Some they ask out loud. Some they don’t.
Here are the answers to the ones I hear absolute most.
Q: How does the transplant list actually work?
Answer:
A heart transplant is surgery to replace a severely failing heart with a healthy donor heart. It’s typically considered when advanced heart failure no longer responds to medications or other procedures.
It’s not a first option.
It’s a life-saving option.
Q: How does the transplant list actually work?
Answer:
When someone is told they need a heart transplant, they are placed on a national waiting list which is operated by UNOS. UNOS is the abbreviation of United Network for Organ Sharing. The system is managed by OPTB which stands for the Organ Procurement and Transplantation Network. Patients are assigned a medical status level (1–6), with 1 being the most urgent. This list is not random. It is not first-come, first-served. It is based on medical urgency and compatibility.
There are several things that must be done prior to even being listed. These things include but are not limited to:
- Heart Testing
- Blood Work
- Imaging
- Psychological Assessment
- Overall Health Assessment
- Assessment of Financial Ability
- Assessment of Support System
Doctors must determine that:
A transplant is medically necessary. The patient is strong enough to survive surgery. The patient can follow lifelong medical care afterward.
Only when all of these have been completed and deemed the best solution to this health issue; a patient is officially placed on the list.
Q: How long do people usually wait?
Answer:
There is no guaranteed timeline. Some wait weeks, some wait months, and some wait longer. It depends on compatibility and urgency. Compatibility is based on blood type, body size (will heart fit properly), antibody sensitivity, and organ availability.
Q: What happens when “the call” comes?
Answer:
Do NOT go into shock! You grab your already packed hospital bag (I’ll tell you about mine later on) and immediately head to the hospital. Once you arrive a battery of tests will be completed again and surgery prep will begin. Not every call leads to transplant — sometimes hearts are declined for safety reasons.
Q: Is the surgery dangerous?
Answer:
All major surgeries carry risk, but heart transplant outcomes have improved significantly over time. The Pros greatly outweigh the Cons in this situation in my mind.
Q: What happens after surgery?
Answer:
After surgery you are taken to the ICU recovery ward where you will start your recovery. Remember, it reality, after transplant is when the real work begins. Entering the ICU- you will be on a ventilator, have multiple IV lines, have chest tubes draining fluid from around your heart and lungs, on medication, and are being monitored nonstop. Once you are no longer intubated, things progress quickly- but safely. There are people who are awake and off intubation within a few short hours of the transplant. It is common to start sitting, standing and even walking within the first day or two. While there are tons of follow up appointments and a lot of recovery, you are on the path to a new normal. Directly after surgery the new lifelong medications begin along with rejection monitoring.
Q: Can your body reject a new heart?
Answer:
Yes. That’s why anti-rejection medications are required for life. Rejection is common early but manageable. There are different signs a body will reject before, during and after. These are commonly found in the antibody sensitivity testing.
Q: Does receiving a donor heart change who you are?
Answer:
No. Personality and identity do not transfer with organs. You yourself may continue to grow and change through the experience but it is still you.
Q: How can someone support a transplant patient?
Answer:
Practical help. Consistent encouragement, Prayer and Patience. These are the most basic. I will share more in detail later on.
Q: How successful are heart transplants?
Answer:
About 85–90% of patients survive the first year. Many live 10–20 years or more after transplant. Outcomes continue to improve with advances in medicine.
Q: What can I do to help?
Answer:
The first thing you can do is register as an organ donor. You can actively research and learn about transplant awareness. Support someone who is waiting for a transplant. It may help you just as much as it helps them!
Medicine is complex. Waiting is emotional. But knowledge removes fear. And faith fills the space knowledge cannot.
The beat goes on — one answered question at a time.
The Beat Goes On 