A heart transplant is only done when it is absolutely necessary and likely to have long-term success. The process of getting accepted into Cleveland Clinic’s heart transplant program involves several steps to ensure the best possible outcomes for every patient.
Step 1: Referral to the program
There are two ways to be referred to Cleveland Clinic’s heart transplant program – by your doctor or you can refer yourself.
Specifically for outpatient transplant or VAD evaluations, please call 216.445.1844.
Transplant referrals can be submitted online through our referral portal.
Consideration of an outpatient transplant or VAD evaluation is recommended when a patient meets any of the C-I-NEEDHELP criteria, which are: Cachexia, Inotropes, NYHA class IV or high Natriuretic peptides, End-organ dysfunction, Ejection fraction <20%, Defibrillator shocks, >1 HF Hospitalization in past year, Edema or Escalating diuretics, Low blood pressure, Prognostic medications de-escalated.
Step 2: Transplant Evaluation
Every patient interested in a heart transplant must have a comprehensive evaluation. The evaluation is done to find out exactly how advanced your heart disease is and to create the best plan of care for you. The evaluation takes 3 to 4 days and includes tests and procedures, meeting the members of the transplant team and getting information about all possible medical and surgical treatment options, including heart transplant.
The team members will talk to you about many aspects of heart transplantation, including:
- How patients are selected for the heart transplant program
- Your support system and any issues that may affect your ability to be selected for a transplant
- Financial responsibilities associated with a transplant
- The importance of following your plan of care before and after your transplant
Tests that you may have during your evaluation include:
- Blood tests
- Chest X-ray
- Urine test
- EKG
- Echocardiogram (echo)
- Cardiac stress test
- CT scan
- MRI
- Right heart catheterization
- Biopsy
- Ultrasound
- Pulmonary function test
- Endoscopy
- General health screening
- Psychosocial evaluation
You will get detailed information about your evaluation and the testing after they are scheduled. After you complete your evaluation, your test results and other information will be reviewed by a committee to determine if you need a transplant at this time and anticipated to benefit from a transplant. Your insurance company must also approve the transplant. After you are fully approved for a transplant, you will be placed on the United Network for Organ Sharing (UNOS) national waiting list.
Step 3: Waiting for transplant
Being placed on the UNOS waiting list does not guarantee you will get a heart transplant. It is critical that you follow your plan of care and do not miss any follow-up appointments.
The organs used for transplant are based on crite