University Hospitals Accepting Referrals of Patients with Advanced Heart Disease

More than 250,000 people in the United States have end-stage heart disease, with approximately a fifth of those in dire need for a heart transplant. While patient demand has increased over the years, the rate of heart transplantation in the U.S. has stayed around 2,000 per year due to availability of donor hearts.

Heart transplantation is a viable treatment option for patients who do not have concomitant medical problems that preclude successful transplant surgery or compliance issues that would interfere with the regimen of immunosuppressant medications required to prevent rejection of the transplanted heart following the transplant operation.

On average, survival after heart transplantation is about 11 years, with many patients living much longer.

Indications for Referral

• Frequent rehospitalization for heart failure exacerbations
• Intolerance to standard heart failure medications
• Severe ischemia consistently limiting routine activity not amenable to revascularization
• Recurrent symptomatic ventricular arrhythmia refractory to all accepted therapeutic modalities
• Maximal VO2 < 14 ml/kg/min and major limitation of the patient’s daily activities
• Recurrent unstable angina not amenable to revascularization
• Unstable fluid balance/renal function not due to patient noncompliance with regimen of weight monitoring, flexible use of diuretics and salt restriction
• End-stage heart disease not amenable to other medical or surgical therapy with irreversible pulmonary hypertension
• NYHA Class III-IV symptoms on optimal medical therapy and prognosis for 1 year survival less than 75%