How to Get Added to the Heart Transplant List

An expert details how you can get added to the heart transplant list at a qualified center such as Keck Medicine of USC.

While advances in modern medicine have helped save countless people with heart issues, sometimes a person might find themselves in a position where they need a heart transplant.  

“If someone has significant or end-stage heart failure, cardiomyopathies or other symptoms and has exhausted medical therapy options, they might be a candidate for a heart transplant,” says transplant cardiologist Ajay S. Vaidya, MD, medical director of the USC Heart Transplant Program, part of the USC Transplant Institute and Keck Medicine of USC. “Despite all medical interventions, you still might feel like your quality of life and your ability to do normal levels of exertion for your age are significantly limited. Or your doctor might tell you that your survival will be limited due to heart failure. All of these are reasons to get added to the heart transplant list.” 

If you or a loved one finds themselves in this situation, here are the steps to getting added to the heart transplant list to wait for an organ donor. 

Find a heart transplant center 

“The first step is to establish yourself with a center that provides heart transplants, or what we call advanced therapies, which include durable mechanical circulatory support devices, like a left ventricular assist device (LVAD), which is a heart pump device that allows eligible patients to safely wait for heart transplantation while at home,” Dr. Vaidya says. 

Patients who wish to establish themselves with the USC Transplant Institute can either refer themselves or be referred by their doctor. The next step after getting established with a center is to make sure that a heart transplant is covered by your insurance. The USC Transplant Institute transplant team can work with you to help you determine what your coverage is.  

Come for an initial evaluation with a multidisciplinary team 

The initial evaluation process at the USC Transplant Institute usually lasts between four to five hours, Dr. Vaidya says. A transplant coordinator will be your guiding light throughout this process, coordinating all your care and appointments and being your primary contact throughout your transplant journey.  

“You’ll meet our entire team, including an advanced heart failure cardiologist, transplant cardiologist, social worker, financial counselor, nutritionist, pharmacist and eventually a physical and occupational therapist,” Dr. Vaidya says. You’ll also undergo a series of laboratory tests and imaging studies and meet some specialized consultants from infectious disease and cardiac surgery. 

There are two questions doctors will try to answer in this initial evaluation to determine if you are eligible for a heart transplant: 1) Are you sick enough from a heart health perspective to qualify for a heart transplant or an LVAD, and have we tried everything short of transplant to improve your quality of life and survival from heart failure? And 2) Is the rest of your body well enough to survive a serious surgery like a heart transplant?  

“A heart transplant is a gift and a privilege, and there are far fewer organs that are available relative to the number of people who need these organs, so we really try to take seriously that obligation to give heart transplants to people who will take care of their heart and who have a good support system to put themselves in a position to succeed after transplant,” Dr. Vaidya says. 

Many factors must be considered before someone receives a heart transplant. At the USC Transplant Institute, a comprehensive committee comprising experts from multiple specialties is dedicated to making decisions of this magnitude. 

“The multidisciplinary committee is specialized in evaluating different aspects of those questions and the evaluation process,” Dr. Vaidya says. “Members give their input, and then we make recommendations on possible options that we can offer you based on what we feel like you’d be a good candidate for.” 

Wait for your center to call you in for your transplant 

If a person has been recommended for a heart transplant, the next step for them is to wait, Dr. Vaidya says. The committee discusses whether the safest and best place for a person to wait is either at home or in the hospital, depending on their condition. Sometimes you might also be given an LVAD while you wait.  

Your center will add you to the heart transplant list, which is managed by a national agency. You don’t have to do anything to get added to the list once your center has determined that you are eligible, Dr. Vaidya says.  

Once an organ becomes available to you, the heart transplant team determines if the compatibility is good enough for a transplant, he says. For example, a heart that comes from a donor of a 100-pound woman would not be a suitable match for a 300-pound man who needs a heart transplant because the size difference is too great, Dr. Vaidya says.  

“There are other factors that might determine how long you’ll wait on the transplant list, such as blood type and whether or not you have certain types of antibodies that might be directed toward potential donors,” Dr. Vaidya says.  

The biggest positive steps a person can take to improve their candidacy is to make sure they are prepared by having a good support system to care for them post-surgery and making sure they are in the best health as possible by avoiding drinking and smoking, Dr. Vaidya says.  

In terms of figuring out how to get added to the heart transplant list, Keck Medicine takes care of it for you. “The only thing a patient has to do is wait by the phone and be ready when the right organ becomes available,” he says.  

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