A premier center for heart transplant care for those in West Virginia and beyond

All care begins with a referral. Referrals are typically placed by a primary care provider or cardiologist. They can also be placed by the patient (self-referral).

During the referral process, representatives from WVU Transplant Alliance will review medical records and testing, provide pre-evaluation education, and explore whether each patient is ready to move on to transplant evaluation.

The financial team will work with your insurance provider to obtain authorization for the evaluation. This pre-evaluation process can help you decide if transplant is right for you.

To make a referral, visit the WVU Medicine Provider Hub or contact the WVU Medicine Transplant Alliance at 304-974-3004.

During the transplant evaluation, our team will assess your eligibility for heart transplant and select the tests and consults needed to determine if a heart transplant is the best option for you.

Patients will be paired with a pre-transplant coordinator as a partner and guide throughout the pre-transplant process.

During the evaluation visit, you and your support person will meet our transplant team, which includes a:

• Cardiologist
• Coordinator
• Dietitian
• Financial coordinator
• Pharmacist
• Social worker
• Transplant surgeon

This team will work together to evaluate your medical, surgical, and psychosocial histories as well as your overall health.

During your evaluation, each discipline will provide ongoing transplant education and a thorough review of the transplant evaluation process, including what to expect following transplantation. If the evaluation moves forward, you’ll then visit the Physician Office Center (POC) outpatient lab for initial blood work.

Soon after the initial evaluation visit, you will receive a list of tests and/or potential healthcare provider appointments that are required as part of the evaluation process. The team will review your medical records to determine what’s necessary for evaluation to avoid repeating tests or appointments that may have already been completed. The sooner the evaluation requirements are completed, the sooner you can move along in the process.

Once all evaluation requirements are complete and all results are received, the pre-transplant coordinator will schedule your case to be reviewed at the next Patient Selection Committee Meeting (PSC). The PSC consists of everyone on the heart transplant team, including those you may not have seen in clinic. This group will thoroughly review all test results (lab work, radiology testing, cardiac testing, etc.), status of requests from team members during evaluation day, and any outside consult notes.

The outcome of this meeting will be one of the following:

• Accepted – You will be added to the waitlist pending tissue testing (HLA) and insurance approval. This may take around one week. The financial coordinators will work with your insurance company to obtain approval for heart transplantation.
• Deferred – Additional testing/information is needed before moving forward.
• Declined – Declined cases may have one of two possible outcomes. “Modifiable” cases will include further instructions on the pathway to becoming a transplant candidate. “Non-modifiable” includes an explanation as to why candidacy is not possible.

Following this decision, the pre-transplant coordinator will guide you through the next steps.

The pre-transplant coordinator will contact you to let you know if you’ll be added to the waiting list for heart transplant. The United Network for Organ Sharing (UNOS) decides how organs are distributed for heart transplants.

Factors in heart transplant distribution include:

• Blood Type/Body Size. Recipients must also have the same blood type and body size as the donor, as the heart needs to match to keep up with body requirements.
• Donor Location. Location of the donor heart plays a role, as the team may need to travel for the heart and get it back in time for transplantation.
• Illness Severity. A significant factor in being selected as a recipient is the severity of illness — those who are stable can wait longer. (See status levels below.)

When you are on the waiting list, there are seven statuses you’ll learn about:

• Status 1 – Critically ill and on mechanical support
• Status 2 – In hospital on mechanical support or with severe heart arrhythmias
• Status 3 – In hospital and having complications with a ventricular assist device (VAD)
• Status 4 – Stable with a ventricular assist device (VAD) or serious heart condition
• Status 5 – In need of a dual heart transplant (heart+lung, heart+kidney, heart+liver) and do not meet the criteria for status 1-4
• Status 6 – Stable without a need for mechanical support or IV medications
• Status 7 – Inactive. This means you are on the list but not receiving offers. This may be due to insurance changes, illness/medical status, or a personal choice (travel, no available caregiver, etc.).

When you receive an organ offer, your transplant coordinator will contact you to discuss the organ offer—including information on the type of donor— so that you and your family can make an informed decision on whether or not to accept. The transplant coordinator will also ask about your current health status, ensuring that you are well enough to receive a transplant at the time of the offer.

If accepted, WVU Medicine Transplant Alliance will then send a surgical team to recover the donor heart. While at the donor center, the team will assess the heart for any cardiac disease that may have been missed or not reported.

Operation

Heart transplantation is an open-heart surgery that can take several hours. If you have had open heart surgery before or have a VAD (Ventricular Assist Device), know that a heart transplant can be more complicated and take longer. Surgeons carefully perform the procedure in an operating room under general anesthesia.

Your Hospital Stay

After surgery, you will stay in the intensive care unit for a few days and then be moved to the step-down unit. You will likely remain in the hospital for 10-14 days. The amount of time spent in the hospital will vary from person to person.

While you are in the hospital, members of the transplant team will assist with medication education, post-transplant care education, follow-up visits/lab work, educating about rejection screening/biopsies, and instructions on how and when to contact the post-transplant office following discharge.

After discharge, you’ll need a caregiver for two weeks or more for daily care, medication management, and traveling to and from appointments. The transplant team will rely on you and your caregiver to let us know of any changes.

It’s important to keep your follow-up appointments. Over time, you will start to recover and feel your normal self. You may feel like these appointments are not needed, but they are— the transplant team is closely monitoring for specific lab values and signs of rejection.

For the first several weeks…

Drink and eat properly – Now that you have a new heart, it’s important to stay hydrated. An increase in hydration will also minimize the risk of constipation after surgery. Eating a healthy diet can also help promote wound healing.

Avoid illness – Patients who have received organ transplants have a higher risk of infections. To prevent illness, we advise transplant recipients to:

• Avoid any new tattoos or piercings
• Avoid contact with animal feces or soil
• Avoid hot tubs, saunas, or steam baths
• Keep environment free of clutter and dust
• Limit visitors and avoid crowds
• Maintain proper hygiene
• Practice food safety when preparing meals
• Use protection during sexual activity
• Wash hands frequently (especially before touching incision)

Follow restrictions. You may need to restrict activities or modify your lifestyle as you heal post-transplant. While you can learn more about post-discharge care in our patient resources section, a few general rules include:

• Avoid lifting heavy objects and strenuous physical work for at least six to eight weeks following surgery. You may not lift, push, or pull more than five pounds until you are cleared by the transplant team. This includes lifting and caring for small children and pets.
• Avoid driving for at least six weeks following surgery. We recommend that you always wear your seatbelt when you are in a moving vehicle.
• Avoid contact sports, as this might cause injury to your new heart. If you have any questions regarding what activity you should or should not avoid, talk with your transplant coordinator.

Move your body. Exercise is encouraged. We recommend you start with walking and gradually increase your activity. The transplant team will be here to help assist with any questions you may have about physical activity. Heart transplantation is a major surgery and everyone recovers at their own pace.

Monitor your incision. It’s important to examine your incision several times throughout the day. Is it pink or red in color? Is there any fluid or drainage coming from the incision? Is there any increase in pain? Learn the signs to watch out for and call your team immediately if you notice changes.

Manage pain. Follow the pain management advice of your doctor. Keeping your pain controlled will promote movement, which will increase healing.

WVUMyChart – is a great way to track your labs and view what results your coordinator will be seeing. Process times for ordered tests vary— unless something is abnormal, your coordinator will not reach out until everything is complete. If you had labs done, but don’t see them in WVUMyChart, please call the office and let them know so we can call for results.

As you improve, you’ll be permitted to return home – blood work will continue and can be done closer to home. Appointments will eventually become less frequent, but our team is always here to answer any questions or concerns.

You will be advised to stay within two hours of the hospital for at least 14 days. If you live a distance from the hospital, there are lodging options. WVU Medicine works together with the Rosenbaum Family House to secure reduced rate rooms located on the campus of J.W. Ruby Memorial Hospital. If rooms are not available, they can help locate a discounted hotel room near the hospital. The transplant social worker is available to assist with the reservation to Rosenbaum Family House.

Learn more about the WVU Medicine Rosenbaum Family House.