Start Your Heart Transplant Application

Your medical records and application to our heart transplant program are more than paperwork. It's your story, our cardiac-specialist team's window into your medical history and the first step toward determining which advanced heart failure therapies, including heart transplantation, will work best for you. From your first name to your last lab report, every little piece of information you share helps paint a bigger picture that arms us with the knowledge we need to start you on the right path to the right heart treatment plan for you. That's why it's so important to cross every "t," dot every "i" and read every word.

Collect Your Medical Records

Just as important as what's written on your application is the following list of medical records. Together with your application, these records help illustrate your journey up until this point. They're essential to helping us make sure you're a candidate for heart transplant and we can't accept your application without them.

Send the following medical records along with your completed application form:

• Cardiologist's history and physical (typed copy)
• Current office notes/progress notes from your cardiologist's office
• Recent labs from your cardiologist's or primary physician's office
• Copies of insurance cards and drug coverage cards (front and back)
• Completed insurance Information sheet (page 4 on application)
• Pathology reports and treatment records for any patient with a history of cancer
• Cardiac catheterization results (if done)
• Echocardiogram results
• Chest x-ray and/or CAT scans (if done)

Send In Your Application

Mail or fax your completed application and medical records to:
AdventHealth Transplant Institute
2415 N. Orange Ave, Suite 700
Orlando, FL 32804
Fax 407-303-2998

We know waiting isn't easy. But we hope it helps to know that once we receive your medical records, your information is in good hands and your well-being is on our minds. Your medical care team will carefully review your application and medical records to see if you meet our program's heart transplant requirements. Once it's reviewed, your financial coordinator will work with you and your caregiver to help you understand what medical and medication coverage is available to you. The second we get the green light, we'll be in touch to help you take the next step: Evaluation.

Pre-Evaluation Review

Once we receive your application (complete with medical records and results) our transplant coordinator will be in touch to review your medical history in more detail. They'll confirm that you meet the following heart transplant requirements:

• 69 or younger
• No major disease that will diminish the chances of long-term survival
• No evidence of active cancer within the past five years (exceptions will be on an individual case review basis.)
• Must be free of alcohol, drugs, and tobacco use for at least six months (and must remain abstinent throughout all phases of transplant)
• No evidence of extensive vascular disease that affects circulation, brain, or other major arteries
• Must have adequate insurance coverage for anti-rejection medications

When our transplant coordinator is confident that you're ready to move forward, we'll begin the formal, more in-depth evaluation process.

Lab and Diagnostic Testing

Our confidence in your body's ability to undergo a successful heart transplant procedure begins with a comprehensive series of lab and diagnostic tests. We'll guide you and your caregivers through the following tests in the comfort of our state-of-the-art Orlando facility:

• Complete blood workup
• Ultrasound exam of heart and other abdominal organs and blood vessels
• Chest X-ray
• Cardiac stress test
• Echocardiogram (a heart exam done by ultrasound)
• Right heart catheterization
• Metabolic stress test
• Electrocardiogram (measures your heart's electrical activity)
• Pulmonary function tests
• Dental consultation
• Ophthalmology consultation
• Skin tests
• CAT scan of your chest
• Mammogram
• X-Rays

Your transplant surgeon will walk you through your test results and any additional testing needs.

Meeting Your Transplant Team

Our patients and their caregivers often say their transplant team becomes like a second family. So it's only natural that the first step is getting to know each specialist on your transplant team. And even though these are one-on-one meetings, your dedicated health team stays closely connected throughout your evaluation process through close communication and innovative technology.

Your Social Worker is here from day one to support your journey and make sure you're mentally and emotionally ready to undergo a heart transplant. Their line of questioning will be geared toward preparing you and your caregivers to take care of your new heart transplant by following the medical team's recommendations. If they feel you need additional resources, whether it's housing or financial assistance, they’ll help connect you to the right resources in your community.

Your Dietitian is focused on keeping you as healthy as possible before, during and after surgery. Nutrition plays a critical role before, during and after surgery, so it's essential that you follow your dietitian's meal plan morning, noon and night. They'll help you stay mindful about what you put into your body leading up to heart transplant surgery and help you understand how certain medications may affect your appetite and/or interact with certain foods and substances. After surgery, your dietitian will create a detailed eating guide designed to keep your new transplant working like new.

Your Transplant Cardiologist will review your test results and your medical history in detail, addressing any unanswered questions or concerns. If more tests are necessary, or they feel you need a Ventricular Assist Device or other advanced heart failure therapy while you wait for a heart transplant, they'll guide you through what needs to happen next. They'll also communicate with your primary cardiologist back home to ensure they're up to date on your treatment plan and medical therapy.

Your Transplant Surgeon is working toward your successful heart transplant and long-term health. They'll walk you through what to expect before, during and after surgery.

These are meant to be candid conversations with a group of people who are as invested in your heart health as you are. Bring the questions that keep you up at night. Bring your support person. And bring your fighting spirit.

Patient Review Committee

Once you've met with every person on your transplant team and your test results have been processed, your transplant coordinator will present your case to the Patient Review Committee. Together, they'll review your case to determine your best course of treatment. If your team is confident a transplant is the best option for you, your name will be placed on the national organ waiting list.

Multiple Listings

You're taking charge of your health, and that means you have every right to be evaluated by different transplant centers. Just let us know if you've already been evaluated by another center so we can avoid duplicate testing and move your evaluation along faster. Our team can help obtain these records. Remember that each center evaluates and accepts patients based on their own criteria, and being listed at one center doesn't guarantee that every center will accept you.

What If I'm Not a Candidate for a Heart Transplant?

Our commitment to comprehensive cardiac care means we specialize in whole-heart care that goes beyond transplants. Once you're referred to our heart transplant program, our world-renowned heart specialists work tirelessly to determine which advanced heart failure therapy works for you, even if a heart transplant isn't an option.

Explore Our Advanced Heart Failure Program

How the Heart Transplant Waiting List Works

The United Network for Organ Sharing (UNOS) manages the list of everyone across the country waiting for an organ transplant. Once your transplant coordinator adds you to the heart transplant list, your information — including your blood type, medical urgency and our institute's location — is entered into UNOS' computerized network. When a donor heart is available, the donor's information is entered into the UNOS system. Using the combination of your information and the donor's, the UNOS computer system generates a "match run," which is a "rank-order list" of candidates. Your place on the list depends on your Listing Status. There are currently three active statuses and one inactive status:

Status 1A
Status 1A patients will be the first to receive a donor heart when one becomes available. That's because patients in this category are critically ill and generally require intensive care monitoring, intravenous medications, special heart monitoring lines, and may need assist devices such as an intra aortic balloon pump or mechanical circulatory support device.

Status 1B
Status 1B patients require continuous infusion of special medication to help support heart function. These medications are called inotropes (i.e. milrinone, dobutamine). Patients with 1B status can wait at home or in the hospital, depending on their medical condition.

Status 2: All others

Status 7: Temporarily inactive

While you're on the heart transplant waiting list, your transplant physician will evaluate you every three to six months to keep you as healthy as possible and to look for any changes that could affect transplantation. You'll also see your Heart Failure Cardiologist periodically. If your transplant team determines that you become too sick for a transplant, your status may be put on hold until your condition can be reevaluated.

Heart Transplant Pre-Education

We've seen first-hand that patient education is key to a successful heart transplant. The more you and your support system know about how to care for yourself before, during and after your transplant, the more likely you are to follow your team's medical recommendations throughout the process. That's why once your name is added to the national organ waiting list, you, your family and your caregivers will receive one-on-one education from your team throughout your treatment. Our transplant team will guide you through each step of the heart transplant process in detail, from how the waiting list works to what resources are available to you after surgery and recovery. We encourage you and members of your support system to ask any questions you may have.

What Can You Do While You Wait?

Resolve to focus on the things you can control: your day-to-day health and habits. Your dietitian will arm you with a nutrition plan. Follow it. Choose salad over sweets. Make a daily date with your treadmill. Take the stairs, not the elevator. And get in your steps wherever else you can. Keep up with your routine health screenings, from dental visits to eye exams. And whenever you need to, take a break. Focusing on your whole health is the best way to make sure that when the right heart becomes available, your mind and body are ready to receive it well.

Be sure to let us know if you have any address, name or insurance changes and let your transplant coordinator know of any illness, surgery or hospitalization. You can also put a plan in place for when you do receive the call. Your new heart will need to be transplanted within four to six hours, so make arrangements to get to the AdventHealth Transplant Institute immediately. Make sure you have a designated driver, reliable transportation and a travel bag packed at all times.

Getting the Call

Your transplant care coordinator will be the first to call you the moment we think we have the right heart for you. Most patients say it's a moment they'll never forget. Let it sink in. Then make your way to our Transplant Institute right away for final evaluation and pre-op. Don't eat, drink or take any medication after you receive the call. We'll be here waiting to prepare you for your new heart.

Helping You Understand the Risks

As with any surgery, there are risks, but we're here to help you understand the potential complications. Some specific heart transplantation risks may include:

• Organ failure. Your new heart may fail to function properly.
• Tissue rejection. Our bodies are smart, and when you receive your new heart, your immune system will sense the new tissue. We'll give you immunosuppressive medications to help your body accept its new heart.
• Immunosuppressive medications' side effects.

We've made incredible strides over the last few decades, and while the possibility of risks will always exist, heart transplant surgery has never been a safer, more effective long-term solution. After we've answered all your questions, we'll ask you to sign a consent form, giving us your permission to perform your heart transplant.

Before Surgery

After you sign the consent form, your transplant care team will complete a physical examination to be 100 percent sure your body is ready for surgery, including blood tests and chest X-rays. If necessary, your team will take additional steps to get you ready for surgery. Your nurse will set you up with an IV line to administer medications as needed. And if you need a hand to hold, we can do that too.

During Surgery

As you get your new heart, you'll be surrounded by our world-renowned team of cardiac specialists. Your team will place you on a heart-lung bypass machine to maintain oxygenation and blood supply to your body. Your anesthesiologist will monitor your heart rate, blood pressure, breathing, and blood oxygen level throughout your surgery. Length of surgery and other details may vary depending on your specific condition, but most heart transplants take anywhere from six to 12 hours and are done under general anesthesia.

After Surgery

This is where the road to recovery and a healthy new life begins. From the moment you leave the operating room, your transplant recovery team will be working hard to get you back on your feet.

No patient's plan is the same, and how long you stay in the hospital depends on a variety of factors, but most patients stay anywhere between two and three weeks after a heart transplant. You'll likely spend the first 24-48 hours in the cardiovascular intensive care unit before you’re transferred to the progressive care unit for the rest of your hospital stay.

You'll start feeling like yourself sooner than you think. Your appetite will come back. Energy levels will rise. We'll monitor you closely through daily exams, regular blood work and various radiologic tests to make sure your heart is working as expected, and that no infections are present. You'll also have a cardiac biopsy to check for rejection at the cell level. Up until the day you're discharged, your dedicated team will guide you through exercises and therapies designed to keep your lungs clear and get you back on your feet as quickly as possible. They'll help you become more independent in your care, working together toward your goals: Get stronger. Master your meds. And adapt to your new heart-care routines, which might include things like learning how to check your blood sugar, inject insulin and taking your own blood pressure.

Outpatient Institute Visits

Once you're cleared to leave the hospital, your team will continue to help ease your transition to independent living. You'll leave AdventHealth armed with detailed instructions, a supply of meds and a list of phone numbers to contact for any questions or emergencies.

We'll be in close, regular contact with you through your nurse coordinator. Typically, we'll need to see you in our Institute every seven to 10 days for the first month following surgery. Our team can help arrange local housing, whether at the Bartch Transplant House (if you qualify) or elsewhere.

After one month, we'll reduce your visits to every two weeks, and eventually, to once a month. At the end of your first year, we’ll refer you back to your transplant coordinator for routine care, and we'll see you back at our Transplant Institute every year for your annual visit.

A Healthy Lifestyle

Treating your new heart with care means treating your body well. Eat smart. Exercise with purpose. And never forget the physical, emotional and mental challenges your mind and body have overcome. Your transplant team will create a detailed health and maintenance plan, from diet and exercise recommendations, to how to avoid infection.

Medications

Anti-rejection medications will be part of your daily routine from this day forward. Without them, your body may begin to reject your new heart. Your transplant team will perform lab tests as needed to make adjustments in your dosage and give you detailed instructions on how and when to take your medications.

Transplant Support Groups

Sharing your experience with other heart and organ transplantation patients can be an essential part of the recovery and maintenance process for many patients. We'll connect you to local and national resources online and in your community.

Staying Connected

We're part of your story and you're part of ours. In addition to your annual physician visits to our Institute, we keep our team-patient connections going strong through annual events like our annual Patient and Family Picnic and the GR8 to DON8 race.