How you prepare

Preparations for a heart transplant often begin weeks or months before you receive a donor heart.

Taking the first steps

If your doctor recommends a heart transplant, you'll likely be referred to a heart transplant center for evaluation. Or you can select a transplant center on your own. Check your health insurance to see which transplant centers are covered under your plan.

When evaluating a heart transplant center, consider the number of heart transplants a center performs each year and the survival rates. You can compare transplant center statistics using a database maintained by the Scientific Registry of Transplant Recipients.

You should also check to see if a transplant center offers other services you might need. These include coordinating support groups, assisting with travel arrangements, helping you find local housing for your recovery period or directing you to organizations that can help with these concerns.

Once you decide on a center, you'll need to have an evaluation to see if you're eligible for a transplant. The evaluation will check to see if you:

• Have a heart condition that would benefit from transplantation
• Might benefit from other, less aggressive treatment options
• Are healthy enough to undergo surgery and post-transplant treatments
• Will agree to quit smoking, if you smoke
• Are willing and able to follow the medical program outlined by the transplant team
• Can emotionally handle the wait for a donor heart
• Have a supportive network of family and friends to help you during this stressful time

Waiting for a donor organ

If the transplant center medical team determines that you're a good candidate for a heart transplant, the center will put you on a waiting list. The wait can be long since there are more people who need hearts than donors. Finding a donor depends on your size, your blood type and how sick you are.

While you're on the waiting list, your medical team will monitor your heart and other organs and adjust your treatment as necessary. The team will help you learn to care for your heart by eating well and being active.

If medical therapy fails to support your vital organs as you wait for a donor heart, your doctors might recommend that you have a device implanted to support your heart while you wait for a donor organ. These devices are known as ventricular assist devices (VADs). The devices are also referred to as bridges to transplantation because they gain you some time to wait until a donor heart is available.

Immediately before your transplant surgery

A heart transplant usually needs to occur within four hours of organ removal for the donor organ to remain usable. As a result, hearts are offered first to a transplant center close by and then to centers within certain distances of the donor hospital.

The transplant center will provide you with a pager or cellphone to notify you when a potential heart is available. You must keep your cellphone or pager charged and turned on at all times.

Once you're notified, you and your transplant team have limited time to accept the donation. You'll have to go to the transplant hospital immediately after being notified.

As much as possible, make travel plans ahead of time. Some heart transplant centers provide private air transportation or other travel arrangements. Have a suitcase packed with everything you'll need for your hospital stay, as well as an extra 24-hour supply of your medications.

Once you arrive at the hospital, your doctors and transplant team will conduct a final evaluation to determine if the donor heart is suitable for you and if you're ready for surgery. If your doctors and transplant team decide that either the donor heart or surgery isn't appropriate for you, you might not be able to have the transplant.