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Helping More Patients Qualify for a Heart Transplant

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Posted by Eman Hamad, MD

A heart transplant is one of modern medicine’s most amazing procedures. But to get this life-saving surgery, you must first qualify for it.

Unfortunately, many patients are turned down for a transplant by hospitals with strict criteria that determine who can and cannot receive a transplant. Sometimes patients are told that they are too old or too sick to be transplanted. Other times it’s something in their medical or personal history that disqualifies them.

At Temple, we don’t believe in a “one-size-fits-all” approach to transplantation. Our goal as heart transplant doctors is to make heart transplants more available to patients who need them, especially those in end-stage heart failure who have no other treatment option.

Broadening Our Heart Transplant Criteria

It’s a sad reality that, without a heart transplant or a mechanical heart pump, most patients with end-stage heart failure will live no longer than 6 months. Patients should not be automatically shut out because they didn't meet a certain set of criteria. That's why we recently broadened our heart transplant criteria to help more patients qualify for transplant.

Instead of having strict cutoffs due to age or medical condition, we evaluate each patient individually and make decisions based on their unique set of circumstances. The changes we made are not arbitrary. Instead, they are based on best practices and our decades of experience in the field of heart transplantation.

Today at Temple, we will consider patients for heart transplant who:

  • Are up to age 74 (other centers only accept patients up to age 70)
  • Have a BMI up to 35
  • Have abstained from alcohol, smoking and marijuana for a time period based on level of dependence
  • Have an elevated panel-reactive antibody (PRA)
  • Have a history of Mantle radiation
  • Have had cancer in the last 5 years
  • Are Jehovah Witness/have objections to receiving blood transfusions
  • Are HIV-positive
  • Have elevated pulmonary vascular resistance
  • Have a history of multiple sternotomies

These new criteria have not affected our survival rates at all. In fact, according to the January 2020 Scientific Registry of Transplant Recipients report, Temple's 1-year survival rate is 94.0% compared to the national expected rate of 91.6%.

Excellence in Evaluating Donor Hearts

In addition to expanding our transplant criteria, we evaluate donor hearts differently than other heart transplant centers. We look very closely at all donor hearts offered to us and are willing to take higher-risk organs because we know that we have the experience to make them work.

Fastest 'List to Transplant' Center in the Region

We also transplant patients more quickly at Temple. On average, 75.6% of our patients receive a new heart within a year of being on the waiting list, compared to 51.9% nationally. That makes Temple the fastest "list to transplant" center in the Philadelphia region and one of the fastest in the nation.

Helpful Resources

Read on for more information about heart transplantation at Temple:

Eman A. Hamad, MD

Eman Hamad, MD

Dr. Eman Hamad is Director of the Advanced Heart Failure and Transplant Program at Temple. Dr. Hamad specializes in advanced heart failure therapies including transplantation and mechanical circulatory support. She is a member of several organizations, including the American Heart Association.

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