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Heart & Vascular Institute

Getting on the Heart Transplant Waiting List

One of the most important steps in having a heart transplant is getting placed on the transplant waiting list. 

Temple's Advanced Heart Failure & Transplantation Program is one of the most experienced heart transplant programs in the country. If you're a transplant candidate, our team guides you through the process of:

  • Getting on the list
  • Transplant procedure
  • Life after a transplant

We provide our expertise and support every step of the way.

What Is the Transplant Waiting List?

Because there are shortages of organ donors, there are waiting lists for transplant organs, including hearts. The United Network for Organ Sharing (UNOS) is the private, non-profit organization that manages the United States' organ transplant system. UNOS manages the lists and allocation of all donor organs for transplants in the United States.

How Do You Get on the Heart Transplant List?

You can only be added to the waiting list by a transplant center that has approved you for transplant. At Temple, approval for transplant begins with a referral from your cardiologist. Next, an extensive evaluation.  

Our transplant team consists of cardiologists, surgeons, nurses and social workers. During the evaluation process, they will review your medical history, conduct diagnostic tests and perform a psychological exam. This allows them to determine if you’re a candidate for transplant at Temple. Financial staff also work with your health insurance company to determine coverage.  

At Temple, we have expanded our transplant criteria to help more patients qualify for this life-saving surgery. Instead of having strict cutoffs due to age or medical condition, we evaluate each patient individually and make decisions based on their unique clinical and personal history. This broader criteria means we often accept patients other hospitals turn down for transplantation.

What Are Temple's Criteria for Heart Transplant?

Indications for Evaluation of Heart Transplantation

  • Advanced heart failure (NYHA) functional class IV heart failure refractory to optimal medical and resynchronization therapy with recurrent admissions and/or not tolerating evidence-based medications.
  • Intractable angina not amenable to intervention or persistent refractory ventricular arrhythmia
  • Cardiogenic shock on continuous intravenous inotropic support or temporary or long-term circulatory support device 
  • Symptomatic restrictive and hypertrophic cardiomyopathy and selected cases with congenital heart disease
  • The ISHLT listing guidelines for cardiopulmonary exercise testing CPET, HF prognosis scores, medical history and detailed testing of other organ systems to assure proper function in addition to psychosocial and financial aspects are reviewed in full and discussed in heart transplant committee. Listing criteria aren’t standardized at Temple, and every patient is discussed on a case-by-case basis. Detailed risk stratification of patients to weigh risk and benefits of cardiac transplantation and prognostic markers to predict possible outcomes are thoroughly reviewed 
  • Patients who are categorized as too high risk for transplant at other institutions due to standardized listing criteria are frequently referred to and re-evaluated at Temple because of our individualized approach   

If Temple's transplant team believes you’re a good candidate, they approve you for transplant and place you on the UNOS waiting list. Your transplant team, not UNOS, lets you know you're on the list.

Expanded Heart Transplant Criteria

In late 2019, Temple’s Heart Transplant Program expanded its transplant guidelines to help more patients qualify for this life-saving surgery. While UNOS sets strict listing criteria for organ transplants, hospitals can choose to "flex" guidelines for transplant candidacy.

Temple changed its criteria based on a literature search and its decades of experience in the field of heart transplantation. Temple will now consider patients for heart transplant who:

  • Are up to age 74 (other centers 70)
  • Have a BMI up to 35
  • Have abstained from alcohol, smoking or 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

How Long Is the Waiting List?

Wait time varies for a donor heart. You may get a heart in days, or it may take a year or more. At Temple, 78.9% of patients received a transplant within 1 year, based on data in the August 2020 Scientific Registry of Transplant Recipients report. That’s a shorter wait than the national average of 64.4%.