The Advanced Heart Failure and Heart Transplant Program

The Advanced Heart Failure and Transplant Program at Robert Wood Johnson University Hospital (RWJUH) New Brunswick stands at the forefront of specialized care for patients with heart failure. We offer the full spectrum of care for the advanced heart failure patient, including biventricular pacemakers, left ventricular assist devices, access to clinical trials, and a Medicare-certified heart transplantation service with shorter waiting times than hospitals in New York City and Philadelphia.

About Heart Transplant

To date, RWJUH has done numerous heart transplants with survival rates better than the national average. Our Advanced Heart Failure and Transplant Program has access to sophisticated diagnostic techniques, the latest and best in cardiac therapy, and a close working relationship between Cardiology and Cardiothoracic Surgery. The statistics make RWJUH one of the leading heart transplant programs in the country.

In addition to patient survival rates, the Advanced Heart Failure and Transplant Program at Robert Wood Johnson University Hospital is well-respected for its current and future heart failure and transplant research. Maintaining the delivery of the best patient care possible as a primary focus, the heart transplant team constantly strives to improve patient outcomes.

Review RWJUH's heart transplant statistics and outcomes

Indications for Heart Transplant

End-stage heart disease means that without some dramatic change in heart function, severe congestive heart failure will persist, and death is likely to occur within two years. Transplant becomes an important treatment option when all medical therapies have been utilized and no other surgical procedures will correct the underlying disease process. In general, patients with advanced heart failure who are taking maximal medication therapy should be considered for a transplantation evaluation.

It is important that candidates be in otherwise good health and free of other serious medical illness. Patients should also be psychologically stable and possess a willingness to be completely compliant with the rigorous medical regimens post-transplant. While the requirements for transplant may differ slightly at various centers, there is a general consensus that certain risk factors are associated with higher morbidity and decreased compliance. There are also well-described exclusion criteria that have been shown to decrease short- and long-term survival.

  • Irreversible pulmonary hypertension, defined as a pulmonary vascular resistance index higher then 6-8 Wood units/m2
  • Irreversible pulmonary parenchymal disease
  • Irreversible renal dysfunction, defined as creatinine greater then 25mg/dl and a creatinine clearance less than 50 ml/min., unless combined with kidney transplantation
  • Primary hepatic dysfunction, such as cirrhosis or hepatic dysfunction with resultant coagulopathy
  • Significant peripheral and cerebrovascular disease
  • Insulin dependent diabetes mellitus with end-organ damage or high insulin requirements without end-organ damage
  • Co-existing neoplasm
  • Acute pulmonary embolism or infarction
  • Myocardial infiltrate or inflammatory disease, such as sarcoidosis and amyloidosis

The Evaluation Process

The evaluation process can be completed during an admission to the hospital or on an outpatient basis after you have seen a transplant cardiologist. You will also meet with other members of the cardiac transplantation team during the evaluation process, including the social worker, psychiatrist, and transplant coordinator. Potential candidates for transplant are first cleared by their health insurance company for coverage of the evaluation process. The financial coordinator handles most of the communication, but may ask the candidate or the candidate’s family to obtain and/or provide information to other community resources or employee relations/human resources/personnel staff as appropriate.

Lab tests will be performed to see how your other organs are functioning, and also to check what viruses you have been exposed to in the past. You will need to collect your urine for 24 hours and bring it to the hospital on the day of your blood work or admission for evaluation.

Other testing that you can expect includes a chest x-ray, Tuberculosis (TB) skin testing (PPD), exercise stress test, an echocardiogram, and a right heart catheterization (RHC). There may be more testing ordered depending on your current condition, the assessment of the cardiologist, and your specific past medical history. All tests and procedures are explained to you. Some examples of other diagnostic testing include a colonoscopy, Doppler ultra-sound studies of the arteries in your legs, neck, and abdomen, pulmonary (breathing) function studies (PFT's), and a left heart catheterization (LHC or coronary angiogram). The cardiologist may ask that you see other physicians who specialize in treating other conditions that the team might find during the evaluation phase.

Once all the necessary information is gathered, your case will be presented to the Transplant Committee. This committee meets on Monday afternoons and consists of the transplant cardiologists, transplant surgeons, nurse coordinators, pharmacist, social workers, a psychiatrist, a dietician, and cardiac rehabilitation nurses. The evaluation process assists the team to reach the appropriate decisions regarding treatment options.

The Waiting Period

Once you have been evaluated, your name and other statistics will be entered into a national database. You will then be “listed” with patients from all over the country and from many other transplant programs.

A match is made for you based on body size, weight, and blood type. Listing status depends on the severity of your illness and to some extent the length of time waiting. Because organs are donated in a spirit of altruism and are considered a national resource, it is only right that those organs be allocated in an equitable manner. It is also important that all donated organs are well-matched donor organs and for as many people as possible.

If you are listed and at home, you will receive a beeper free of charge. We are not able to tell you how long the waiting period will be. You will be expected to follow-up in our outpatient clinic as directed and come in to have blood work drawn once a month for the Sharing Network. You will be encouraged to attend some of the support group meetings and may be asked to come in for educational classes.

Being listed does not guarantee continued listing at the original status. During the course of your care, unfortunate events and circumstances can arise. These circumstances may change your suitability as a transplant candidate and the transplant team might decide to remove a candidate from the list on a temporary basis or permanently. You will be informed of any changes of your listing status.

Heart Transplant and LVAD Support Group

In support of our pre- and post-heart transplant patients, and our LVAD patients, we encourage attending our helpful support group that gathers each month. The support group offers a comfortable environment in which patients, their families and friends, can learn about heart health and healing, and meet people with shared experiences. Learn more.

Patient Stories

  • How do you thank people who saved your life? They gave me back to my family.

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  • Walter knew that his new heart was coming and he was right.

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Patient Stories

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