Everybody’s transplant journey is personal but these are some of the common events that many often experience.
Referral is made by the cardiologist, nurse or patient them self. Insurance card copies are obtained. Approval for initial cardiology appointment is obtained.
Patient sees a cardiologist and it decided if patient is an acceptable candidate to complete a full evaluation.
Authorization is obtained by the transplant program from the insurance company. At this time benefit summary for surgery, hospitalization and medications are obtained.
Patient is called and an appointment is scheduled for full evaluation. Patients are required to complete 1-2 days of evaluation at transplant center and may need help with housing or transportation for these appointments if they live far from hospital.
The patient meets with the transplant team: nurse coordinator, surgeon, psychiatrist, financial coordinator, social worker, dietician and heart transplant recipient. The financial coordinator will inform patient how much of the surgery and medications will be there responsibility to pay. The social worker will discuss options such as fund raising if needed.
Full evaluation includes some or all of the following tests depending on diagnosis and age of potential recipient: blood work, chest x-ray, angiogram and right heart catheterization, CT scan, carotid artery scan, leg artery scans, colonoscopy, dental clearance, ophthalmology clearance, pap smear, mammogram, and consults with other specialists.
After all testing is complete the patient is presented to the heart transplant selection committee. This committee is made up of all the members of the transplant team i.e.: surgeons, social workers, nurses and financial coordinators. The committee’s job is to decide if a patient is a good candidate, that they are not too sick or too well, and that there is no other option (surgery or medication) for them.
A packet is submitted to the insurance company containing all the tests that were completed and a letter stating the committee’s decision. The approval is obtained for the surgery at the time of listing.
Once authorization is obtained a patient is placed on wait list for heart transplant. Patients that are listed need to be within 3 hours of the hospital at all times. Patients that are out of state or too far to make it in time for surgery will be required to relocate at the time of listing. Most insurance does not cover this. An alternative for patients not too far away would be arrangement of medical air or ambulance transportation. Some insurance will cover this.
At the time of transplant patients may be hospitalized for any where from 6 days to several months. Depending on insurance there may be co pays for the hospitalization a patient is responsible for.
After discharge patients will take all new medications. With out insurance coverage medications may cost up to $6,000 a month. Even with insurance co- pays may still be expensive. These medications will be life long.
After transplant patients are seen a minimum if every 3-6 months and biopsies or blood tests will be done every about 12 times in the first year to monitor for rejection. Patients may be responsible for co-pays for each of theses visits or tests.
Angiograms and/or stress tests will be required annually.
Transplant recipients will also see their Primary MD and will heath screenings. Transplant recipients may face the following health issues: rejection, cancer – especially skin cancers, kidney failure or insufficiency, bone fractures, infections etc.