The University of Colorado's Adult Heart Transplant Program has been in existence since 1986 and is the only Medicare-certified heart transplant program in Colorado. This program achieved patient and graft survival rates in the top percentiles nationwide with over 200 patients transplanted. A multi-disciplinary approach is used for patient management in all phases of care from the selection phase through post-operative follow-up.
Pre-operative care is delivered by the transplant cardiologists in the Heart Failure Clinic at University of Colorado Hospital. Care is coordinated through the patient's referring physician and communication is maintained with the referring physicians on each visit. The transplant coordinators, transplant cardiologists, social worker and transplant financial coordinator are always available to patients during their visits to clinic or during their hospital stay. Patients waiting for a transplant are provided educational assistance in preparing for their transplant and are accessible 24 hours a day in the event they need to be contacted immediately.
Patient selection for cardiac transplantation at University Hospital is based on both critical medical need for the transplantation and the likelihood of a successful outcome. Critical need for cardiac transplantation is defined as a life expectancy of less than 12 months due to cardiac disease with no reasonable possibility of improvement with medical or surgical therapy. Likely success is predicted by a lack of absolute contraindications and absent or few relative contraindications.
Relative Contraindications include: Insulin-dependent diabetes mellitus; Asymptomatic severe peripheral or cerebrovascular disease; Documented active peptic ulcer disease; Current or recent history of symptomatic diverticulitis; Systemic hypertension unresponsive to medical therapy; Cachexia; Need for concurrent organ transplant.
Absolute Contraindications are: Age greater than 70 years (60-70 considered individually); Severe pulmonary hypertension; Renal or hepatic dysfunction not related to heart failure; Symptomatic peripheral or cerebrovascular disease; Chronic obstructive lung disease or chronic bronchitis; Active systemic infection; Unresolved pulmonary infarction; Unexplained pulmonary infiltrate on chest x-ray; Other systemic diseases likely to limit survival or rehabilitation post transplantation; Behavioral or psychiatric problems likely to interfere with compliance with a disciplined medical regimen; Positive HIV testing; Unresolved alcohol or substance abuse.
Patients are asked to stay in the Denver area for two to three months post-transplantation. All patients are followed at University of Colorado Hospital when possible. Transplant follow-up care can also be arranged for the patient at an alternate transplant center. The CU Heart Transplant Team at University Hospital continues to track these patients indefinitely.