Maryland Heart Center
Eligibility Criteria for Heart Transplantation
We believe that heart failure patients should be optimized on standard
medications, if at all possible, prior to transplantation. When patients
have continued severe symptoms despite standard medications, the University
of Maryland Medical Center can provide many options, including investigational
medications, devices, and transplantation.
In general, we consider patients with advanced heart failure on maximal
medical therapy for transplant evaluation. Patients with increasing medication
requirements, frequent hospitalizations, or overall deterioration of clinical
status should also be considered relatively urgently for heart transplantation.
Below is a list of criteria for inclusion in our heart transplant program,
as well as a list of situations/conditions that will usually prevent a
patient from receiving a transplant or even exclude them from consideration.
Note that even if a patient is not a good candidate to receive a heart
transplant, they may be a candidate for one of several alternative treatments,
or for an experimental medical or surgical therapy available here at UMMC.
The inclusion criteria/indications for cardiac transplantation may include
any of the following:
- An estimated life expectancy of less than one year without transplant.
- Objective evidence of advanced physical incapacity due to documented, isolated
- Solid agreement that previous medical therapy has been optimal and that
no medical therapy or surgical procedure other than transplantation offers
realistic expectation of extension of life and functional improvement.
- Strong family support to help the patient emotionally before and after the
Conditions sometimes causing heart failure, for which a heart transplant may
- Inoperable coronary artery disease with congestive heart failure.
- Cardiomyopathy (weakening of the heart muscle) of various causes.
- Inoperable heart valve disease with congestive heart failure.
- Severe congenital heart disease without other surgical options.
- Life-threatening abnormal heart rhythms that do not respond to other therapy.
Possible Exclusion Criteria
The following factors may exclude people from receiving a heart transplant:
- Age of more than 65 years.
- Severe irreversible pulmonary hypertension (high pressure in the lung arteries
due to permanent changes in the lung blood vessels).
- Irreversible kidney or liver dysfunction not explained by (caused by) underlying
- Symptomatic peripheral (legs), renal (kidney) or cerebrovascular (neck or
brain) artery disease. These conditions may cause symptoms such as leg cramping
with walking or at rest, foot ulcers; kidney failure or severe hypertension;
or "transient ischemic attack" or stroke.
- Severe chronic lung disease (Emphysema, asthma, chronic bronchitis).
- Active systemic infection (Infection in the blood, lung, urine, or elsewhere,
or open wound).
- Insulin-dependent diabetes mellitus (IDDM) with evidence of damage to other
organs, such as kidney, eye (retina), or nerves.
- Cancer within the past 5 years. Exceptions may be made for some types of
early skin cancer, or under other very unusual circumstances.
- Other life-threatening diseases likely to severely limit length of life
even if the transplant were successful, or to severely limit quality of life.
Under some exceptional circumstances, patients over the age of 65 or with conditions
listed here that can likely be successfully managed will be considered for transplantation.
In the final analysis, in order to receive a heart transplant, the patient
must believe that the potential benefits of transplantation are worth the risks.
Remember: Even if you are not a good candidate to
receive a heart transplant, you may be a candidate for one of several alternative
treatments, or for one of several experimental medical or surgical therapies
available at UMMC.
Please call if you would like to make an
appointment or talk to someone about our services. Patients dial 1-866-408-6885, physicians dial 410-328-6622 or 1-800-318-1019.