A successful heart transplant program requires medical professionals with different expertise. While some aspects of transplantation have become routine, others aspects require innovation. This is where the experience of the team can make the difference between success and failure for an individual patient, particularly if the problem is unusual or serious.
Our multidisciplinary heart transplant team includes cardiologists, transplant surgeons, nurse practitioners, a psychiatrist, social worker and a secretary. Each member of the team will want to get to know you and will play different roles in your care. Below you'll find more information on our heart transplant team and the critical role they play in this process.
Role of the Nurse Practitioner: Transplant nurse practitioners coordinate care throughout the transplant process by maintaining open communication between all team members. They accept new patient referrals, and provide care for candidates on the waiting list for a new heart, as well as for recepients after transplant.
Our nurses have advanced practice degrees and extensive experience in the management of heart failure and heart transplant patients. They are able to perform history and physical examinations, order tests, make diagnoses, and write prescriptions.
In consultation with the cardiologists and surgeons, they screen medical records of patients referred for consideration of transplant, and coordinate the evaluation process. After transplant they cordinate care, including adjustment of imunosuppressive medications, ordering and following up on scheduled tests and keeping the patient and referring physicians informed about the progress of their patient. They are usually the primary point of contact for referring physicians, team physicians and patients alike.
Role of the Secretary: The secretary will answer the telephone when you call during office hours. They may answer basic questions, arrange for records to be conveyed to and from referring doctors, and schedule any tests or lab work that may be needed. Often the secretary can help solve problems and answer basic questions. In other instances they will pass questions along to the nurse practitioner or physician. Often the secretary may be the person who calls back with routine test results or information.
Role of the Social Worker: The social worker helps to marshal the personal and financial resources necessary to have a successful transplant. A psychosocial assesment, which includes the social worker, patient, and patient's support people, is generally completed prior to listing. All organ transplant patients are welcome to attend a transplant education series, which meets on the third Tuesday of each month.
Role of the Transplant Cardiologist: Transplant cardiologists participate in the pre-transplant evaluation, in management around transplant, and with the long-term care of heart transplant recipients. The transplant cardiology team includes experts in the evaluation and management of patients with heart failure as well as in performing heart echocardiograms, and heart biopsy procedures. In addition to transplantation, they will consider or provide other options for heart failure treatment, including changes in the drugs used or their doses, or clinical trials of new medicines or approaches.
Once transplantation is chosen as the best option for a given patient, the transplant cardiologist directs medical heart failure management in conjunction with the referring cardiologist and the transplant nurse practitioners to keep the patient in the best possible condition while awaiting transplant. This approach can prevent life-threatening problems from arising, or facilitate quick and effective response with medicines or even a temporary artificial heart pump if a patient deteriorates while waiting for a new heart.
After transplant, a cardiologist performs regularly scheduled heart ultrasound ("echo") tests, and endomyocardial biopsies that are done in the heart catheterization suite. In addition, the cardiology team follows patients closely along with the surgeons and nurses, helps to adjust antirejection, blood pressure, and other medications, institutes and monitors preventive medical strategies (lipid lowering, exercise regimen), and treats other medical problems (diabetes, hypertension) that may arise.
Role of the Transplant Surgeon: The surgeons work together and provide the leadership to the teams of doctors, nurses, and allied health care providers who perform your transplant. Typically one surgeon will travel with a team to the hospital where the donor is located, to remove the heart from the donor and to "put it to sleep" in a way that is likely to protect "preserve" its function. Meanwhile another team of surgeons will prepare the recipient to receive the new heart, and then perform the actual transplant procedure and associated peri-operative care.
Role of the Psychiatrist: They meet with all potential transplant recipients in order to help determine the patients' ability to understand his/her options, ability to cope with the stresses and rigors of the transplant experience, and to make recommendations regarding the best way to manage any psychological issue that may occur at any time after transplantation.
Once the evaluation is complete, the transplant team will decide if heart transplantation is the best option. The risks and benefits will be discussed with each patient. If the patient and the transplant team agree that transplantation is the best available choice, the patient is then placed on the transplant waiting list at the University of Maryland.