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Heart Transplant

Heart Transplant

The first heart transplant was performed in 1967. Heart transplant surgery and other transplant procedures have come a long way since then. Westchester Medical Center's Cardiology Team offers the latest medical interventions available for heart failure patients.

Pioneering Heart Transplant Procedures

The Heart Transplant Program at Westchester Medical Center is on the cutting edge of many national and international research programs, giving patients access to congestive heart failure treatments, medications and heart transplant procedures years before they are available to the general public.

Our heart transplant specialists at Westchester Medical Center also treat heart failure patients with implantable, artificial devices.

About Heart Transplants and Heart Disease

Heart transplantation is not a cure for heart disease. It is a surgical treatment that is reserved only for patients with the most advanced stage of heart disease who can no longer be managed effectively with maximal medical therapy. Cardiomyopathy, or disease of the heart muscle, affects more than four million people in the United States, with approximately 500,000 new cases diagnosed each year. Some of the most common causes of heart disease  include ischemia, diabetes, uncontrolled high blood pressure, alcohol, myocarditis and idiopathic.

Each Heart Transplant Surgeon at Westchester Medical Center is committed to providing the best medical care possible. During your evaluation for a heart transplant, you will meet many of the healthcare professionals on this team.

  • Heart Transplant surgeons
    Doctors who perform transplant operations of the heart. During your evaluation, the transplant surgeon will answer any questions or concerns you may have. Your surgeon will discuss your disease and the options that may be available to you, including transplantation.
  • Transplant cardiologists
    Doctors who manage patients diagnosed with heart failure before and after transplant. They are skilled in the management of immunosuppressant drugs and their complications.
  • Transplant coordinators
    Registered nurses who will coordinate your care. The coordinators are responsible for maintaining close contact with you and your family doctor. The coordinators are available to answer any questions about your medical care before and after your operation.
  • Transplant clerks
    Sschedule your tests and procedures.
  • Social workers
    Assist patients and their families with financial information and emotional support. Social workers will be available to help you when you are hospitalized and in the outpatient areas.
  • Anesthesiologists
    Doctors who give you medication to keep you unconscious and who monitor your vital signs (heartbeat, blood pressure and breathing) during your transplant operation.
  • Psychiatrists
    Work with patients and families on assessing their ability to cope with life before and after transplant, ruling out problems that might preclude transplant.

The evaluation and treatment of a person with heart disease involves a variety of tests and procedures. Many of these tests and procedures may be repeated during your evaluation before heart transplant surgery and again after your heart transplant. If you have any questions about these tests before heart transplant, ask your doctor, nurse practitioner or any other member of the transplant team.

Some of the tests before Heart Transplant include:

  • CT scan (computed tomography)
    An X-ray technique for detecting masses or abnormalities in the body. A narrow X-ray beam directed by a computer revolves around you on an examination table. This computer compiles the information into a picture of your body.
  • Ultrasound
    A test that uses high-frequency sound waves to identify your organs and any abnormalities that might not show up on a normal X-ray. This test can also detect how fast your blood flows through a blood vessel.
  • Heart biopsy
    A procedure to obtain a small piece of heart tissue through a small hollow tube placed through a neck vein.
  • Colonoscopy
    A procedure to examine the large intestine or colon to detect and diagnose abnormalities such as erosions, enlarged veins, inflammation, hemorrhage (internal bleeding) or hemorrhoids.
  • Pulmonary function tests (PFTs)
    Tests to evaluate how well you breathe during and after your surgery.
  • Echocardiogram (ECHO)
    A test of your heart to show the position and motion of the walls of your heart and the function of your heart valves. It is also used to diagnose congenital heart disease, valvular disease, cardiomyopathy (enlarged heart muscle), and pericardial effusions (accumulation of fluid around the heart).
  • Electrocardiogram (EKG or ECG)
    A test of your heart's electrical activity to show the heart's rate and rhythm.
  • Chest X-ray
    An X-ray picture of your chest to evaluate your heart and lungs.
  • Multiple-gated acquisition scan (MUGA)
    A scan that takes a rapid sequence of pictures of your heart's motion to determine the amount of blood your heart's ventricles pump or eject.
  • Blood tests
    Tests to determine your blood type, and kidney and liver function.
  • Metabolic stress test (MV02)
    A modified exercise test that gives your health providers information about your heart functions during times of exercise. You will be closely monitored throughout the testing process.
  • Heart catheterization
    A test in which a dye is injected into a neck/leg vein through a small hollow tube. Pictures are taken to detect any blockage or abnormalities in the heart's blood vessels.

 Additional testing that may be required as part of your pre-transplant evaluation include:

  • Lab work - blood and urine
  • Left heart catheterization
  • Right heart catheterization
  • Heart biopsy as indicated
  • Echocardiogram
  • Metabolic stress test
  • Chest X-ray
  • CT Scan of your chest
  • Pulmonary function test
  • Carotid doppler
  • Peripheral doppler
  • Abdominal ultrasound
  • Osteoporosis work-up (labs) and bone density as warranted
  • Dental evaluation
  • Tuberculosis (PPD) testing
  • Females - gynecological exam, mammogram
  • Ophthalmology exam
  • Nutrition assessment as warranted
  • Colonoscopy

Waiting List

  After your tests are completed, the results are discussed by the heart transplant surgeons, transplant cardiologists, psychiatrists, nursing coordinators and other consultants who, based on these results, will decide whether you are a suitable candidate for a heart transplant.

Your transplant coordinator will notify you and your referring doctor about the transplant team's decision. Keep in mind that even after your initial tests are completed, additional testing may be required by the selection committee.

Your transplant coordinator will inform you when you have been placed on the national waiting list for a new heart, and you will receive a letter confirming your placement on the list.

Because there is no way to predict when a donor heart will become available, you may be on the waiting list for many months. When a heart becomes available, many factors determine if that heart is right for you. The two main factors are that the donor must have a compatible blood type with you, and the donor must be about the same weight as you.

We realize that the time spent waiting for your transplant can be very stressful. This is normal. But there are things you can do to help alleviate some of this stress and deal with your fears. Talk about your concerns with your family or supportive friends. Plan to attend the heart failure support group that meets regularly at Westchester Medical Center. If you have any questions, call your transplant coordinator. If necessary, the transplant social worker may be able to recommend a counselor or put you in touch with a support group of people who have undergone what you are going through. All of these people can help you to redirect your energy toward more positive, enjoyable activities. Always remember that you are not alone. The transplant team is available to help you throughout the waiting period.

Matching a Donor

To match a donor organ, including a heart, with a recipient, you both must have the same blood type. Your blood type will be determined during your evaluation. People have one of four blood types: A, B, AB and O. The most common blood is type O, followed by type A, then type B and the rarest blood type, AB. Most patients waiting on the transplant list have type O blood. Even though type AB is the most rare, there are fewer patients waiting for hearts in this blood type.

It is also important that the new heart be a good fit. This is determined by the height and weight of you and the donor, and by the size of the heart.

Traveling Before Surgery

Some people think they must stay close to home while they are waiting for their transplant. This is not always the case. If you are traveling before a heart transplant surgery, you should first check with your primary physician. Before your trip, you must call the transplant office at (914) 493-7632 and notify your transplant coordinator of your plans. We will need to know:
  • The dates of your departure and return
  • Where you are traveling
  • Telephone numbers where you can be reached, especially if you will be out of signal range on your pager.

Remember, if a donor heart becomes available during your trip, you will need to travel to Westchester from your location. Therefore, to avoid delay, you should make transportation arrangements to get to Westchester from your destination before you leave for your trip. Making these arrangements in advance will save time if you are called about a donor heart during your trip and is your responsibility.

Notification of Heart Availability

24-Hour Communication

You will be able to order a pager when you are placed on the waiting list. The pager is free of charge and will take about six to eight weeks to arrive. When your pager arrives, it is important that you call your transplant coordinator with the information about your pager as soon as possible.

It is very important that you can be reached at all times once you have been placed on the transplant waiting list. For this reason, you must provide us with a list of telephone numbers of relatives, friends and neighbors who will know where you can be reached if you are not at home. We also will need your work number, if applicable. These phone numbers will help us locate you until your pager arrives or if you cannot be reached at your home telephone number.

Having a pager will give you more freedom away from the telephone. There is no need to wear the pager when you are at home. We will always call your home telephone number first. If there is no answer, we will assume you are out and have your pager with you. We will then page you.

If your pager beeps, you must call the transplant office at (914) 493-7632 within 15 to 20 minutes of being paged. This telephone is answered 24 hours a day. If we cannot reach you within a reasonable amount of time, it may be necessary to contact another potential recipient from the list. Inform the operator in the transplant office that you are waiting for a heart transplant and that you have just been paged.

Sometimes your pager may be activated falsely by outside signals. Since there is no way for you to know if this is a false page, you must always call the transplant office when you are paged. The transplant coordinator will give you instructions on what to do next.

Heart Availability

When a donor heart becomes available for you, your transplant coordinator will call you and tell you what you need to do. Although you may be anxious, things will go smoothly if you have prepared in advance and are fully equipped with heart transplant info.

If you are not in the hospital waiting for your transplant, when you are called you will need to get to Westchester Medical Center as quickly as possible. Your transplant coordinator will tell you what time you must arrive at the Medical Center. This time frame will determine whether you can drive or fly by commercial airline or air charter service. Remember, time is very important, so make sure your travel plans are in order and available to you and your family members.

Getting the call that a heart is available for you produces mixed emotions. There are many things that need to be done in a short time. However, here is some info on things that you can do in advance to prepare yourself while you are waiting for a heart transplant.

  • If you live far from the Westchester Medical Center, check flight arrangements. Begin to check flight schedules, airfares and reservation requirements for both commercial and charter air companies.
  • Make a list of what you plan to bring with you. Storage space is limited in your patient room, so review your list carefully and bring only the essentials.
  • Keep a suitcase packed and ready to go. Pack toiletries and basic personal items, along with pajamas, a robe and slippers. Your family can keep your additional clothing with them.
  • Make sure that your family or whoever is accompanying you to the Medical Center is prepared to leave at a moment's notice.
  • Keep your medications together. You will need to bring them with you to the Medical Center.

For additional information please call 914.493.8793

Westchester Medical Center
100 Woods Road
Valhalla, NY 10595

By Car

Train

Westchester Medical Center is served by Metro North's Harlem line via two stations:

  • White Plains - Bus transfer options available
  • Hawthorne - Taxi service available

For train fare and schedule information, call 1-800-METRO-INFO or go to www.mta.info/mnr .

Bus

There are three bus lines (Westchester Bee Line) you can take to our campus. Please call 914-813-7777 for bus routes and fares

Campus Map

The Westchester Medical Center campus includes the Maria Fareri Children's Hospital and the Behavioral Health Center.

David Spielvogel, MD – Director, Heart Transplant, Heart Transplant Surgeon
Alan Gass, MD – Medical Director, Heart Transplant
Gregg Lanier, MD – Transplant Cardiologist
Chhya Aggarwal, MD – Transplant Cardiologist
Ramin Malekan, MD – Heart Transplant Surgeon
Masashi Kai, MD – Heart Transplant Surgeon
Joshua Goldberg, MD – Heart Transplant Surgeon
Abhay Dhand, MD – Director, Transplant Infectious Diseases
Rajat Nog, MD – Transplant Infectious Diseases
Bettina Knoll, MD – Transplant Infectious Diseases
Martha Gamboa, MD – Transplant Psychiatrist