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Who Needs a Heart Transplant? – NHLBI, NIH

Most patients referred to heart transplant centers have end-stage heart failure. Their heart failure might have been caused by:

Coronary heart disease.

Hereditary conditions.

Viral infections of the heart.

Damaged heart valves and muscles. (Alcohol, pregnancy, and certain medicines can damage the heart valves and muscles.)

Most patients considered for heart transplants have tried other, less drastic treatments. They also have been hospitalized many times for heart failure.

Who Is Eligible for a Heart Transplant?

The specialists at the heart transplant center will assess whether a patient is eligible for a transplant. Specialists often include a:

Cardiologist (a doctor who specializes in diagnosing and treating heart problems)

Cardiovascular surgeon (a doctor who does the transplant surgery)

Transplant coordinator (a person who arranges aspects of the surgery, such as transportation of the donor heart)

Social worker



In general, patients selected for heart transplants have severe end-stage heart failure, but are healthy enough to have the transplant. Heart failure is considered “end stage” when all possible treatments—such as medicines, implanted devices, and surgery—have failed.

Certain conditions and factors make it less likely that a heart transplant will work well. Examples include:

Advanced age. There is no widely accepted upper age limit for a heart transplant. However, most transplant surgeries are done on patients younger than 70 years old.

Poor blood circulation throughout the body, including the brain.

Kidney, lung, or liver diseases that can’t be reversed.

A history of cancer or malignant tumors.

Inability or unwillingness to follow a lifelong care plan after a transplant.

Pulmonary hypertension (high blood pressure in the lungs) that can’t be reversed.

Active infection throughout the body.

Diabetes with end organ damage (damage of major organs).

Patients who have one or more of the above conditions might not be eligible for heart transplant surgery.

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