For end-stage heart failure patients, replacement of the diseased heart with a healthy one is currently established as the most effective treatment. According to the most recent American Heart Association data, the one-year survival rate for transplant patients is 85 percent, with 77 percent surviving 3 years and 71 percent surviving 5 years. But transplant patients can survive 10 years or more following successful surgery. And survival rates continue to improve as doctors and researchers refine the protocol for post-operative treatment, a regimen that includes drugs to suppress the immune system and prevent the body from rejecting the new heart.
Still, not everyone diagnosed with end-stage heart failure is eligible for a transplant. And while a 10-year survival rate is great for patients in their later years, it presents a difficult situation to children and young people who receive transplants. But perhaps the biggest drawback to heart transplant surgery is the sheer scarcity of donor hearts — a situation that makes the implementation of eligibility criteria strictly necessary. Heart failure patients must be assessed to determine if they are among those in greatest need and likely to derive the maximum benefit from transplantation.
The American Heart Association and the American College of Cardiology have offered guidelines for the selection of transplant candidates based on prognostic factors, such as how responsive they are to other treatments, how old they are, and what conditions ail them besides heart failure. Once put on the donor heart waiting list administered by the United Network of Organ Sharing (UNOS), a patient is given a priority status according to his or her condition. The length of the patient's wait depends on his or her priority status, blood type, and other factors.