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Archive for April 27th, 2011

Just how sick must a person be to be offered a new heart? Sounds like a simple question.  The truth is there is no black or white answer. There  are tests; that if your body fails them will only serve to keep you in the running.  Results of those tests, may tell the doctor that you simply are not ready for a heart yet. Lets look at some of those tests, and compare my results to the standards many transplant hospitals use to help determine eligibility.

The first test, one we talked about a few months ago is called an mVo2 test.  According to “CHF Patients.com”, “The Vo2max is also called the mVo2 test or the CPX test – for cardiopulmonary stress test. This test shows the maximum amount of oxygen your heart can provide to your muscles during sustained activity. Vo2max is the point at which your body cannot increase its intake of oxygen despite an increase in exercise intensity.  Doctors consider this a true measure of your heart’s ability to keep you going. In most medical centers, a Vo2max score of 14 (in ml/kg/minute) or less qualifies you for heart transplant. One test result never tells the whole story, of course.” My test result for this test just a few months ago was 12. As the article mentioned, one test never tells the whole story.  Lets keep looking.

Your ejection fraction (EF) is also used as a gauge.  According to the   Cleveland Clinic, this is what EF results mean.     

What do the numbers mean?

Ejection fraction is usually expressed as a percentage. A normal heart pumps a little more than half the heart’s blood volume with each beat. We are looking at left ventricular ejection fraction.

A normal LVEF ranges from 50-70%. A LVEF of 65, for example, means that 65% of the total amount of blood in the left ventricle is pumped out with each heartbeat.

The LVEF may be lower when the heart muscle has become damaged due to a heart attack, heart muscle disease (cardiomyopathy), or other causes.

An EF of 35 to 40% may confirm a diagnosis of systolic heart failure. Someone with diastolic failure can have a normal EF.

An EF of less than 35% increases the risk of life threatening irregular heartbeats that can cause sudden cardiac arrest (loss of heart function) and sudden cardiac death. An implantable cardioverter defibrillator (ICD) may be recommended for these patients.

Hummm. I have a defibrillator built in. I have a history of Ventricular Tacardia, but is this enough to get a new heart? Lets keep looking. From here, most web information is vague. Nobody wants to say anything bad.  In 2006, when I was in the care of the Methodist Specialty and Transplant Hospital, the doctor was unable to get a reading. My EF was only listed as less than 10%. That’s when they decided to put that bi-ventricular pace maker in me. It helps my heart squeeze.  Last year, my EF was up to 15 to 20%.  Thank you bi-ventricular pace maker. Now like I said, the available literature is too chicken to set the standard for messed up hearts. Luckily our government does that for us. According to the Social Security Administration, an EF of less than 30% is considered 100% disabled. So, lets just say, if your EF is less than 30%, you are in the ball park for a transplant.

Two important indicators to determine just how sick you are, and if you stand any chance of getting a new heart. Unfortunately, getting a new heart is a complex issue. One that requires many facts, looked at both separately and in conjunction with other data. I failed these indicators.  How will I fare against the other criteria. I will let you know next week.

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