Successful heart transplantation in the southeastern United States began at UAB on November 24, 1981. In the decades since, the heart and heart-lung transplant effort at UAB has grown into a multidisciplinary program coordinated through the Divisions of Cardiovascular and Thoracic Surgery and Cardiovascular Disease. Through October, 1999, 570 heart and 19 heart-lung transplants have been performed at UAB.

One of the distinguishing features of the heart and lung transplantation programs is the presence of the Heart Transplant Intensive Care Unit (HTICU). This facility consists of a 20-bed unit in which the surgeon serves as the patient’s primary care physician for the entire length of their stay. It is one of only a few such specialized units is the country.

In general, any patient age 65 or less with end-stage cardiac disease and less than a 50 percent chance of surviving for one year should be considered for heart transplantation. This primarily includes patients with severe congestive heart failure (New York Heart Association Class III or IV) or patients with severe life-threatening arrhythmias not controlled with medication or with implantable antitachycardia devices.

In addition, patients with severe, inoperable, diffuse coronary disease with intractable angina despite maximum medical therapy and those with severe congenital heart disease are considered for transplantation.

Patients referred to UAB for heart transplantation usually undergo a screening clinic visit, if possible, to be evaluated for alternative therapies for their cardiac disease or for contraindications for transplantation. After this visit, patients undergo comprehensive evaluation on an outpatient basis. Moreover, these patients receive extensive education on the rigors and demands of post-transplant life.

Patients for whom heart transplantation is not an option often elect to participate in congestive heart failure drugs trials (oral positive inotropes and new vasodilators) to improve their symptoms.

Due to the urgency of heart transplantation, recipients on the waiting list must reside within two hours’ travel time from Birmingham, either by automobile or by pre-arranged urgent air transport.