The Heart Transplant Clinic cares for patients before and after their heart transplant.
The clinic also accepts patient referrals for transplant assessment from other healthcare professionals. During this review, patients are assessed to determine if they need a transplant and to make sure there are no contraindications for a heart transplant.
If your physician refers you to the clinic for a heart transplant assessment, this does not mean you are on the transplant waitlist. You must first undergo numerous tests. A multidisciplinary team will review your results to determine if you are a candidate for a transplant.
The Heart Transplant Clinic assigns a pre-transplant or post-transplant nurse coordinator to all patients. Patients can contact the coordinator with any health concerns or questions about their upcoming appointments. We encourage patients to sign up for MyChart so they may access information about their upcoming appointments and test results.
The Heart Transplant Clinic uses a shared care model. This means any one of our transplant physicians may see you in the clinic.
Your physician’s office should send your referral for transplant evaluation. They should include your complete medical history, an updated medication list, and any relevant testing. Your physician’s office may fax the referral to 613-696-7165.
What to Expect
For a workup referral:
If your physician refers you for a transplant workup, you must complete several tests and assessments. Depending on your medical situation, you may complete these tests and assessments as an inpatient or as an outpatient. If your testing is performed while you are an outpatient, you will have a clinic appointment in the Heart Transplant Clinic.
Some examples of tests you may need to complete:
- Cardiopulmonary stress test
- Carotid Doppler ultrasound
- Computed tomography (CT) scan of your chest and abdomen
- Flow studies of your legs
- Electrocardiogram (ECG)
- Right heart catheterization
- Referrals to a psychologist, social worker, dietitian, physiotherapist, and other specialists
Once your testing is complete, our Transplant Committee will review your case. The Transplant Committee is a multidisciplinary committee including transplant cardiologists, surgeons, registered nurses, a psychologist, a social worker, and other allied healthcare professionals. The committee will discuss if you require transplantation, if you have any contraindications to transplant, and whether transplantation is in your best interest. The committee relays its review to you and your referring physician and informs you whether you are a candidate for heart transplantation. If the committee decides to proceed with transplantation, it will provide you with more education about the transplant process before you are placed on the waitlist.
For patients on the heart transplant waitlist:
As a patient on the waitlist, a cardiologist may see you every month or every three months. The frequency of your visits will depend on your condition.
You will undergo regular testing while you wait for a heart to ensure your condition has not changed. These tests include the following:
- Right heart catheterization
- Blood work
Your cardiologist may request additional tests depending on your condition.
For post-transplant patients:
You must undergo weekly bloodwork for approximately four weeks after discharge from the hospital. If your condition remains stable, the frequency of this testing will decrease. The transplant advanced practice nurse (APN) will provide further information about this process. All patients will require fasting bloodwork every three months.
You will require many heart biopsies to monitor for signs of rejection. You must complete one biopsy before you leave the hospital. The rest are performed on an outpatient basis.
The following schedule is typical for biopsies, but this may change depending on your condition:
- Weekly for the first month.
- Every two weeks in the second month.
- At three, six, nine, 12, 18, and 24 months.
- If treated for rejection, you will have a biopsy two weeks after that treatment.
The APN will relay your biopsy results and any medication changes to you.
For the first year post-transplant, you will see a cardiologist in the clinic every one to three months. After one year, you must visit the clinic every six months. If you live far away from the hospital, you may visit the clinic for annual testing. The frequency of your tests and visits depends on your condition. Some visits can be completed with the use of telemedicine.
Transplant patients undergo annual testing after their operation. Annual testing includes:
- Electrocardiogram (ECG)
- Chest X-ray
- Positron emission tomography (PET) scan
You may require an angiogram in the first and fifth year after your transplant, or as needed. Your cardiologist will make this decision for you.
Your cardiologist will decide if additional testing is required.
Please bring an up-to-date list of your medications to your clinic appointment. Review your medications at home to see if you need refills before you come to your clinic appointment.
You will receive a notification through your MyChart account or a phone call with the date and time of your next follow-up.
- COVID-19 Vaccine Information Sheet for Patients Heart Transplant Recipients (PDF)
- Canadian Society of Transplantation – National Transplant Consensus Guidance on COVID Vaccine (March 6, 2021) (PDF)
- The International Society for Heart and Lung Transplantation – SARS-CoV-2 Vaccination in Heart and Lung Transplantation: Recommendations for the ISHLT Covid-19 Task Force (15 March, 2021) (PDF)