Heart Transplant Conditions, Diagnostics & Treatments
The heart transplant team at Cedars-Sinai has extensive experience with heart failure and other conditions that may require heart transplants, as well as recovery and support options after heart transplant surgery. Our specialists evaluate patients with care and promptness, and their groundbreaking work has consistently led to patient outcomes that are higher than the national average.
Learn more about conditions related to heart transplants and the diagnostics and treatments we offer.
- Arrhythmogenic right ventricular dysplasia (ARVD)
- Cardiac amyloidosis
- Cardiac tumor
- Chagas cardiomyopathy
- Chemotherapy-related cardiomyopathy
- Congenital heart disease in the adult
- Constrictive pericarditis
- Coronary artery disease
- Diastolic heart failure (HFpEF)
- Dilated cardiomyopathy
- Familial cardiomyopathy
- Heart failure
- Heart valve disorders
- Hypertensive (high blood pressure) cardiomyopathy
- Hypertrophic cardiomyopathy
- Ischemic cardiomyopathy
- Non-compaction cardiomyopathy
- Postpartum (after giving birth) cardiomyopathy
- Pulmonary hypertension
- Restrictive cardiomyopathy
- Systolic heart failure (HFrEF)
- Ventricular tachycardia
In the post-transplant world, we can now not only detect antibodies, but also assess their quantity and ability to cause harm through special testing available at Cedars-Sinai. We have premiere immunology labs that can support our program in guiding therapy for patients with antibody problems.
- Cardiac catheterization with angiography: A special substance is injected into the blood vessel that reveals the inside of the artery.
- Cardiac imaging: Cedars-Sinai has a number of imaging modalities to detect acute and chronic rejection, including echocardiography, specialized cardiac MRI, and rubidium PET scanning.
- DNA test
- Endomyocardial biopsy: Performed to diagnose rejection in the first year post-transplantation. This is an invasive procedure used routinely to obtain small samples of heart muscle, primarily for detecting rejection of a donor heart following heart transplantation.
- Non-invasive tests: We are currently utilizing non-invasive blood tests to detect rejection, including the AlloMap and donor-derived cell free DNA tests. The use of the AlloMap test has decreased the need for invasive biopsies by 80% in our program. In studies, we are utilizing biomarker analyses including intragraft mRNA transcripts and circulating miRNA.
- Other tests: Our program routinely employs the T-cell immune function test to guide immunosuppression. This is one of the only tests available to let us know how immunoresponsive a patient is on immunosuppression.
- Anti-rejection medications (immunosuppression): In general, we employ three types of immunosuppressive agents: tacrolimus, mycophenolate mofitil and steroids. This triple-drug regimen helps to prevent rejection of the donor heart and is initiated at the time of transplantation. For patients who are highly sensitized or who have a kidney issue, we may utilize induction therapy with ATG, given in the first few days post-transplant, to help maintain kidney function and further prevent rejection. We also routinely utilize statins in our heart transplant patients. We have pioneered research demonstrating that statins, a cholesterol-lowering medication, also have anti-rejection properties. In our program, rejection rates are down to 5%.
- Desensitization treatments: We are the largest desensitization center in the country with the ability to treat and manage highly sensitized patients successfully to transplant. We have an array of treatments to reduce antibodies including IVIG, rituximab, alemtuzumab, bortezomib, eculizumab and tocilizumab for select cases.
- Other treatments: Prophylactic antibiotics are also employed routinely in the perioperative period and after transplant to prevent viruses and bacterial infections.