Advance Directive: A document in which a person either states
choices for medical treatment or designates someone who should make
treatment choices if the person should become unable to make
decisions. Most often the term refers to formal, written documents,
but it can also be used to include spoken statements by the patient.
Allograft (allogeneic graft or homograft): An organ or tissue
transplanted from one individual to another of the same species, i.e.
human to human.
Antibody: A protein substance made by the body's immune system
in response to a foreign substance, for example a previous transplant,
blood transfusion or pregnancy. Because the antibodies attack the
transplanted organ, heart transplantation patients must take powerful
Antigen: A foreign molecule or substance, such as a transplant,
that triggers an immune response. This response may be the production
Anti-hypertensive drug: A drug that reduces hypertension (high
Atherosclerosis: A disease in which fatty deposits accumulate
on the inner walls of the arteries, causing narrowing or blockage that
may result in a heart attack. Commonly known as "hardening of the arteries."
Attending or Primary Physician: The doctor who has the main
responsibility for your care while you are in the hospital during
heart transplantation. There may be other doctors caring for you such
as consulting doctors, resident doctors, and medical students.
Biopsy: The removal of a sample of tissue via a small needle.
The tissue is removed for examination to determine a diagnosis.
Blood Typing: A test that can help establish compatibility
between two different types of blood. Blood types include A, B, AB or O.
Blood Urea Nitrogen (BUN): A waste product regularly removed by
the kidneys and eliminated in the urine. Regular testing of the BUN
level serves as an indicator of how well the kidney is functioning.
Breathing Tube (endotracheal tube): A temporary tube put into
the nose or mouth. Anesthesia or air and oxygen pass through the tube
allowing artificial breathing.
Cadaveric Donor: An individual who has recently passed away of
causes not affecting the organ intended for transplantation. Cadaver
organs usually come from people who have willed their organs before
death by signing organ donor cards. Permission for donation also can
be given by the deceased person's family at the time of death.
Catheter: A thin, flexible instrument used to introduce or
withdraw fluids from the body. A catheter also may be used to monitor
Caregiver: the primary person assisting in the management of
your illness: this may include a family member, a medical
worker or allied health professional, who assists in the management of
an illness or disability
Categories for urgency – in Heart Transplantation:
1A – Patients are very sick and are in the hospital with intravenous
monitoring equipment or mechanical devices helping to temporarily
sustain heart function
1B – Patients may be in or out of the hospital and have IV
medications or a mechanical device stabilizing heart function
Status 2 – Most patients are out of the hospital and stable
Status 7 – Patients temporarily inactive on the transplant list
Chest X-ray: Used to view the lungs and lower respiratory
tract. A chest X-ray may be used for diagnosis and therapy.
CPR (cardiopulmonary resuscitation): A procedure using cardiac
and respiratory equipment and medications possibly to restore the
heartbeat and/or breathing.
Compliance: The act of following orders and adhering to rules
and policies, i.e. taking one's medications after transplant.
Complication: The occurrence of diseases or medical problems
simultaneously in the body.
Coronary Angiography (Cardiac Catheterization): A procedure
that allows picture to be taken of the arteries supplying the heart
with blood (the coronary arteries). Angiography shows blockages in the arteries.
Creatinine: A waste product in the blood, creatinine is removed
by the kidneys and eliminated in the urine. Regular testing of the
creatinine level serves as an indicator of how well the kidney is functioning.
Crossmatch: A test that establishes the compatibility or
closeness of blood between the organ donor and recipient. A positive
crossmatch shows that the donor and patient are incompatible. A
negative crossmatch means there is no reaction between donor and
patient and that the transplant may proceed.
Cyclosporine Level Test: A blood test that measures the amount
of cyclosporine in the blood. Based on the amount of cyclosporine
measured, a physician decides what dose of cyclosporine is appropriate
for a patient.
Cytomegalovirus (CMV): A common virus that may be present
without symptoms in healthy people, but can be a serious condition if
present in transplant patients.
Dialysis: An artificial means of cleansing the blood of waste
products and removing fluids from the body when the patient's own
kidneys are unable to continue this process.
Diastolic: The lower number in a blood pressure reading that
indicates the pressure in the heart when the muscle is relaxed (the
point of least pressure).
Diuretic: A drug that helps the body get rid of excess water by
increasing the amount of urine the body excretes.
DNR Order (Do Not Resuscitate Order): An advanced directive
that means no CPR is to be done when the heart and lungs stop.
Donor: A person who gives an organ, tissue or blood to another
person. A compatible donor is a person who has the same tissue and
blood types as the person who receives the organ, tissue or blood.
Durable Power of Attorney for Health Care: A written advance
directive in which individuals name someone else (the
"agent" or "proxy") to make health care decisions
for them when they are unable to speak for themselves.
Echocardiogram: An imaging procedure that creates a moving
picture outline of the heart's valves and chambers using
high-frequency sound waves that come from a hand held wand placed on
your chest or passed down your throat. Echo is often combined with
Doppler ultrasound and color Doppler to evaluate blood flow across the
heart's valves. Doppler senses the speed of sound and can pick up
abnormal leakage or blockage of valves.
Electrocardiogram (EKG or ECG): A test that records on graph
paper the electrical activity of the heart via small electrode patches
attached to the skin. An EKG helps a physician determine the causes of
abnormal heartbeat or detect heart damage.
Glucose: Blood sugar. Manufactured by the body from
carbohydrates, protein, and fat, glucose is the main source of energy
for all living organisms.
Graft: A transplanted tissue or organ (such as the lung or liver).
Heart Transplantation: Heart transplantation is a treatment
option for irreversible, life-threatening heart diseases that cannot
be managed by other medical or surgical methods.
Herpes: An infection for which transplant patients are at risk.
It appears as small sores on the skin, lips or genitals. When there
are no sores, the herpes virus lays dormant (not causing infection) in
Hypertension: High blood pressure.
HLA System (Human Leukocyte Antigens): There are three major
genetically controlled groups: HLA-A, HLA-B and HLA-DR. In
transplantation, the HLA tissue types of the donor and recipient are
sometimes an important part of the selection process. This depends on
the recipient's antibodies.
Histocompatibility Antigens: Molecules found on all nucleated
cells in the body that characterize each individual as unique. These
antigens are inherited from one's parents. Human leukocyte antigens
determine the compatibility of tissues for transplantation from one
individual to another.
Hospice: A program that provides care for the terminally ill in
the form of pain relief, counseling, and support, either at home or in
Hydration: Provision of fluids by any means to prevent dehydration.
Immune Response: The body's defense against foreign objects or
organisms, such as bacteria, viruses or transplanted organs or tissue.
Immune System: The body's response mechanism for fighting
against bacteria, viruses and other foreign substances. If a cell or
tissue (such as bacteria or a transplanted organ) is recognized as not
belonging to the body, the immune system will act against the
"invader." The immune system is the body's way to fight disease.
Immunosuppressant Drug: A drug that prevents the immune system
from responding to cells that it recognizes as foreign to the body.
Such drugs prevent the immune system from recognizing that a
transplanted organ, such as a lung, is not the organ a person had when
he or she was born.
Immunosuppression: The artificial suppression of the immune
response, usually through drugs, so that the body will not reject a
transplanted organ or tissue. Drugs commonly used to suppress the
immune system after transplant include prednisone, azathioprine
(Imuran), mycophenolate mofetil (CellCept), and cyclosporine (Neoral).
Infectious Disease Team: A team of physicians who help control
the hospital environment to protect you against harmful sources of infection.
Intensive Care Unit (ICU): A special nursing area devoted to
providing continuous and immediate care to seriously ill patients.
Intravenous (IV): Delivery of drugs, fluids or food directly
into a vein.
Informed Consent: A process of reaching an agreement based on
full disclosure. Informed consent has components of disclosure,
comprehension, competence and voluntary response. Informed consent
often refers to the process by which one decides to donate the organs
of a loved one.
Legal Guardian: A person charged (usually by court appointment)
with the power and duty of taking care of and managing the property
and rights of another person who is unable to take care of their own affairs.
Life-Sustaining Treatment: A medical treatment given to a
patient that prolongs life and delays death.
Living Will: A written advance directive in which an individual
states which health care decisions should be made if the individual
becomes unable to make these decisions.
Medical Student: A student in the third or fourth year of
medical school training. The student doctor assists the primary and
resident doctors in daily care of patients.
Noncompliance: Failure to follow instructions given by health
care providers, such as not taking medication as prescribed or not
attending follow-up appointments.
NOTA: The National Organ Transplant Act, passed by Congress in
1984, outlawed the sale of human organs and initiated the development
of a national system for organ sharing and a scientific registry to
collect and report transplant data.
Organ Preservation: Between procurement from a donor and heart
transplantation, organs require special methods of preservation. The
length of time that organs and tissues can be kept outside the body
vary, depending on the organ, the preservation fluid and the temperature.
Palliative Care: Medical treatments intended to control
suffering and discomfort (such as pain medication or treatment of an
infection). These treatments will not cure the patient.
Panel Reactive Antibody (PRA): The percentage of cells from a
panel of donors with which a potential recipient's blood serum reacts.
The more antibodies in the recipient's blood, the higher the PRA. The
higher the PRA, the less chance of getting a good crossmatch.
Patient Advocate: A patient advocate acts as a representative
for individuals requiring assistance with their health care needs;
someone who acts as a liaison between the patient and the healthcare provider.
Physical Therapist: An expert who can recommend exercises to
help you maintain flexibility and regain your strength.
Pre-transplant Evaluation: A series of interviews and tests for
patients who are being considered for a transplant. It is the second
step in the transplant evaluation process. After this evaluation, the
transplant team decides if a transplant is a suitable treatment.
Pre-transplant Screening: A series of interviews and physical
examinations for patients who are being considered for a transplant.
Pre-transplant screening is the first step in the transplant process
to discover if a patient has any condition that would immediately rule
him or her out for a transplant.
Proxy: A person appointed to make decisions for someone else,
as in a Durable Power of Attorney for Health Care (also called a
surrogate or agent).
Pulmonary Function Tests (PFTs): Tests that measure the volume
of air that is inhaled and exhaled. The PFTs also measure gases, such
as oxygen and carbon dioxide, in the lungs.
Recipient: A patient who receives an organ, tissue or blood
from another person.
Rejection: The process by which the body tries to get rid of a
transplanted organ or tissue by producing antibodies.
Immunosuppressive drugs help to prevent rejection.
Resident Physician: A doctor who works closely with the primary
physician to manage a patient's daily care. The resident is a licensed
medical school graduate doing further training in one of the
specialties of medicine.
Retransplantation: Due to organ rejection or transplant
failure, some patients return to the waiting list. Reducing the number
of retransplants is a critical concern when examining ways to maximize
a limited supply of organs.
Sensitization: Potential recipients are "sensitized"
if there are antibodies in their blood, usually because of pregnancy,
blood transfusions or previous rejection of an organ transplant.
Sensitization is measured by PRA. Highly sensitized patients are more
likely to reject an organ transplant than unsensitized patients.
Side Effect: An unintended effect of a drug on tissues or
organs other than the drug benefits.
Status: Indicated degree of medical urgency for patients
Survival Rates: Survival rates indicate the percentage of
patients or grafts (transplanted organs) that are still alive
functioning at a certain point post transplant. Survival rates are
often given at one-, three-, and five-year increments. Policy
modifications are never made without examining their impact on
transplant survival rates. Survival rates improve with technological
and scientific advancements. Developing policies that reflect and
respond to these advances in transplantation will also improve
Systolic: The top number in a blood pressure reading that
indicates the force of the heart muscle's contractions as blood is
pumped through the heart's chambers.
Thrush: A yeast infection for which transplant patients are at
risk. It can occur in the mouth or vagina.
Tissue Typing: A test that evaluates the compatibility or
closeness of tissue between the organ donor and recipient.
TPN (total parenteral nutrition): A special intravenous (IV)
solution providing hydration, vitamins, minerals and calories to
sustain life. This IV is usually inserted into a large vein in the
Transplant Coordinator: A registered nurse who coordinates all
of the events leading up to and following your transplant. The
transplant coordinator helps arrange your pre-transplant tests and
helps find a suitable donor.
Transplant Surgeon: The staff physician who performs the
transplant surgery. The transplant surgeon follows your progress while
you are in the hospital and monitors your post-transplant care after
you are discharged.
Tube Feeding (enteral feeding): A temporary artificial method
of providing food through a tube inserted into the stomach. This food
is in a liquid form and contains calories, vitamins and electrolytes.
Enteral feeding may be necessary when food cannot be taken by mouth.
UNOS:United Network for Organ Sharing: The national nonprofit
agency that establishes and enforces regulations to ensure equality in
organ transplantation and fairness in distribution of donor organs.
U.S. Scientific Registry of Transplant Recipients: A database
of post-transplant information. Follow-up data on every transplant are
used to track transplant center performance, transplant success rates
and medical issues impacting transplant recipients. UNOS facilitates
the collection, tracking and reporting of transplant recipient and
Ventilator: A machine used to assist or control breathing (may
be called a respirator).
Waiting List: After evaluation by the transplant physician, and
after committee presentation, a patient is added to the national
waiting list by the transplant center. Lists are specific to both
geographic area and organ type: heart, lung, kidney, pancreas,
intestine, heart-lung, kidney-pancreas.
This unusual procedure, known as a "domino" transplant, occurs when one recipient receives a heart-lung transplant from a deceased donor, while the existing healthy heart of the heart-lung recipient is given to a second patient. The rare procedure has only been performed eight times at Stanford, last in 1994.
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Open trials refer to studies currently accepting participants. Closed trials are not currently enrolling, but may open in the future.