Heart Transplant & Advanced Heart Failure Centre

The Heart Transplant & Advanced Heart Failure Centre at SilverOak Health is a specialist programme dedicated to the management of end-stage heart failure and the evaluation and performance of cardiac transplantation. Our multidisciplinary team — comprising advanced heart failure cardiologists, cardiac transplant surgeons, specialist heart failure nurses, and transplant coordinators — provides the full continuum of care from optimised medical therapy through mechanical circulatory support and ultimately transplantation.

Advanced heart failure management at our centre begins with comprehensive evaluation including right heart catheterisation, cardiopulmonary exercise testing, and cardiac imaging to characterise haemodynamic status, functional capacity, and reversibility of cardiac dysfunction. Optimised guideline-directed medical therapy — including RAAS inhibition, beta-blockade, mineralocorticoid receptor antagonism, SGLT2 inhibition, and diuresis — is titrated by our specialist team to achieve the best possible clinical status before considering escalation.

For patients who deteriorate despite optimal medical therapy, our centre offers temporary mechanical circulatory support using intra-aortic balloon pumps, Impella micro-axial ventricular assist devices, and venoarterial ECMO as bridges to recovery, decision, or transplantation. Long-term durable left ventricular assist devices provide destination therapy for transplant-ineligible patients and bridge-to-transplant support for listed candidates, significantly improving quality of life and survival in this otherwise critically ill population.

Cardiac transplantation evaluation follows rigorous multidisciplinary criteria encompassing haemodynamic and functional assessments, psychosocial evaluation, comorbidity screening, and immunological workup. Our transplant team maintains close liaison with national organ allocation networks to minimise waiting times for listed candidates. The surgical procedure itself employs bicaval anastomosis techniques that preserve sinus node function and reduce the need for permanent pacing after transplantation.

Post-transplant immunosuppression management, surveillance endomyocardial biopsies, rejection treatment, and long-term monitoring for allograft vasculopathy, malignancy, renal dysfunction, and infection are provided by our dedicated transplant follow-up clinic. Our one-year and five-year post-transplant survival rates are consistently at or above national registry benchmarks. Patient and family support throughout the transplant journey — from listing through recovery and beyond — is provided by our transplant coordinators and specialist psychosocial team.