Recipient selection and management before cardiac transplantation.
Cardiac transplantation is a proven, effective therapy for selected patients with end-stage congestive heart failure. Recipient selection is performed by a multidisciplinary team consisting of transplant physicians and surgeons. Clinicians responsible for patient assessment must establish the severity of cardiac dysfunction, formulate a prognosis, and stratify patients according to risk for mortality. Patients whose survival and quality of life are most limited without cardiac transplantation are candidates for therapy. The scarcity of organ donors makes careful screening of potential recipients necessary to identify those individuals most likely to obtain a long-term benefit. Recipient selection criteria and management strategies are evolving because of extended waiting times and high mortality caused by the lack of sufficient numbers of donors. Alternative therapies should be applied wherever possible.
Frantz
R P
RP
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.
Olson
L J
LJ
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000517:prevention & control; D019090:Case Management; D002423:Cause of Death; D003141:Communicable Diseases / Q000209:etiology; D004656:Enalapril / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery; D008017:Life Expectancy; D018579:Patient Selection; D011379:Prognosis; D012307:Risk Factors; D014850:Waiting Lists
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril