title: Heart transplantation: state of the art.
abstract: Outcomes in cardiac transplantation have improved during the past 30 years because of advances made in medicine and surgery. Patients referred for cardiac transplantation are examined through a rigorous evaluation process that involves a multidisciplinary approach to determine candidacy. The list for candidates awaiting transplantation has grown more rapidly than the donor pool, resulting in a need to expand the criteria for donors. Some centers now extend criteria to include older donors, those with prolonged periods of ischemia, donor-recipient mismatches, and donors requiring bypass surgery. Long-term outcomes from the expanded donor pool are under evaluation. Studies are currently in progress to explore inducing tolerance through bone marrow infusion and rejection detection with the use of a pacemaker. Future alternatives to transplantation include the left ventricular assist device as a bridge to recovery, xenotransplantation, and the totally artificial heart.
authors.affiliation: Cardiomyopathy and Transplant Center, Temple University Hospital, Philadelphia, PA 19140, USA.
authors.forename: T K
authors.initials: TK
authors.lastname: Rourke
authors.forename: M T
authors.initials: MT
authors.lastname: Droogan
authors.forename: L
authors.initials: L
authors.lastname: Ohler
mesh_terms: D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D006331:Heart Diseases / Q000601:surgery*; D016027:Heart Transplantation / Q000276:immunology / Q000379:methods* / Q000451:nursing / Q000706:statistics & numerical data; D006801:Humans; D010348:Patient Care Team; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods / Q000451:nursing; D012017:Referral and Consultation; D009927:Tissue and Organ Procurement / Q000379:methods; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014850:Waiting Lists