Heart transplantation: state of the art.
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.
Rourke
T K
TK
Cardiomyopathy and Transplant Center, Temple University Hospital, Philadelphia, PA 19140, USA.
Droogan
M T
MT
Ohler
L
L
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