title: The current status of heart transplantation and the development of "artificial heart systems".
abstract: BACKGROUND
  In view of the major technical advances in ventricular assist devices (VAD) in recent years, the authors discuss the question whether these "artificial hearts" are still no more than a temporary measure for patients awaiting heart transplantation (HTx), or whether they can already be used as an independent form of long-term treatment.
  
  
  METHODS
  Statistics from Eurotransplant regarding heart transplantations and transplant waiting lists in Germany are presented. Technical developments in cardiac support systems, the variation in results depending on the indication, and the findings with respect to quality of life are all discussed on the basis of a selective review of the literature and the authors' own clinical experience.
  
  
  RESULTS
  The waiting list for heart transplantation in Germany has grown to a record size of nearly 800 patients, while fewer than 400 hearts are transplanted each year. Technical advances have improved outcomes in VAD therapy, but the outcome depends on the patient's preoperative condition. The physical performance of patients who have received VAD is comparable to that of HTx patients; nonetheless, HTx patients have a better quality of life.
  
  
  CONCLUSIONS
  Chronic VAD therapy has become a clinical reality. Because of the greater number of patients awaiting HTx, many will not receive their transplants in time. When the decision to treat with VAD is made early, it can be used as an alternative form of treatment with a comparable one-year survival (>75%).
authors.affiliation: Klinik für Herz-, Thorax-, Transplantations- und Gefässchirurgie, Medizinische Hochschule Hannover, Hannover, Germany. strueber.martin@mh-hannover.de
authors.forename: Martin
authors.initials: M
authors.lastname: Strüber
authors.forename: Anna L
authors.initials: AL
authors.lastname: Meyer
authors.forename: Doris
authors.initials: D
authors.lastname: Malehsa
authors.forename: Christiane
authors.initials: C
authors.lastname: Kugler
authors.forename: Andre R
authors.initials: AR
authors.lastname: Simon
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
mesh_terms: D004867:Equipment Design; D005858:Germany; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation / Q000379:methods* / Q000639:trends*; D006354:Heart, Artificial / Q000639:trends*; D006801:Humans; D013673:Technology Assessment, Biomedical