title: UK guidelines for referral and assessment of adults for heart transplantation.
abstract: Patients with advanced heart failure have a dismal prognosis and poor quality of life. Heart transplantation provides an effective treatment for a subset of these patients. This article provides cardiologists with up-to-date information about referral for transplantation, the role of left ventricular assist devices prior to transplant, patient selection, waiting-list management and donor heart availability. Timing is of central importance; patients should be referred before complications (eg, cardiorenal syndrome or secondary pulmonary hypertension) have developed that will increase the risk of, or potentially contraindicate, transplantation. Issues related to heart failure aetiology, comorbidity and adherence to medical treatment are reviewed. Finally, the positive role that cardiologists can play in promoting and facilitating organ donation is discussed.
authors.affiliation: Consultant in Cardiology, Transplant Medicine and Circulatory Support, The Royal Brompton and Harefield NHS Trust, Harefield Hospital, Hill End Road, Harefield, Middlesex UB9 6JH, UK. n.banner@rbht.nhs.uk
authors.forename: Nicholas R
authors.initials: NR
authors.lastname: Banner
authors.forename: Robert S
authors.initials: RS
authors.lastname: Bonser
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Clark
authors.forename: Stephen
authors.initials: S
authors.lastname: Clark
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Cowburn
authors.forename: Roy S
authors.initials: RS
authors.lastname: Gardner
authors.forename: Paul R
authors.initials: PR
authors.lastname: Kalra
authors.forename: Theresa
authors.initials: T
authors.lastname: McDonagh
authors.forename: Chris A
authors.initials: CA
authors.lastname: Rogers
authors.forename: Lorna
authors.initials: L
authors.lastname: Swan
authors.forename: Jayan
authors.initials: J
authors.lastname: Parameshwar
authors.forename: Helen L
authors.initials: HL
authors.lastname: Thomas
authors.forename: Simon G
authors.initials: SG
authors.lastname: Williams
mesh_terms: D006333:Heart Failure / Q000150:complications / Q000601:surgery* / Q000628:therapy; D016027:Heart Transplantation / Q000009:adverse effects; D006353:Heart-Assist Devices; D006801:Humans; D018579:Patient Selection; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D012307:Risk Factors; D006113:United Kingdom; D014850:Waiting Lists