title: Management of the ACC/AHA Stage D patient: cardiac transplantation.
abstract: Over the last 4 decades, cardiac transplantation has become the preferred therapy for select patients with end-stage heart disease. Heart transplantation is indicated in patients with heart failure despite optimal medical and device therapy, manifesting as intractable angina, refractory heart failure, or intractable ventricular arrhythmias. This article provides an overview of heart transplantation in the current era, focusing on the evaluation process for heart transplantation, the physiology of the transplanted heart, immunosuppressive regimens, and early and long-term complications.
authors.affiliation: Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Kittleson
authors.forename: Jon A
authors.initials: JA
authors.lastname: Kobashigawa
mesh_terms: D064591:Allografts; D001379:Azathioprine / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D000075202:Contraindications; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006084:Graft Rejection / Q000517:prevention & control; D006321:Heart / Q000294:innervation; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008134:Long-Term Care / Q000379:methods; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009369:Neoplasms / Q000209:etiology; D009894:Opportunistic Infections / Q000209:etiology / Q000628:therapy; D011182:Postoperative Care / Q000379:methods; D013256:Steroids / Q000627:therapeutic use
chemical_list: D002316:Cardiotonic Agents; D007166:Immunosuppressive Agents; D013256:Steroids; D009173:Mycophenolic Acid; D001379:Azathioprine
keywords: Cardiac transplantation; End-stage heart failure; Immunosuppression; Rejection