title: Heart transplantation: review.
abstract: Heart transplantation is currently the definitive gold standard surgical approach in the treatment of refractory heart failure. However, the shortage of donors limits the achievement of a greater number of heart transplants, in which the use of mechanical circulatory support devices is increasing. With well-established indications and contraindications, as well as diagnosis and treatment of rejection through defined protocols of immunosuppression, the outcomes of heart transplantation are very favorable. Among early complications that can impact survival are primary graft failure, right ventricular dysfunction, rejection, and infections, whereas late complications include cardiac allograft vasculopathy and neoplasms. Despite the difficulties for heart transplantation, in particular, the shortage of donors and high mortality while on the waiting list, in Brazil, there is a great potential for both increasing effective donors and using circulatory assist devices, which can positively impact the number and outcomes of heart transplants.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Sandrigo
authors.initials: S
authors.lastname: Mangini
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Bárbara Rubim
authors.initials: BR
authors.lastname: Alves
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Odílson Marcos
authors.initials: OM
authors.lastname: Silvestre
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Philippe Vieira
authors.initials: PV
authors.lastname: Pires
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Lucas José Tachotti
authors.initials: LJ
authors.lastname: Pires
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Milena Novaes Cardoso
authors.initials: MN
authors.lastname: Curiati
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bacal
mesh_terms: D001938:Brazil; D002598:Chagas Cardiomyopathy / Q000150:complications / Q000601:surgery; D006084:Graft Rejection / Q000145:classification / Q000150:complications* / Q000503:physiopathology; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation / Q000379:methods / Q000639:trends; D006353:Heart-Assist Devices; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D009369:Neoplasms / Q000139:chemically induced / Q000150:complications; D009894:Opportunistic Infections / Q000150:complications*; D011183:Postoperative Complications; D055031:Primary Graft Dysfunction / Q000150:complications*; D014019:Tissue Donors / Q000600:supply & distribution