title: Innovations in cardiac transplantation.
abstract: OBJECTIVE
  As the number of people living with heart failure continues to grow, future treatments will focus on efficient donor organ donation and ensuring safe and durable outcomes. This review will focus on organ procurement, graft surveillance and emerging therapies.
  
  
  RESULTS
  Preliminary studies into donation after cardiac death have indicated that this may be an effective means to increase the donor pool. Novel preservation techniques that include ex-vivo perfusion to improve donor metabolic stabilization prior to implantation may also expand the donor pool. Biomarkers, including circulating-free DNA, are emerging that could replace the endomyocardial biopsy for acute graft rejection, but we lack a risk predictive biomarker in heart transplantation. Novel immune suppressants are being investigated. Emerging therapeutics to reduce the development of chronic allograft vasculopathy are yet to be found.
  
  
  CONCLUSIONS
  This review highlights the most recent studies and future possible therapies that will improve outcomes in cardiac transplantation. Larger clinical trials are currently taking place and will be needed in the future to develop and sustain current trends toward better survival rates with cardiac transplantation.
authors.affiliation: aDepartment of Internal Medicine/Cardiovascular Medicine bDepartment of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Reema
authors.initials: R
authors.lastname: Hasan
authors.forename: Ashraf Abou El
authors.initials: AAE
authors.lastname: Ela
authors.forename: Daniel
authors.initials: D
authors.lastname: Goldstein