Heart Transplant
Introduction
Cardiac transplantation, also called heart transplantation, has evolved into the treatment of choice for many people with severe heart failure (HF) who have severe symptoms despite maximum medical therapy. Survival among cardiac transplant recipients has improved as a result of improvements in treatments that suppress the immune system and prevent infection.
Definition
A heart transplant, or a cardiac transplantation, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease
Indications
The general indications for cardiac transplantation include deteriorating cardiac function and a prognosis of less than 1 year to live. Specific indications include the following:
Dilated cardiomyopathy
Ischemic cardiomyopathy
Congenital heart disease for which no conventional therapy exists or for which conventional therapy has failed
Ejection fraction less than 20%
Intractable angina or malignant cardiac arrhythmias for which conventional therapy has been exhausted
Pulmonary vascular resistance of less than 2 Wood units
Age younger than 65 years
Ability to comply with medical follow-up care
Contraindications
Some patients are less suitable for a heart transplant, especially if they suffer from other circulatory conditions related to the heart. The following conditions in a patient increase the chances of complications:
Kidney, lung, or liver disease
Insulin-dependent diabetes with other organ dysfunction
Life-threatening diseases unrelated to heart failure
Vascular disease of the neck and leg arteries.
High pulmonary vascular resistance
Recent thromboembolism
Age over 65 years (some variation between centers)
Active systemic infection
Active systemic disease such as collagen-vascular disease or sickle cell disease
Active malignancy - Patients with malignancies
Cardiac transplantation, also called heart transplantation, has evolved into the treatment of choice for many people with severe heart failure (HF) who have severe symptoms despite maximum medical therapy. Survival among cardiac transplant recipients has improved as a result of improvements in treatments that suppress the immune system and prevent infection.
Definition
A heart transplant, or a cardiac transplantation, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease
Indications
The general indications for cardiac transplantation include deteriorating cardiac function and a prognosis of less than 1 year to live. Specific indications include the following:
Dilated cardiomyopathy
Ischemic cardiomyopathy
Congenital heart disease for which no conventional therapy exists or for which conventional therapy has failed
Ejection fraction less than 20%
Intractable angina or malignant cardiac arrhythmias for which conventional therapy has been exhausted
Pulmonary vascular resistance of less than 2 Wood units
Age younger than 65 years
Ability to comply with medical follow-up care
Contraindications
Some patients are less suitable for a heart transplant, especially if they suffer from other circulatory conditions related to the heart. The following conditions in a patient increase the chances of complications:
Kidney, lung, or liver disease
Insulin-dependent diabetes with other organ dysfunction
Life-threatening diseases unrelated to heart failure
Vascular disease of the neck and leg arteries.
High pulmonary vascular resistance
Recent thromboembolism
Age over 65 years (some variation between centers)
Active systemic infection
Active systemic disease such as collagen-vascular disease or sickle cell disease
Active malignancy - Patients with malignancies