Heart Transplant

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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

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