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Current Cardiology Reports
Erschienen in: Current Cardiology Reports 12/2017

01.12.2017 | Heart Failure (HJ Eisen, Section Editor)

Evaluation of a Heart Transplant Candidate

verfasst von: Sook Jin Lee, Kyung Hee Kim, Suk Keun Hong, Shelley Hankins

Erschienen in: Current Cardiology Reports | Ausgabe 12/2017

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Abstract

Purpose of Review

Heart transplantation is the best option for irreversible and critically advanced heart failure. However, limited donor pool, the risk of rejection, infection, and right ventricular dysfunction in short-term post-transplant period, as well as, the development of coronary allograft vasculopathy and malignancy in the long-term post-transplant period limits the utility of heart transplantation for all comers with advanced heart failure. Therefore, selection of appropriate candidates is very important for the best short and long-term prognosis. In this article, we discuss the principles of selection of candidates and compare to the recently updated International Society for Heart and Lung Transplantation (ISHLT) listing criteria with the goal of updating current clinical practice.

Recent Findings

We found that while most of the recommendations in the new listing criteria are continuous with the previous criteria, updated recommendations are made on the risk stratification models in choosing transplantation candidates. Recommendation on hepatic dysfunction is not directly included in the updated ISHLT listing criteria; however, adoption of the Model for End-stage Liver Disease (MELD) score and modified MELD scores in the evaluation of risk are suggested in recent studies.

Summary

In conclusion, evaluation of patient selection for heart transplantation should be comprehensive and individualized with respect to indications and the risk of comorbidities of candidates. With the advancement of mechanical circulatory support (MCS), the selection of heart transplantation candidate is continuously evolving and widened. MCS as bridge to candidacy should be considered when the candidate has potentially reversible risk factors for transplantation.
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Metadaten
Titel
Evaluation of a Heart Transplant Candidate
verfasst von
Sook Jin Lee
Kyung Hee Kim
Suk Keun Hong
Shelley Hankins
Publikationsdatum
01.12.2017
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 12/2017
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-017-0934-y

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