Heart transplantation

Abstract

Abstract Heart transplantation (HTx), represents the golden standard of treatment for patients with refractory advanced heart failure. The aim of HTx is to improve survival, symptoms and quality of life. In general, HTx rates are by far too low with respect to the growing numbers of potential allograft recipients, even in countries with highest transplant rates. At least 50% of patients on transplant lists have to be bridged with the use of ventricular assist devices. Current guidelines offer detailed instructions for pretransplant work-up, and define indications and contraindications for HTx. Age 70+, severe pulmonary hypertension and other significant comorbidities should be considered as prohibiting factors for HTx. Organ allocation, explantation and allograft implantation should be performed by experienced teams. Posttransplant management requires dedicated multidisciplinary team approach, and in appropriately selected pateints, provides a median survival of 12.5 years, with good functional capacity and quality of life.