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===Congenital Heart Disease===
===Congenital Heart Disease===
* New York Heart Association functional class IV Heart Failure not amenable to surgery.
* CHD resulting in New York Heart Association functional class IV Heart Failure not amenable to surgery.
* Severe symptomatic cyanotic congenital heart disease.
* Severe symptomatic cyanotic congenital heart disease.
* Presence of some degree of pulmonary hypertension with the potential risk of developing fixed and irreversible elevation of pulmonary vascular resistance (PVR)
* Presence of some degree of pulmonary hypertension with the potential risk of developing fixed and irreversible elevation of pulmonary vascular resistance (PVR)

Revision as of 19:16, 6 June 2020

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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D.; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [1]

Indications

In order for a patient to be recommended for a heart transplant they will generally have advanced, irreversible heart failure with a severely limited life expectancy.[1] It is important to note that the life expectancy of heart failure has improved over the past two decades due to improvements in both medical therapy (ACE Inhibition, beta-blockers, aldosterone antagonists and device therapy such as automatic implantable cardiac defibrillators AICDs and cardiac resynchronization. Thus, patients should not be considered for cardiac transplantation unless they have failed aggressive medical and device therapy.

According to the The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation, the main indications for heart transplant are the following- [2]

Systolic Heart Failure with a Left Ventricular Ejection Fraction less than 35%

  • Due to either:

Ischemic Coronary Artery Disease with Refractory Angina

  • Ischemia which is not amenable to percutaneous or surgical revascularization (coronary artery bypass graft surgery CABG) and is refractory to maximally tolerated medical and/or device therapy

Intractable life-threatening Arrhythmias

Cardiomyopathies

Congenital Heart Disease

  • CHD resulting in New York Heart Association functional class IV Heart Failure not amenable to surgery.
  • Severe symptomatic cyanotic congenital heart disease.
  • Presence of some degree of pulmonary hypertension with the potential risk of developing fixed and irreversible elevation of pulmonary vascular resistance (PVR)

Additional Considerations

  • The patient should have a stable psychosocial situation

References

  1. Steinman TI, Becker BN, Frost AE, Olthoff KM, Smart FW, Suki WN, Wilkinson AH (2001). "Guidelines for the referral and management of patients eligible for solid organ transplantation". Transplantation. 71 (9): 1189–204. PMID 11397947. Unknown parameter |month= ignored (help)
  2. Mehra MR, Canter CE, Hannan MM, Semigran MJ, Uber PA, Baran DA; et al. (2016). "The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: A 10-year update". J Heart Lung Transplant. 35 (1): 1–23. doi:10.1016/j.healun.2015.10.023. PMID 26776864.


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