EDUCATION IN HEART

Heart failure

Cardiac transplantation

Mario C Deng

Correspondence to:
Correspondence to:
Mario C Deng, MD, The Heart Failure Center & Division of Circulatory Physiology, Columbia University College of Physicians & Surgeons, New York Presbytarian Hospital, Milstein Hospital Building Room 5-407, 177 Fort Washington Avenue, New York NY 10032, USA;
md785@columbia.edu

Keywords: heart failure; cardiac transplantation; immunosuppression; post-transplantation management; transplant vasculopathy; rejection; xenotransplantation

Abbreviations: COCPIT, Comparative Outcomes and Clinical Profiles In Transplantation; CMV, cytomegalovirus; HFSS, Heart Failure Survival Score; ISHLT, International Society for Heart and Lung Transplantation; LVAD, left ventricular assist device; PRA, panel reactive antibody; REMATCH, Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart failure; UNOS, United Network for Organ Sharing

As a consequence of improved management in acute coronary syndromes and improved longevity of the population, the number of patients with heart failure is growing. The prevalence and incidence in industrialised countries are estimated to be around 1% and 0.15% of the population, respectively.^w1 Up to 10% of people with heart failure are at an advanced stage, amounting to 300 000 patients in the USA and 60 000 in the UK. In parallel, research ^w2–5 has led to the concept of cardiac replacement by transplantation. Following the first successful heart transplantation in 1967 in the Groote-Schuur-Hospital, Kapstadt, South Africa,^w6 the first successful US heart transplant was performed in 1968 at Stanford University. In the same year, an ad hoc committee at Harvard University established the criteria of brain death.^w7 More than 55 000 cardiac transplants have now been performed in more than 200 hospitals worldwide (
www.ishlt.org). The . . . [Full text of this article]

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