Background: Despite several task forces and numerous reviews, criteria for candidate selection for heart transplantation are not uniform.
Methods and results: This report summarizes results compiled from a survey that was reviewed at a consensus conference held before the meeting of the International Society of Heart and Lung Transplantation in 1993 in Boca Raton, Florida. The meeting was attended by representatives of 52 programs from the United States, Canada, England, and Australia. The unique feature of this report is that is represents a review of the actual practice of patient selection at some of the largest and most experienced centers in the field. Key areas of the selection process including medical and surgical alternatives to transplantation, the composition of the transplant work-up, specific inclusion criteria as well as specific psychosocial factors and specific disease etiologies and co-morbidities that might represent contraindications were extensively reviewed. In addition, the standard follow-up for a patient on an active waiting list, and criteria to remove patients from the active waiting list are described. This survey provides information and insight regarding current areas of consensus as well as disagreement regarding candidate selection for heart transplantation.
Conclusions: These differences may be important when considering outcomes and possible strategies in the use of resources.