Strategies to manage the heart failure patient after transplantation

Cardiac transplantation has emerged as an effective form of therapy for end-stage congestive heart failure (CHF), but patients are predisposed to both dilated and restrictive congestive physiology. The etiologies of post-transplant CHF are unique and complicated, most certainly reflecting a chronic rejection process that has yet to be elucidated. Successful identification of underlying pathophysiologic mechanisms and subsequent therapeutic approaches will require close coordination among cardiologists, cardiac surgeons, and immunobiologists.