[Evaluation and maintenance of heart donors]

Heart transplantation is currently the best treatment option to improve hope and quality of life in patients with terminal heart failure that is refractory to conventional treatment. The scarcity of donors remains a difficult problem and is the main factor limiting the number of transplants that can be performed. Given the current situation of stagnation and disparity between the number of potential organ donors, actual donors, and patients requiring transplants, we need effective strategies to reduce the differences between supply and demand and to ensure the best possible prognosis in organ recipients. These strategies should aim to ensure optimal donor selection. Likewise, it is essential to increase the number of potential donors by widening the criteria for donation and to improve our ability to take advantage of suboptimal donors. Moreover, we need to achieve acceptable physiological maintenance of donated organs. All these actions, together with the standardization of future treatments like hormone replacement therapy and genomic evaluation, will undoubtedly lead to an increase in the rate of transplants in the short and mid term, because the option of heart transplantation continues to have only slight repercussions in the high prevalence of terminal heart failure in our environment.