[Use of an artificial heart and ventricular support system before heart transplantation]

Acute, uncontrollable heart failure in young candidates for transplantation should be considered an indication for implantation of an artificial heart or artificial support of the hear ventricle, if a suitable graft for transplantation is not available at the time. It may be assumed that the two systems will ensure an adequate circulation and will improve organ function. The success of two-stage transplantation is cca 50%. Postoperative haemorrhage and infection are a major problem. Infection after implantation of an artificial heart is frequently incurable and is a clear contra-indication for further implantation. Thromboembolism caused by the artificial blood pump does not seem to be a serious complication when used temporarily. As none of the patients died due to failure of the pump and as also the other problems associated with the use of an artificial heart or a supporting device were successfully resolved, research and development of artificial blood pumps should proceed. Clinical results also confirmed the success of two-stage transplantation of the heart.