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Heart transplantation: current practice and outlook to the future
1Service de Cardiologie, Département de Médecine Interne, Centre Hospitalier Universitaire (CHUV), Faculté Biologie et Médecine d'UNIL, Lausanne, Switzerland.
Swiss Medical Weekly
|August 8, 2014
Summary
Heart transplantation survival has plateaued, necessitating a review of candidate selection and post-operative care. Future research should focus on non-immunological factors to improve long-term outcomes for heart transplant recipients.
Area of Science:
- Cardiology
- Transplantation Medicine
- Immunology
Background:
- Heart transplantation has advanced significantly over 40 years, with recent stagnation in long-term survival improvements.
- Changes in heart failure treatment have altered the profile of heart transplant candidates, who are now older and have more comorbidities.
Purpose of the Study:
- To review current recommendations for identifying heart transplant candidates.
- To summarize guidelines for immunological and non-immunological postoperative follow-up after heart transplantation.
Main Methods:
- This study is a review of current recommendations and literature.
- Analysis of progress in immunosuppression and heart failure treatment.
Main Results:
- Candidate evaluation requires careful consideration of age and comorbidities.
- Advances in immunosuppression have reduced acute rejection and improved survival.
- New immunosuppressive molecules are in development, promising future improvements.
Conclusions:
- The profile of heart transplant recipients has evolved due to advances in heart failure management and immunosuppression.
- Emerging immunosuppressive therapies offer new options.
- Further research is crucial to address non-immunological comorbidities and enhance long-term survival post-transplant.
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