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Implantation of Total Artificial Heart in Congenital Heart Disease

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Published on: July 18, 2014

Heart transplantation candidacy.

Jefferson L Vieira¹, Mandeep R Mehra

¹Heart and Vascular Center, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Current Opinion in Organ Transplantation

|December 5, 2020

Summary

Evaluating heart transplant candidates is becoming more complex due to changing patient profiles and new policies. Recent advances focus on improving eligibility assessments for advanced therapies like heart transplantation.

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Area of Science:

Cardiology
Transplantation Medicine
Medical Ethics

Background:

Heart transplantation eligibility criteria have evolved.
Candidate profiles have become more complex over time.
Advanced therapies like heart transplantation require careful candidate selection.

Purpose of the Study:

To review recent advancements in the evaluation process for heart transplantation eligibility.
To discuss the changing landscape of heart transplant candidate characteristics.
To summarize updates in heart transplantation allocation policies.

Main Methods:

Review of recent literature on heart transplantation evaluation.
Analysis of changes in heart transplantation allocation policies in the USA.
Examination of listing practices and candidate acceptance criteria.

Main Results:

Heart transplantation allocation policies have been updated to reduce waitlist mortality and ensure equitable organ distribution.
Patients with chronic infectious diseases and malignancies are increasingly considered for heart transplantation.
Listing practices vary, with higher-volume centers showing more willingness to accept high-risk candidates.

Conclusions:

The decision to list high-risk candidates requires a blend of quantitative data, qualitative analysis, and clinical judgment.
The organ donor shortage presents ethical challenges in heart transplantation candidate selection.
Future guidelines should address fair organ allocation and improved post-transplantation outcomes.