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A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
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Treatment of Advanced Heart Failure-Focus on Transplantation and Durable Mechanical Circulatory Support: What Does

Federica Guidetti1, Mattia Arrigo2, Michelle Frank1

  • 1Department of Cardiology, University Hospital of Zürich, Rämistrasse 100, Zürich 8091, Switzerland.

Heart Failure Clinics
|September 13, 2021
PubMed

Insights

Heart transplantation (HTx) offers improved survival for advanced heart failure (Advanced HF). However, donor organ shortages lead to significant waiting list mortality, necessitating alternative strategies.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Mechanical Circulatory Support

Background:

  • Advanced heart failure (Advanced HF) necessitates heart transplantation (HTx) as a primary treatment.
  • Current HTx survival rates are 87% (1 year), 77% (5 years), and 57% (10 years), with an average life expectancy of 9.16 years.
  • Donor organ scarcity results in waiting times exceeding life expectancy, causing approximately 20% mortality on the waiting list.

Purpose of the Study:

  • To review current standard treatments for Advanced HF.
  • To highlight recent advances in managing Advanced HF.
  • To explore future developments in Advanced HF treatment, focusing on mechanical circulatory support and HTx.

Main Methods:

  • Literature review of current standard treatments for Advanced HF.
  • Analysis of recent advancements in mechanical circulatory support and HTx.
  • Exploration of future therapeutic strategies for Advanced HF.

Main Results:

  • Heart transplantation (HTx) significantly improves survival in advanced heart failure (Advanced HF).
  • Waiting list mortality for HTx remains high due to donor organ shortages.
  • Long-term mechanical circulatory support presents a viable alternative and adjunct to HTx.

Conclusions:

  • Mechanical circulatory support is crucial for managing Advanced HF patients awaiting HTx.
  • Innovations in mechanical support and transplantation are vital to overcome donor organ limitations.
  • Future strategies must integrate mechanical support and HTx for optimal long-term outcomes in Advanced HF.

Keywords:
Advanced heart failureDCD donorsHeart transplantationHemocompatibilityMechanical circulatory supportRVADTAHXenotransplantation

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