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Updated: Jul 8, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
[Heart Transplantation at the University of Tokyo:Present and Future]
1Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan.
Insights
Japan
Area of Science:
- Cardiology
- Transplantation Medicine
- Medical Devices
Background:
- Heart transplantation numbers in Japan increased post-2010 organ transplantation act revision.
- Long-term survival after heart transplantation in Japan exceeds that of the USA and Europe.
- A critical donor organ shortage leads to rapidly increasing waiting lists.
Purpose of the Study:
- To describe real-world outcomes for patients on ventricular assist device (VAD) waiting lists.
- To discuss future strategies for managing insufficient donor organ supply in heart transplantation.
- To analyze the long-term impact of VADs on patients awaiting heart transplants.
Main Methods:
- Review of 125 adult heart transplantations performed.
- Analysis of patient outcomes and survival rates.
- Evaluation of ventricular assist device (VAD) utilization and patient management.
Main Results:
- Over 90% five-year survival rate achieved in 125 adult heart transplantations.
- Waiting periods for heart transplantation are exceeding five years.
- Ventricular assist device (VAD) use is increasing for patients awaiting transplants.
Conclusions:
- Strategies to address donor organ shortage include VAD weaning with myocardial recovery, utilizing marginal donors, and expanding destination therapy indications.
- Optimizing VAD management is crucial for patients awaiting heart transplantation.
- Further research into donor organ allocation and alternative therapies is warranted.
Abstract:
The number of heart transplantation in Japan has gradually increased since the revised organ transplantation act became effective in July 2010. The long-term survival after heart transplantation is superior, compared to the survival in Europe and United States of America( USA). However, the number of patients on a waiting list is rapidly increasing due to an extreme donor shortage. Because of stagnating heart transplantation, there is a need for an optimal solution to an insufficient donor organ supply. We have experienced 125 adult heart transplantations with acceptable survival rate of over 90% at five years. On the other hand, an expected waiting period is lengthening to far longer than five years. Here, based on our experience, we describe the "real world" outcomes and mention the future aspect of the patients on the waiting list on ventricular assist device (VAD). Our suggestions are 1) to promote VAD weaning in patients with myocardial recovery, 2) to aggressively utilize marginal donors, and 3) to expand the indication to destination therapy.
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