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Heart transplantation

Lookup NU author(s): Dr Lu Wang, Professor John Dark

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Abstract

© 2020. Heart transplantation is the definitive treatment for selected patients with end-stage heart failure refractory to medical, interventional and surgical treatment. However, due to limited number of donor organs, most patients wait a long time for heart transplantation and a significant proportion die or become unsuitable for transplantation while waiting. Although post-transplant survival outcomes continue improving, a fifth of recipients die within 1 year after transplantation. In addition, recipients face constant threats from infection, rejection, malignancy and chronic allograft vasculopathy. Therefore, it is imperative to increase donor heart utilization to reduce waiting list mortality, and maintain allograft quality during transportation and optimize post-transplant care to improve outcomes. This review summarizes the process of heart transplantation from recipient and donor selection and matching to post-transplant management with a focus on the surgical aspects, and highlights the recent advancement, including donation after circulatory death programme, mechanical circulatory support, and ex-vivo heart perfusion.

Publication metadata

Author(s): Wang L, Dark JH

Publication type: Review

Publication status: Published

Journal: Surgery

Year: 2020

Volume: 38

Issue: 7

Pages: 375-381

Print publication date: 01/07/2020

Online publication date: 18/06/2020

Acceptance date: 02/04/2018

ISSN (print): 0263-9319

ISSN (electronic): 1878-1764

Publisher: Elsevier Ltd

URL: https://doi.org/10.1016/j.mpsur.2020.05.001

DOI: 10.1016/j.mpsur.2020.05.001

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