102 - Heart Transplantation

Abstract

Over the past five decades, heart transplantation has progressed from a mere aspiration to a life-saving treatment reality for many patients with heart failure. Today, orthotopic heart transplantation is the gold-standard treatment for end-stage heart failure. According to the 2019 Registry of the International Society for Heart and Lung Transplantation, 4978 heart transplantations were performed from July 1, 2017 to June 30, 2018. Historically, short- and long-term results improved until 2006 and subsequently remained stable. Despite the advent of innovative mechanical circulatory support systems for treating patients with heart failure, heart transplantation has continued to be the gold standard for the surgical treatment of heart failure. With the increasing prevalence of heart failure, it is estimated that more than 25,000 patients could benefit from heart transplantation annually. In this chapter, we review the current practices used in heart transplantation, with emphasis on the historical background, donor and recipient selection, donor and recipient management, operative procedure, identification and management of complications, and the outcomes related to the procedure.