Abstract

The excellent survival rate with cardiac transplantation now makes this a potentially attractive procedure in many patients who have debilitating congestive heart failure despite optimal medical therapy. Because the number of donor hearts is severely limited, there are many patients on transplant waiting lists and the waiting time can be more than several months. As a consequence, many patients die while awaiting transplantation. Alternatively, it has been observed that some patients who survive several months on a waiting list may derive relatively little incremental advantage from the procedure. We review the process of selecting patients for cardiac transplantation, including consideration of the major indications, exclusionary factors, and how best to select patients who have the greatest potential for benefit. (Cardiol Rev 1993;1:4, 218-227)

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