Swimming in the Deep (or Is It Shallow?) End of the Donor Pool

Abstract

Heart allotransplantation (HT) and durable mechanical circulatory support are the principal treatments for patients with end-stage heart failure (ESHF). However, the number of patients with ESHF persistently exceeds donor supply, and durable mechanical circulatory support has not yet achieved outcomes equivalent to HT. Notwithstanding recent developments in clinical cardiac xenotransplantation and total artificial heart technologies, which may be conceived as “building new pools,” expanding the existing allogeneic donor pool should have greater impact on recipient life-years saved than these highly conceptually innovative developments.