Heart transplantation remains the optimal treatment for end-stage heart failure, with recent expansions of the donor pool through hepatitis C-positive and circulatory death donors showing comparable survival outcomes.
This narrative review highlights that heart transplantation provides a median survival of over 12 years for end-stage heart failure, while outlining ongoing challenges such as graft availability, rejection, and long-term complications.
The first human heart transplantation was performed by Christian Barnard in 1967. While the technical aspect had been worked out, allograft rejection was a major limitation in the early days of heart transplant. The discovery of cyclosporine revolutionized the field and led to the modern era of transplant. Heart transplantation now offers the best survival benefit for patients with end-stage heart failure with a median survival over 12 years. However, there are still limitations including the impact of limited availability of graft, graft dysfunction, and rejection, and long-term non-cardiac complications. This review serves as an update on the short- and long-term outcomes following heart transplantation focusing on the new donor allocation system, efforts to expand the donor pool, primary graft dysfunction, acute cellular and antibody-mediated rejection, cardiac allograft vasculopathy, and post-transplant malignancy and renal dysfunction.
Awad et al. (Tue,) conducted a review in End-stage heart failure. Heart transplantation was evaluated. Heart transplantation remains the optimal treatment for end-stage heart failure, with recent expansions of the donor pool through hepatitis C-positive and circulatory death donors showing comparable survival outcomes.