Key result
Extended-criteria donors and novel preservation expand the donor pool in heart transplantation.
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This review summarizes contemporary strategies to expand the heart transplant donor pool and adapt to evolving recipient phenotypes under recent allocation policy changes.
Although the burden of end-stage heart failure continues to increase, the number of available organs for heart transplantation (HT) remains inadequate. The HT community has been challenged to find ways to expand the number of donor hearts available. Recent advances include use of hearts from donors infected with hepatitis C virus as well as other previously underutilized donors, including those with left ventricular dysfunction, of older age, and with a history of cocaine use. Concurrently, emerging trends in HT surgery include donation after circulatory death, ex vivo normothermic heart perfusion, and controlled hypothermic preservation, which may enable procurement of organs from farther distances and prevent early allograft dysfunction. Contemporary HT recipients have also evolved in light of the 2018 revision to the U.S. heart allocation policy. This focus seminar discusses recent trends in donor and recipient phenotypes and management strategies for successful HT, as well as evolving areas and future directions.
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DeFilippis et al. (2022) conducted a review in End-stage heart failure. Heart transplantation strategies and donor selection was evaluated. Recent advances in heart transplantation, including the use of extended-criteria donors and novel preservation techniques, aim to expand the donor pool and improve outcomes for end-stage heart failure.
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