Orthotopic heart transplantation

Kenneth K. Liao, Ranjit John, Sara J. Shumway

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Heart transplantation has become the most effective therapy for end-stage congestive heart failure. Since the first human-to-human transplant in 1967, outcomes have changed from relatively poor to a mean survival of more than 11 years, according to data reported in 2012. These improved outcomes and increased numbers of patients receiving orthotopic heart transplants are due to multiple reasons, including changes in immunosuppressive drugs, better management of heart failure patients on the waiting list, increasing use of ventricular assist devices (VADs) as bridge support, improved VAD technology, and improved donor organ preservation. Much of this chapter focuses on details of the orthotopic transplantation procedure itself. Other sections describe the steps involved in accepting transplant recipients and potential contraindications and how patients are prepared for the transplant. Criteria for donor acceptance are also described, as is the critical nature of the target time frame from donor heart availability to transplant, how a donor heart is checked for viability, considerations of posttransplant care including management of immunosuppressive agents, and monitoring for various types of potential rejection and how to treat them.

Original languageEnglish (US)
Title of host publicationCongestive Heart Failure and Cardiac Transplantation
Subtitle of host publicationClinical, Pathology, Imaging and Molecular Profiles
PublisherSpringer International Publishing
Pages431-447
Number of pages17
ISBN (Electronic)9783319445779
ISBN (Print)9783319445755
DOIs
StatePublished - Jun 1 2017

Keywords

  • Biatrial anastomosis
  • Bicaval anastomosis
  • Cardiectomy
  • Donor organ allocation
  • End-stage heart failure
  • Heart transplant surgery
  • Immunosuppression
  • Orthotopic heart transplantation
  • Ventricular assist device

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