Korean Circ J.  2018 Jul;48(7):565-590. 10.4070/kcj.2018.0189.

The Past, Present and Future of Heart Transplantation

Affiliations
  • 1Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Korea.
  • 2Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea. jong.chan.youn@gmail.com
  • 3Division of Cardiology, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA. Kobashigawaj@cshs.org

Abstract

Heart transplantation (HTx) has become standard treatment for selected patients with end-stage heart failure. Improvements in immunosuppressant, donor procurement, surgical techniques, and post-HTx care have resulted in a substantial decrease in acute allograft rejection, which had previously significantly limited survival of HTx recipients. However, limitations to long-term allograft survival exist, including rejection, infection, coronary allograft vasculopathy, and malignancy. Careful balance of immunosuppressive therapy and vigilant surveillance for complications can further improve long-term outcomes of HTx recipients.

Keyword

Heart transplantation; History; Current practice; Forecasting; Heart failure

MeSH Terms

Allografts
Forecasting
Heart Failure
Heart Transplantation*
Heart*
Humans
Tissue Donors

Figure

  • Figure 1 Number of HTx (adult and pediatric) by year and geographic region.HTx = heart transplantation.

  • Figure 2 Current status of HTx and risk modification strategy.AMR = antibody-mediated rejection; HTx = heart transplantation; MCS = mechanical circulatory support; PGD = primary graft dysfunction.

  • Figure 3 Temporal trends in HTx in Korea after 2000.HTx = heart transplantation.

  • Figure 4 Balanced HTx listing strategy.HTx = heart transplantation.

  • Figure 5 Physiology of the transplanted heart. Blue arrow indicates blockage of the nerve fibers, red arrow indicates remained effect of circulatory catecholamines.HR = heart rate; SA = sinoatrial.


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