1. Heart transplantation: review.
- Author
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Mangini S, Alves BR, Silvestre OM, Pires PV, Pires LJ, Curiati MN, and Bacal F
- Subjects
- Brazil, Chagas Cardiomyopathy complications, Chagas Cardiomyopathy surgery, Graft Rejection classification, Graft Rejection physiopathology, Heart-Assist Devices, Humans, Immunosuppression Therapy adverse effects, Immunosuppression Therapy methods, Neoplasms chemically induced, Neoplasms complications, Tissue Donors supply & distribution, Graft Rejection complications, Heart Failure surgery, Heart Transplantation methods, Heart Transplantation trends, Opportunistic Infections complications, Postoperative Complications, Primary Graft Dysfunction complications
- Abstract
Heart transplantation is currently the definitive gold standard surgical approach in the treatment of refractory heart failure. However, the shortage of donors limits the achievement of a greater number of heart transplants, in which the use of mechanical circulatory support devices is increasing. With well-established indications and contraindications, as well as diagnosis and treatment of rejection through defined protocols of immunosuppression, the outcomes of heart transplantation are very favorable. Among early complications that can impact survival are primary graft failure, right ventricular dysfunction, rejection, and infections, whereas late complications include cardiac allograft vasculopathy and neoplasms. Despite the difficulties for heart transplantation, in particular, the shortage of donors and high mortality while on the waiting list, in Brazil, there is a great potential for both increasing effective donors and using circulatory assist devices, which can positively impact the number and outcomes of heart transplants.
- Published
- 2015
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