Heart Transplantation

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Narrod Ja - One of the best experts on this subject based on the ideXlab platform.

Neerukonda Sk - One of the best experts on this subject based on the ideXlab platform.

M R Costanzo - One of the best experts on this subject based on the ideXlab platform.

  • Selection and treatment of candidates for Heart Transplantation.
    Seminars in thoracic and cardiovascular surgery, 1996
    Co-Authors: M R Costanzo
    Abstract:

    Improved outcome of Heart failure in response to medical therapy, coupled with a critical shortage of donor organs, make it imperative to confine Heart Transplantation to patients who are most disabled by Heart failure and who are likely to derive the maximum benefit from Heart Transplantation. Hemodynamic and functional indices of prognosis (such as peak exercise oxygen consumption) has improved the ability to identify adult patients who should be selected for Heart Transplantation. These patients should have a poor prognosis despite optimization of medical and surgical therapy. When deciding the impact of individual comorbid conditions on a patient's candidacy for Heart Transplantation, the detrimental effects of each comorbid condition on post Heart Transplantation outcome should be weighed. Evaluation of patients with severe Heart failure should be done by a multidisciplinary team expert in the management of Heart failure, performance of cardiac surgery in patients with low left ventricular ejection fractions, and Transplantation. Potential Heart Transplantation candidates should be reevaluated on a regular basis to assess the continued need for Heart Transplantation.

  • Candidate evaluation and selection for Heart Transplantation.
    Current opinion in cardiology, 1995
    Co-Authors: W. Kao, E. Winkel, M R Costanzo
    Abstract:

    Because of the increasing discrepancy between the number of identified candidates for Heart Transplantation and available donor organs, appropriate selection of patients for Heart Transplantation is critical. The establishment of a cardiac prognosis that is significantly worse than that following Heart transplant is central in the determination of candidacy for Transplantation. However, with recent improvements in Heart failure management, prognosis must be considered a dynamic state involving periodic reassessment to ensure an individual's ongoing suitability for Transplantation. There have been many descriptions of prognostic indexes in Heart failure, but care must be used when extrapolating observations collected from patients with a broad range of conditions to those with end-stage disease. The contraindications to Heart Transplantation have also evolved with the increasing success of the transplant process. Many conditions that precluded patients from Heart transplant in the past are no longer regarded as absolute. Despite less stringent conditions for recipient candidacy, the need to achieve optimal results with an increasingly valuable donor resource will necessitate careful scrutiny of the posttransplant implications of the various conditions currently regarded as contraindications to Heart transplant. Determination of Heart Transplantation candidacy therefore continues to remain a highly individualized process, requiring clinical judgment and experience.

Nampalli Vk - One of the best experts on this subject based on the ideXlab platform.

Fred W. Schoonmaker - One of the best experts on this subject based on the ideXlab platform.