Journal article
Heart transplantation: current practice and outlook to the future.
- Hullin R Service de Cardiologie, Département de Médecine Interne, Centre Hospitalier Universitaire (CHUV), Faculté Biologie et Médecine d'UNIL, Lausanne, Switzerland.
- 2014-08-08
Published in:
- Swiss medical weekly. - 2014
Adrenal Cortex Hormones
Bone Diseases
Comorbidity
Diabetes Mellitus
Forecasting
Graft Rejection
Heart Failure
Heart Transplantation
Humans
Hypertension
Immunosuppression
Immunosuppressive Agents
Neoplasms
Patient Selection
Renal Insufficiency, Chronic
English
QUESTIONS UNDER STUDY
The field of heart transplantation has seen substantial progress in the last 40 years. The breakthroughs in long-term survival were followed by a period of stagnation in the last decade. This review summarises current recommendations for the identification of candidates for heart transplantation and their immunological and non-immunological postoperative follow-up.
RESULTS
The progress made in the treatment of patients with advanced heart failure has considerably changed the profile of candidates for heart transplantation. Patients are older, and the load of co-morbidities is more important requiring careful evaluation for candidacy. Long-standing research in the field of immunosuppression made available various drugs, which decrease the risk of acute allograft rejection and prolong survival after heart transplantation. Powerful new molecules are entering early phase clinical studies, suggesting further improvement in the near future. As a consequence, treatment of non-immunological co-morbidity after heart transplantation will gain in importance, however, the base of evidence guiding current recommendations is poor.
CONCLUSIONS
The substantial progress in heart failure treatment and immunosuppression after heart transplantation has changed the profile of heart transplant recipients. The arrival of new molecules will provide additional alternatives for immunosuppressive treatment while studies have to address non-immunological treatment in order to improve long-term survival after heart transplantation.
The field of heart transplantation has seen substantial progress in the last 40 years. The breakthroughs in long-term survival were followed by a period of stagnation in the last decade. This review summarises current recommendations for the identification of candidates for heart transplantation and their immunological and non-immunological postoperative follow-up.
RESULTS
The progress made in the treatment of patients with advanced heart failure has considerably changed the profile of candidates for heart transplantation. Patients are older, and the load of co-morbidities is more important requiring careful evaluation for candidacy. Long-standing research in the field of immunosuppression made available various drugs, which decrease the risk of acute allograft rejection and prolong survival after heart transplantation. Powerful new molecules are entering early phase clinical studies, suggesting further improvement in the near future. As a consequence, treatment of non-immunological co-morbidity after heart transplantation will gain in importance, however, the base of evidence guiding current recommendations is poor.
CONCLUSIONS
The substantial progress in heart failure treatment and immunosuppression after heart transplantation has changed the profile of heart transplant recipients. The arrival of new molecules will provide additional alternatives for immunosuppressive treatment while studies have to address non-immunological treatment in order to improve long-term survival after heart transplantation.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.4414/smw.2014.13977
- PMID 25102016
- Persistent URL
- https://sonar.ch/global/documents/20283
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