Purpose of review: To most effectively utilize available cardiac transplant organ donors clinicians must identify those patients with advanced heart failure whose symptoms are substantial and life expectancy short enough to justify the risks of the procedure and limitations of postoperative management. Reasonable consensus has recently arisen regarding heart transplant patient selection and the purpose of this review is to highlight the basics of the process.
Recent findings: Selecting patients for heart transplantation is a tedious process that involves a multidisciplinary approach. Assessing patient exercise capacity, heart failure mortality risk, and presence and extent of all comorbidities is important. Also essential is the sociologic and psychologic evaluation. More precise clarification of the risks of comorbidities has evolved.
Summary: Advanced heart failure patients meeting more precisely defined and objectively measured metabolic exercise parameters without specific success-limiting comorbidities, as reviewed, have substantial benefit after cardiac transplantation.