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The Path From Heart Failure to Cardiac Transplant

Freeman, Regi MSN, RN, ACNS-BC; Koerner, Erika BSN, RN, CSC; Clark, Courtney MSN, RN, FNP-BC, CCRN, CSC, CMC; Halabicky, Kathy MSN, RN, ACNP-BC

doi: 10.1097/CNQ.0000000000000114
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Heart failure is a progressive and fatal disease impacting millions of American each year. Divided into stages, heart failure presents with progressive symptoms requiring a wide range of medical treatments. Treatments include diet and lifestyle changes, medications, electrical therapies (defibrillator and/or cardiac resynchronization therapy), as well as mechanical circulatory support. Cardiac transplant is the gold standard treatment of heart failure, although the availability of donors limits the utility of a cardiac transplant. This article outlines heart failure treatments and the indications, contraindications, and pretransplant evaluation for a cardiac transplant. Information on the allocation of donor hearts and donor characteristics is also included for the reader.

Samuel and Jean Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor (Mss Freeman, Koerner, Clark, and Halabicky); and University of Michigan School of Nursing, Ann Arbor (Mss Freeman and Halabicky).

Correspondence: Regi Freeman, MSN, RN, ACNS-BC, 4726C Cardiovascular ICU, Samuel and Jean Frankel Cardiovascular Center, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI 48109 (colthorp@med.umich.edu).

This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. We acknowledge the care provided by our extraordinary multidisciplinary team at the Samuel and Jean Frankel Cardiovascular Center at the University of Michigan. We could not provide the finest care to our patients without our nursing staff, advance practice team, respiratory therapists, physical and occupational therapists, spiritual care professionals, heart failure team, pharmacists, social workers, case managers, perfusionists, surgeons, intensivist team, and many others. Special thanks go to Dr Francis Pagani, Director of the Center for Circulatory Support and the Heart Transplant Program, and Dr Jonathan Haft, Director of the Extracorporeal Membrane Oxygenation Program, for their review and assistance with the manuscript.

The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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