Heart transplantation causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ifrah Fatima, M.B.B.S [2]

Overview

The need for cardiac transplantation may result from advanced, irreversible heart failure with a severely limited life expectancy. Common causes include- Systolic Heart Failure with a Left Ventricular Ejection Fraction less than 35%, Ischemic Coronary Artery Disease with Refractory Angina, Intractable life-threatening Arrhythmias, Cardiomyopathies, and congenital Heart Disease.

Causes

Life-threatening Causes

All the causes listed below are life-threatening as they lead to irreversible heart failure with very low ejection fraction and may cause sudden cardiac death if not optimized.

Common Causes

Common causes and indications that result in the need for cardiac transplantation may include:^[1] ^[2] ^[3]

Systolic Heart Failure with a Left Ventricular Ejection Fraction less than 35%
- Ischemic cardiomyopathy
- Dilated cardiomyopathy
- Valvular heart disease
- Hypertensive heart disease
- Etiologies which are excluded are amyloid, HIV, and cardiac sarcoma
Ischemic Coronary Artery Disease with Refractory Angina
Intractable life-threatening Arrhythmias
- Ventricular arrhythmias which are not controlled by an implantable cardioverter-defibrillator
Cardiomyopathies
- Restrictive and Hypertrophic Cardiomyopathies with NYHA Class IV heart failure symptoms
- Non-dilated cardiomyopathies
Congenital Heart Disease
- New York Heart Association functional class IV Heart Failure not amenable to surgery.

References

↑ Mehra MR, Canter CE, Hannan MM, Semigran MJ, Uber PA, Baran DA; et al. (2016). “The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: A 10-year update”. J Heart Lung Transplant. 35 (1): 1–23. doi:10.1016/j.healun.2015.10.023. PMID 26776864.
↑ Alraies MC, Eckman P (2014). “Adult heart transplant: indications and outcomes”. J Thorac Dis. 6 (8): 1120–8. doi:10.3978/j.issn.2072-1439.2014.06.44. PMC 4133547. PMID 25132979.
↑ Lund LH, Khush KK, Cherikh WS, Goldfarb S, Kucheryavaya AY, Levvey BJ; et al. (2017). “The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Heart Transplantation Report-2017; Focus Theme: Allograft ischemic time”. J Heart Lung Transplant. 36 (10): 1037–1046. doi:10.1016/j.healun.2017.07.019. PMID 28779893.

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[pmid26776864-1] Mehra MR, Canter CE, Hannan MM, Semigran MJ, Uber PA, Baran DA; et al. (2016). “The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: A 10-year update”. J Heart Lung Transplant. 35 (1): 1–23. doi:10.1016/j.healun.2015.10.023. PMID 26776864.

[pmid25132979-2] Alraies MC, Eckman P (2014). “Adult heart transplant: indications and outcomes”. J Thorac Dis. 6 (8): 1120–8. doi:10.3978/j.issn.2072-1439.2014.06.44. PMC 4133547. PMID 25132979.

[pmid28779893-3] Lund LH, Khush KK, Cherikh WS, Goldfarb S, Kucheryavaya AY, Levvey BJ; et al. (2017). “The Registry of the International Society for Heart and Lung Transplantation: Thirty-fourth Adult Heart Transplantation Report-2017; Focus Theme: Allograft ischemic time”. J Heart Lung Transplant. 36 (10): 1037–1046. doi:10.1016/j.healun.2017.07.019. PMID 28779893.

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