| Theme |
Renal Transplantation in Organ-Sharing-Network |
| Title |
The review of the current status of clinical heart transplantation |
| Author |
Goro Matsumiya |
Department of Surgery, Course of Interventional Medicine, Osaka University Graduate School of Medicine |
| Author |
Hikaru Matsuda |
Department of Surgery, Course of Interventional Medicine, Osaka University Graduate School of Medicine |
| [ Summary ] |
The number of heart transplants performed worldwide annually has plateued at around 3,000 cases. The long-term survival rate however has not improved recently mainly from the post-transplant coronary artery disease, which is the focus of intense investigation. The bicaval anastomosis method has been substituted for the Lower-Shumway method as the surgical procedure of choice. The left ventricular assist system is being utilized more frequently because it enables the stabilization of the recipients' condition and rehabilitation takes place under circulatory support. A serious shortage of donor hearts has made it necessary to accept marginal donors, who have some risk factors for early or late graft failure. Six cardiac transplantats from brain dead donors have been performed successfully in Japan since 1999. The expansion of the donor pool is mandatory to promote this procedure as the choice for surgical management of end-stage heart failure patients. |