Integrating risks and benefits: pretransplant assessment and patient selection for heart transplantation in adult congenital heart disease.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9717388 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-7013 (Electronic) Linking ISSN: 10872418 NLM ISO Abbreviation: Curr Opin Organ Transplant Subsets: MEDLINE

Publication: <2003->: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Philadelphia, PA : Rapid Science Publishers,

Heart Transplantation*/adverse effects ; Patient Selection* ; Heart Defects, Congenital*/surgery ; Heart Failure*/surgery ; Heart Failure*/physiopathology; Humans ; Risk Assessment ; Risk Factors ; Treatment Outcome ; Adult ; Clinical Decision-Making ; Time Factors

Purpose of Review: The number of adult congenital heart disease (ACHD) patients presenting for consideration of heart transplantation continues to grow. Comprehensive pretransplant assessment and thoughtful patient selection are of critical importance to mitigate perioperative and posttransplant morbidity and mortality in this population.
Recent Findings: There is increasing evidence that patient outcomes after the onset of heart failure in the ACHD population are poor while overall transplant outcomes for ACHD patients have improved over time. Delineation of factors associated with better versus worse posttransplant outcomes is an area of ongoing research. Several studies have found that delayed patient referral, anatomic complexity and the presence of noncardiac organ dysfunction may increase peri-transplant and posttransplant risk.
Summary: Pretransplant assessment and patient selection in ACHD patients should focus on mitigating perioperative and early posttransplant risk. Anatomic complexity, noncardiac organ dysfunction, and referral timing after the onset of heart failure can contribute to poor posttransplant outcomes and should inform patient selection.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

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Date Created: 20240731 Date Completed: 20240903 Latest Revision: 20240903

20240903

10.1097/MOT.0000000000001170

39082967