eMedicine Specialties > Transplantation > Surgery

Heart Transplantation: Follow-up

Author: Mary C Mancini, MD, PhD, Professor, Department of Surgery, Louisiana State University Health Sciences Center
Contributor Information and Disclosures

Updated: May 1, 2009

Outcome and Prognosis

The 1-year survival rate after cardiac transplantation is as high as 81.8%, with a 5-year survival rate of 69.8%. A significant number of recipients survive more than 10 years after the procedure. The functional status of the recipient after the procedure is generally excellent, depending upon the motivation of the individual.

Future and Controversies

The future of cardiac transplantation rests upon several issues.

The ongoing shortage of donor organs has fueled a search for alternative therapies for the failing heart. These therapies include artificial assist devices, dual-chamber pacing, new drug interventions, and genetic therapy. These efforts have proven to be successful in reducing the need for transplantation. Research in the area of xenografts continues.18,19

The prevention of allograft vascular disease remains a paramount challenge. This pathology is clearly multifactorial in origin, making the research and therapy equally complex. Resolution of this issue will prolong graft survival and lives.

The question of recipient selection and listing status continues to pose medical and ethical dilemmas. If the donor situation were not an issue, then the listing of potential recipients would not be troublesome.

Finally, in this era of cost containment in health care, the escalating costs of this advanced therapy raises the interesting questions of who should pay for the therapy and whether it should be available on demand.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Deepak M Gangahar, MBBS, MD, to the writing and development of this article.



More on Heart Transplantation

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Workup: Heart Transplantation
Treatment: Heart Transplantation
Follow-up: Heart Transplantation
Multimedia: Heart Transplantation
References
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References

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Further Reading

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Keywords

cardiac replacement, cardiac transplantation, cardiac allograft, cardiopulmonary bypass, cyclosporine, intra-aortic balloon pump, implantable assist devices, coronary artery angioplasty, coronary artery bypass surgery, CABG, valve repair, allografts, xenografts, end-stage congestive heart failure, CHF, ischemic cardiomyopathy, angina, pulmonary disease, malignant cardiac arrhythmias, coronary artery disease, CAD, congenital heart disease, CHD, cytomegalovirus, CMV, rejection, organ donors, organ donation

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Contributor Information and Disclosures

Author

Mary C Mancini, MD, PhD, Professor, Department of Surgery, Louisiana State University Health Sciences Center
Mary C Mancini, MD, PhD is a member of the following medical societies: American Association for Thoracic Surgery, American College of Surgeons, American Surgical Association, Phi Beta Kappa, Society of Thoracic Surgeons, and Southern Surgical Association
Disclosure: Nothing to disclose.

Medical Editor

Richard Thurer, MD, B and Donald Carlin Professor of Thoracic Surgical Oncology, Miller School of Medicine, University of Miami
Richard Thurer, MD is a member of the following medical societies: American Association for Thoracic Surgery, American College of Chest Physicians, American College of Surgeons, American Medical Association, American Thoracic Society, Florida Medical Association, Society of Surgical Oncology, and Society of Thoracic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Shreekanth V Karwande, MBBS, Chair, Professor, Department of Surgery, Division of Cardiothoracic Surgery, University of Utah School of Medicine and Medical Center
Shreekanth V Karwande, MBBS is a member of the following medical societies: American Association for Thoracic Surgery, American College of Chest Physicians, American College of Surgeons, American Heart Association, Society of Critical Care Medicine, Society of Thoracic Surgeons, and Western Thoracic Surgical Association
Disclosure: Nothing to disclose.

CME Editor

Michael E Zevitz, MD, Assistant Professor of Medicine, Finch University of the Health Sciences, The Chicago Medical School; Consulting Staff, Private Practice
Michael E Zevitz, MD is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Medical Association, and Michigan State Medical Society
Disclosure: Nothing to disclose.

Chief Editor

John Geibel, MD, DSc, MA, Vice Chairman, Professor, Department of Surgery, Section of Gastrointestinal Medicine and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital
John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract
Disclosure: AMGEN Royalty Other

 
 
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