Cardiac transplantation: indications, eligibility and current outcomes

Bhagra, Sai; Pettit, Stephen; Parameshwar, Jayan

doi:10.1136/heartjnl-2018-313103

Cited by 52 publications

(41 citation statements)

References 69 publications

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“…The sequence and timing of coronary revascularization and kidney transplantation have always been debatable. Cardiac transplantation in ESRD is contraindicated . Similarly, isolated kidney transplantation in heart failure is equally questionable.…”

Section: Clinical Decision‐making: Processes and Problemsmentioning

confidence: 99%

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Kidney transplantation and cardiomyopathy: Concepts and controversies in clinical decision‐making

Jha

Lata

2020

Clinical Transplantation

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Increasing comorbidities and an aging population have led to a tremendous increase in the burden of both kidney and cardiac dysfunction. Concomitant cardiomyopathy exposes the patients with kidney disease to further physiological, hemodynamic, and pathologic alterations. Kidney transplantation imposes lesser anesthetic and surgical complexities compared to another solid organ transplant. The surgical decision‐making remains an unsettled issue in these conditions. The surgical choices, techniques, and sequences in kidney transplant and cardiac surgery depend on the pathophysiological perturbations and perioperative outcomes. The absence of randomized controlled trials eludes us from suggesting definite management protocol in patients with end‐stage kidney disease with cardiomyopathy. Nevertheless, in this review, we extracted data from published literature to understand the pathophysiologic interactions between end‐stage renal diseases with cardiomyopathy and also proposed the management algorithm in this challenging scenario. The proposed management algorithm would ensure consensus across all stakeholders involved in decision‐making. Our simplistic evidence‐based approach would augur future randomized trials and would further ensure refinement in our management approach after the emergence of more definitive evidence.

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Section: Clinical Decision‐making: Processes and Problemsmentioning

confidence: 99%

“…Cardiac transplantation in ESRD is contraindicated. 32 Similarly, isolated kidney transplantation in heart failure is equally questionable. Therapeutic optimization of heart failure as suggested by the ESC guideline may not be attained in patients with ESRD.…”

Section: Clinic Al Decis Ion -Making : Pro Ce Ss E S and Prob Lemsmentioning

confidence: 99%

Kidney transplantation and cardiomyopathy: Concepts and controversies in clinical decision‐making

Jha

Lata

2020

Clinical Transplantation

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“…All patients are prescribed statin therapy after transplantation to lower cholesterol, improve 1-year survival and reduce the likelihood of cardiac allograft vasculopathy (CAV). 32 Statins are contraindicated in pregnancy and must be stopped when pregnancy is confirmed. Up to seventy per cent of patients post heart transplant develop hypertension (predominantly due to CNI therapy) and require anti-hypertensive treatment.…”

Section: Immunosuppression and Other Cardiac Medicationmentioning

confidence: 99%

<p>Pregnancy in heart transplant recipients – current perspectives</p>

Watson¹,

Bhagra²,

Bhagra³

2019

TRRM

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Successful pregnancy with a live birth and preserved graft function is possible in women following cardiac transplantation but requires careful assessment and planning in conjunction with the coordinated care of a specialist multidisciplinary team. Pregnancy poses significant risks to the mother, graft and foetus; these include the challenges of managing immunosuppression to avoid rejection whilst balancing the risks to the foetus from potentially teratogenic medication. This article aims to provide a contemporary perspective on the issues pertaining to pregnancy in heart transplant recipients; describing the pre-conception, pre-partum, intrapartum and postpartum management in this unique group of women.

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“…Heart transplantation (HTx) is a surgery for patients with heart failure who are not eligible for drug or other surgical treatments, involving mechanical assistance such as extracorporeal membrane oxygenation or a ventricular assist device, which is then replaced with a healthier heart [ 1 , 2 ]. Since Barnard performed the world’s first HTx in 1967 [ 3 ], according to the International Society for Heart and Lung Transplantation, there have been approximately 5000 HTx (adult and pediatric) performed every year worldwide [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Developing a Heart Transplantation Self-Management Support Mobile Health App in Taiwan: Qualitative Study

Chen

Wei

Chen

et al. 2020

JMIR Mhealth Uhealth

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Background Heart transplantation (HTx) is the most effective treatment for end-stage heart failure patients. After transplantation, patients face physiological, psychological, social, and other health care problems. Mobile health (mHealth) apps can change the delivery of conventional health care to ubiquitous care and improve health care quality. However, a dearth of mHealth apps exists for patients with HTx worldwide, including in Taiwan. Objective The aim of this study was to investigate the information needed and to develop a preliminary framework for an mHealth app for post-HTx patients. Methods A qualitative approach with individual in-depth interviews was conducted at a heart center in the regional hospital of northern Taiwan from June to November 2017. Patients that had undergone HTx and their health professionals were recruited for purposeful sampling. A semistructured interview guideline was used for individual interviews and transcribed. Thematic analysis was used for data analysis. Results A total of 21 subjects, including 17 patients and 4 health professionals, were recruited for the study. The following five major themes were identified: reminding, querying, experience sharing, diet, and expert consulting. Minor themes included a desire to use the app with artificial intelligence and integration with professional management. Conclusions An intelligent mHealth app that addresses the five main themes and integrates the processes of using a mobile app could facilitate HTx self-management for Taiwanese patients.

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Cardiac transplantation: indications, eligibility and current outcomes

Cited by 52 publications

References 69 publications

Kidney transplantation and cardiomyopathy: Concepts and controversies in clinical decision‐making

Kidney transplantation and cardiomyopathy: Concepts and controversies in clinical decision‐making

<p>Pregnancy in heart transplant recipients – current perspectives</p>

Developing a Heart Transplantation Self-Management Support Mobile Health App in Taiwan: Qualitative Study

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