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DOI: 10.1055/s-2007-995638
© Georg Thieme Verlag KG Stuttgart · New York
Herztransplantation heute - ein Update
Publikationsverlauf
Publikationsdatum:
11. März 2008 (online)
![](https://www.thieme-connect.de/media/kardiologie-u2d/200801/lookinside/thumbnails/10.1055-s-2007-995638-1.jpg)
Abstract
On the third of december 1967 the first human heart transplantation was performed. During the last decades the evolution of clinical heart transplantation went from a hazardous adventure towards a safe and very successful treatment for end-stage heart failure patients. The major limiting factor is the shortage of donor organs. Patients with end-stage heart failure without any treatment options for conventional heart surgery or medical treatment are suitable candidates for heart transplantation. The major contraindication is a refractory pulmonary hypertension with a high risk for postoperative right heart failure. Due to the lack of donor organs, there is an age limitation above 65 years for the acceptance of patients in the majority of transplant centers. The distribution of donor organs is regulated by the german transplant law with eurotransplant as the executive organization. Within an acceptable cold ischemic time of 4 hours, harvesting of the donor organ, transportation and implantation of the heart has to be done. The implantation technique was developed by R. Lower and N. Shumway. In some centers, the more advanced total orthotopic heart transplantation is the technique of choice with a reduced risk of AV-valve incompetence. Postoperative treatment is very similar to standard heart surgery patients. The major difference is the immunosuppressive treatment. A balance between the risk of rejection and the risk of infection due to over immunosuppression requires an individual monitoring and tailoring of the medication. Despite the risk of heart transplantation, long term survival with one year survival greater 80 percent and 5 year survival greater than 60 percent in this particular patient group is excellent. Besides survival, quality of live and exercise capability is well restored after heart transplantation.
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Prof. Dr. Falk-Udo Sack
Klinik für Herzchirurgie
Im Neuenheimer Feld 110
69120 Heidelberg
eMail: falk-udo.sack@urz.uni-heidelberg.de