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Review
. 2024 Feb;95(2):101-107.
doi: 10.1007/s00104-023-01981-z. Epub 2023 Nov 13.

[Heart transplantation : Current situation]

[Article in German]
René Schramm  1 , Jan F Gummert  2
Affiliations
Review

[Heart transplantation : Current situation]

[Article in German]
René Schramm et al. Chirurgie (Heidelb). 2024 Feb.

Abstract
in English, German

Heart transplantation is the gold-standard in the treatment of terminal heart failure. The shortage of donor hearts represents the major obstacle in patient care and necessitates the creation of waiting lists and allocation algorithms. The Transplantation Act regulates donor heart allocation according to the urgency and the prospects of success. Donor hearts can be implanted following the classical biatrial or the modern bicaval valve implantation technique with a slightly lower spectrum of complications. Modern mechanical perfusion systems enable extended transport times. After heart transplantation rejection reactions must be controlled by an individually adjusted immunosuppression to guarantee long-term survival with as few complications as possible.

Die Herztransplantation ist der Goldstandard in der Behandlung der terminalen Herzinsuffizienz. Der Mangel an Spenderherzen stellt das größte Hindernis in der Patientenversorgung dar und erzwingt das Erstellen von Wartelisten und Verteilungsalgorithmen. Das Transplantationsgesetz sieht die Vergabe von Spenderherzen nach Dringlichkeit und Erfolgsaussicht vor. Zur Implantation von Spenderherzen wird die klassische biatriale oder die modernere bikavale Implantationstechnik mit einem etwas niedrigeren Komplikationsspektrum genutzt. Durch moderne Maschinenperfusionssysteme können verlängerte Transportzeiten überwunden werden. Nach einer Herztransplantation müssen durch eine individuell adjustierte Immunsuppression Abstoßungsreaktionen unterdrückt werden, um ein möglichst komplikationsarmes Langzeitüberleben zu gewährleisten.

Keywords: Complications; Donor hearts; Immunosuppression; Implantation technique; Organ shortage; Terminal heart failure.

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References

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