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Herztransplantation vs. „Destination“-Therapie

Behandlungsoptionen beim älteren Patienten

Heart transplantation versus destination therapy

Treatment options in elderly patients

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Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

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Zusammenfassung

Die Herztransplantation im fortgeschrittenen Lebensalter zählt zu den am meisten diskutierten und umstrittenen Fragen in der Herzchirurgie. In einigen Transplantationszentren wird erhöhtes Lebensalter immer noch als Kontraindikation angesehen. Mit Verbesserung der Immunsuppression und damit der Langzeitergebnisse nach Herztransplantation hat sich die Altersgrenze im Laufe der Zeit nach oben verschoben. Dazu beschreibt die vorliegende Arbeit die gegenwärtige Studienlage. Auch gibt sie Ausblick auf neue Allokationsstrategien aufgrund weiterhin bestehender Spenderknappheit, die bereits in naher Zukunft eine Herztransplantation wieder auf jüngere Empfänger einschränken könnten. Erläuterungen zum aktuellen Stand der „Destination-Therapie“ als Alternative zur Herztransplantation bilden den zweiten Teil der Arbeit.

Abstract

Advanced recipient age represents a contraindication in numerous transplant centers worldwide. Due to mprovements in immunosuppression and therefore also of long-term results after heart transplantation, more and more older patients are being listed for transplantation. The present paper describes the literature regarding heart transplantation in advanced age. Nevertheless, because of new allocation strategies in times of persistent donor organ shortage, heart transplantation could be restricted to younger recipients in the near future. Therefore, in the second part of the present paper the so-called destination therapy as an alternative to heart transplantation is described.

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Authors and Affiliations

  1. Klinik für Herzchirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    N. Reiss, M. Karck & A. Ruhparwar

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  1. N. Reiss
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  2. M. Karck
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  3. A. Ruhparwar
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Correspondence to N. Reiss.

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Reiss, N., Karck, M. & Ruhparwar, A. Herztransplantation vs. „Destination“-Therapie. Z Herz- Thorax- Gefäßchir 27, 302–307 (2013). https://doi.org/10.1007/s00398-013-1016-0

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  • DOI: https://doi.org/10.1007/s00398-013-1016-0

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