New Issues in Heart Transplantation for Heart Failure
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Opinion statement
Heart transplantation is the preferred therapy for patients with end-stage heart failure with refractory symptoms despite optimal medical and device therapy. The major impediment to survival is rejection and infection in the short term and cardiac allograft vasculopathy and malignancy in the long term. Current therapies are focused on the prevention and treatment of rejection and limiting the long-term problems of cardiac allograft vasculopathy and malignancy. Advances in monitoring assays now allow better assessment of rejection and the level of immune response. This will allow clinicians, in the future, to tailor current therapies to the needs of individual heart transplant recipients to maximize benefit and minimize toxicity.
Keywords
Heart failure Transplant Biopsy AlloMap Cylex Immunosuppression Corticosteroids Calcineurin inhibitors Antimetabolites Proliferation signal inhibitors Antithymocyte globulin Basiliximab Intravenous immunoglobulin Plasmapheresis Photopheresis Rituximab BortezomibNotes
Disclosure
No conflicts of interest relevant to this article are reported.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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