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Complications of Cardiac Transplantation

  • Heart Failure (H Eisen, Section Editor)
  • Published:
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Abstract

Purpose of Review

Despite the improvement in medical therapy for heart failure and the advancements in mechanical circulatory support, heart transplantation (HT) still remains the best therapeutic option to improve survival and quality of life in patients with advanced heart failure. Nevertheless, HT recipients are exposed to the risk of several potential complications that may impair their outcomes. In this article, we aim to provide a practical and scholarly framework for clinicians approaching heart transplant medicine, as well as a concise update for the experienced readers on the most relevant post-HT complications.

Recent Findings

While recognizing that most of the treatments herein discussed are based more on experience than on solid scientific evidence, significant step forward has been made in particular in the recognition and management of primary graft dysfunction, antibody-mediated rejection, and renal dysfunction.

Summary

Complications after HT may vary according to the time from surgery and can be related to graft function and pathology or to diseases and dysfunctions occurring in other organs or systems, mainly as side effects of immunosuppressive drugs and progression of pre-existing conditions. Future research needs to focus on improving precision diagnostics of causes of graft dysfunction and on reaching an optimal and customized balance between efficacy and toxicities of immunosuppressive strategies.

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Authors and Affiliations

  1. Heart Transplant Program, Bologna Academic Hospital, Policlinico S. Orsola-Malpighi, Building 25, Via Massarenti, 9, 40138, Bologna, Italy

    Luciano Potena & Francesco Barberini

  2. Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria

    Andreas Zuckermann & Arezu Aliabadi-Zuckermann

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  1. Luciano Potena
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  2. Andreas Zuckermann
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  3. Francesco Barberini
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  4. Arezu Aliabadi-Zuckermann
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Correspondence to Luciano Potena.

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Conflict of Interest

LP received speaker honoraria from Sandoz, One Lambda, and Novartis and institutional grant support from Qiagen.

AZ received speaker honoraria from One Lambda, Sanofi, and Mallincrodt and institutional grant support from Biotest, Chiesi.

AAZ received travel grants from Sanofi and institutional grant support from Fresenius.

FB declares that he has no conflicts of interest to disclose.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Heart Failure

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Potena, L., Zuckermann, A., Barberini, F. et al. Complications of Cardiac Transplantation. Curr Cardiol Rep 20, 73 (2018). https://doi.org/10.1007/s11886-018-1018-3

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