scholarly journals Listing criteria for heart transplantation in the Netherlands

2021 ◽  
Author(s):  
N. de Jonge ◽  
K. Damman ◽  
F. Z. Ramjankhan ◽  
N. P. van der Kaaij ◽  
S. A. J. van den Broek ◽  
...  
Keyword(s):  
The Netherlands ◽  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Tertiary Centre ◽  
Prognostic Stratification ◽  
End Stage ◽  
Timely Referral ◽  
Selection Of

AbstractThe updated listing criteria for heart transplantation are presented on behalf of the three heart transplant centres in the Netherlands. Given the shortage of donor hearts, selection of those patients who may expect to have the greatest benefit from a scarce societal resource in terms of life expectancy and quality of life is inevitable. The indication for heart transplantation includes end-stage heart disease not remediable by more conservative measures, accompanied by severe physical limitation while on optimal medical therapy, including ICD/CRT‑D. Assessment of this condition requires cardiopulmonary stress testing, prognostic stratification and invasive haemodynamic measurements. Timely referral to a tertiary centre is essential for an optimal outcome. Chronic mechanical circulatory support is being used more and more as an alternative to heart transplantation and to bridge the progressively longer waiting time for heart transplantation and, thus, has become an important treatment option for patients with advanced heart failure.

Surgical methods of treatment of chronic heart failure and their place in modern clinical recommendations

2020 ◽  
Vol 22 (4) ◽  
pp. 183-191
Author(s):  
O. T. Kotsoeva ◽  
A. V. Koltsov ◽  
V. V. Tyrenko ◽  
A. A. Ialovets
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricle ◽  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Surgical Methods ◽  
The Moment

This review discusses a number of aspects of surgical methods for treating severe chronic heart failure: resynchronizing therapy, mechanical circulatory support systems, and heart transplantation. Surgical methods for the treatment of heart failure are a rapidly developing field of modern cardiology and cardiac surgery. The main surgical method of treatment was and remains orthotopic transplantation of a donor heart. The advent of implantable systems has affected the problem of heart transplantation. Over the past decade, the use of mechanical circulatory support systems has grown significantly. At the moment, there are 3 main directions: creating devices for auxiliary blood circulation, various modes and methods of electrical stimulation of the myocardium, creating devices that mechanically remodel the heart chambers (left ventricle). All of these directions to some extent (depending on the evidence base) have found their place in modern recommendations for the treatment of chronic heart failure. The use of mechanical left ventricular remodeling shows good results in patients suffering from symptomatic heart failure, which leads to a significant and persistent decrease in the volume of the left ventricle and improvement of its function, symptoms and quality of life. Despite the fact that at the moment the geography and prevalence of their use is small, the number of implanted devices will only grow. Thus, given the need for frequent hospitalizations and high treatment costs, it is necessary to improve modern methods of surgical treatment of severe and terminal heart failure, make them more accessible, which will affect the duration and quality of life of these patients.

A contemporary review of paediatric heart transplantation and mechanical circulatory support

2016 ◽  
Vol 26 (5) ◽  
pp. 851-859 ◽  
Author(s):  
Steven J. Kindel ◽  
Melanie D. Everitt
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Fontan Patient ◽  
Number Of Children ◽  
Acquired Heart Disease ◽  
Number Of Publications ◽  
End Stage

AbstractImprovements in the care of children with cardiomyopathy, CHDs, and acquired heart disease have led to an increased number of children surviving with advanced heart failure. In addition, the advent of more durable mechanical circulatory support options in children has changed the outcome for many patients who otherwise would have succumbed while waiting for heart transplantation. As a result, more children with end-stage heart failure are being referred for heart transplantation, and there is increased demand for a limited donor organ supply. A review of important publications in the recent years related to paediatric heart failure, transplantation, and mechanical circulatory support show a trend towards pushing the limits of the current therapies to address the needs of this growing population. There have been a number of publications focussing on previously published risk factors perceived as barriers to successful heart transplantation, including elevated pulmonary vascular resistance, medication non-adherence, re-transplantation, transplantation of the failed Fontan patient, and transplantation in an infant or child bridged with mechanical circulatory support. This review will highlight some of these key articles from the last 3 years and describe recent advances in the understanding, diagnosis, and management of children with end-stage heart disease.

scholarly journals DURABLE MECHANICAL CIRCULATION SUPPORT AS AN ALTERNATIVE TO HEART TRANSPLANTATION

2016 ◽  
Vol 18 (3) ◽  
pp. 128-136 ◽  
Author(s):  
S. V. Gautier ◽  
G. P. Itkin ◽  
A. O. Shevchenko ◽  
T. A. Khalilulin ◽  
V. A. Kozlov
Keyword(s):  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Assisted Circulation ◽  
Bridge To Recovery ◽  
Myocardial Recovery ◽  
Bridge To Transplant ◽  
Mechanical Circulation ◽  
End Stage ◽  
Prospects Of Application

In the review a comparative analysis of the treatment of end-stage chronic heart failure using heart transplantation and durable mechanical circulatory is conducted. It shows the main advantages and limitations of heart transplantation and the prospects of application of durable mechanical circulatory support technology. The main directions of this technology, including two-stage heart transplant (bridge to transplant – BTT), assisted circulation for myocardial recovery (bridge to recovery – BTR) and implantation of an auxiliary pump on a regular basis (destination therapy, DT). 

scholarly journals Current Status of Mechanical Circulatory Support: A Systematic Review

2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Kyriakos Spiliopoulos ◽  
Gregory Giamouzis ◽  
George Karayannis ◽  
Dimos Karangelis ◽  
Stelios Koutsias ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Public Health Problem ◽  
Current Status ◽  
Circulatory Support ◽  
Major Public Health Problem ◽  
Number Of Patients ◽  
Mechanical Circulatory Support Devices ◽  
End Stage

Heart failure is a major public health problem and its management requires a significant amount of health care resources. Even with administration of the best available medical treatment, the mortality associated with the disease remains high. As therapeutical strategies for heart failure have been refined, the number of patients suffering from the disease has expanded dramatically. Although heart transplantation still represents the gold standard therapeutical approach, the implantation of mechanical circulatory support devices (MCSDs) evolved to a well-established management for this disease. The limited applicability of heart transplantation caused by a shortage of donor organs and the concurrent expand of the patient population with end-stage heart failure led to a considerable utilization of MCSDs. This paper outlines the current status of mechanical circulatory support.

scholarly journals Mechanical circulatory support saves lives – three years’ experience of the newly established assist device program at Semmelweis University

2015 ◽  
Vol 156 (13) ◽  
pp. 521-527
Author(s):  
Levente Fazekas ◽  
Balázs Sax ◽  
István Hartyánszky ◽  
Miklós Pólos ◽  
Ferenc Horkay ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Right Heart Failure ◽  
Circulatory Support ◽  
Assist Device ◽  
Cardiac Assist ◽  
Cardiac Assist Device ◽  
End Stage Heart Failure ◽  
End Stage

Introduction: Since the celebration of the 20th anniversary of the first heart transplantation in Hungary in 2012 the emerging need for modern heart failure management via mechanical circulatory support has evolved. In May 2012 the opening of a new heart failure and transplant unit with 9 beds together with the procurement of necessary devices at Semmelweis University accomplished this need. Aim: The aim of the authors was to report their initial experience obtained in this new cardiac assist device program. Method: Since May, 2012, mechanical circulatory support system was applied in 89 cases in 72 patients. Indication for support were end stage heart failure refractory to medical treatment and acute left or right heart failure. Results: Treatment was initiated for acute graft failure after heart transplantation in 27 cases, for end stage heart failure in 24 cases, for acute myocardial infarction in 21 cases, for acute postcardiotomy heart failure in 14 cases, for severe respiratory insufficiency in 2 cases and for drug intoxication in one case. Among the 30 survivor of the whole program 13 patients were successfully transplanted. Conclusions: The available devices can cover all modalities of current bridge therapy from short term support through medium support to heart transplantation or long term support and destination therapy. These conditions made possible the successful start of a new cardiac assist device program. Orv. Hetil., 2015, 156(13), 521–527.

Mechanical circulatory support: 60 years of evolving knowledge

2019 ◽  
Vol 42 (5) ◽  
pp. 215-225 ◽  
Author(s):  
Amedeo Terzi
Keyword(s):  
Mechanical Circulatory Support ◽  
Flow Dynamics ◽  
Circulatory Support ◽  
Clinical Aspects ◽  
Bridge To Recovery ◽  
Future Directions ◽  
Acute Complications ◽  
Patient Health ◽  
Selection Of

Since the 1950s when the first devices for mechanical circulatory support were developed, there has been an impressive evolution of their technology. The first pioneering pumps were used to rescue acute complications after cardiac surgery. Advances in technology, increased knowledge of flow dynamics, and a more appropriate selection of the patients who actually need this support have contributed to significantly improve the benefits of this therapy. Today, mechanical circulatory support is an essential tool for the treatment of advanced heart failure. This strategy is used either as a bridge to heart transplantation or as a destination therapy for patients who do not meet the transplant criteria. A third indication is the bridge to recovery option for those patients in whom the improvement in cardiac function may be so important that the pump can be removed and the transplantation circumvented. In addition, mechanical circulatory support has fostered marked improvements in several clinical aspects affecting both patient health and quality of life. Despite the improvements in the technology of the devices of the last generation, severe adverse effects are still the Achilles heel of mechanical circulatory support therapy. This review summarizes the history, the technology, the clinical outcomes, and the possible future directions of this therapy.

scholarly journals Orthotopic Heart Transplantation and Mechanical Circulatory Support in Cancer Survivors: Challenges and Outcomes

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Nina Ghosh ◽  
John Hilton
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Mechanical Circulatory Support ◽  
Significant Proportion ◽  
Left Ventricular ◽  
Circulatory Support ◽  
Orthotopic Heart Transplantation ◽  
Advanced Therapies ◽  
End Stage Heart Failure ◽  
End Stage

Chemotherapy-induced cardiomyopathy (CCMP) is a significant cause of morbidity and mortality. Compared to cardiomyopathy due to other causes, anthracycline-induced cardiomyopathy is associated with a worse survival. As cancer survival improves, patients with CCMP can be expected to comprise a significant proportion of patients who may require advanced therapies such as inotropic support, cardiac transplantation, or left ventricular assist device (LVAD). Distinct outcomes related to advanced therapies for end-stage heart failure in this patient population may arise due to unique demographic characteristics and comorbidities. We review recent literature regarding the characteristics of patients who have survived cancer undergoing orthotopic heart transplantation and mechanical circulatory support for end-stage heart failure. The challenges and outcomes of advanced therapies for heart failure related specifically to anthracycline-induced cardiomyopathy are emphasized.

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