This work provides a one-of- a-kind volume that includes all aspects of heart transplantation from its historic beginning to its current day standards which now make the procedure a long-term treatment option for heart failure patients. The subjects covered include technical aspects of the procurement and implant procedures, as well as the medical nuances of pre-operative preparation and post-transplant immunosuppression management; the current day multi-disciplinary make up of the transplant team along with information on the keys to building and running a successful transplant program; regulatory standards and listing policies and the impact of the growing mechanical circulatory support technologies on the transplant field; and emerging technologies and future possibilities. All chapters are written by experts in the field and include the most up-to-date peer reviewed studies and clinical guidelines. This book gives an ever-changing reference that will become the text of choice for those beginning or continuing their transplant careers.
Section 1: Historical Background.- History of Heart Transplant.- Immunosuppression related to transplant.- Section 2: Pre-operative evaluation process.- Pathophysiology of heart failure.- Contraindications to heart transplantation.- Psycho-Social considerations.- Multi-disciplinary team input.- Section 3: Organ Allocation.- Current Listing System.- Proposed Changes.- Matching donor to recipient.- Section 4: Organ Procurement.- Organ preservation.- The donor operation.- Ex Vivo perfusion.- Section 5: Transplant Operation.- Surgical techniques.- Surgical Complications.- Section 6: Anesthesia Management.- Anesthesia techniques for heart transplant.- Section 7: Post-operative ICU and hospital management.- Ventilator management.- Weaning of inotropes.- Imaging studies and laboratory testing.- Physical and Occupational therapy.- Section 8: Transplant Immunology.- Induction and maintenance agents.- Complication of immunosuppression.- Rejection.- Section9: Long term outpatient management of the heart transplant patient.- Chronic immunosuppression medications.- Infection prophylaxis.- Monitoring for rejection.- Section 10: Mechanical Support of the pre-transplant patient.- ECMO.- LVAD support.- Section 11: The Contemporary successful Heart transplant program.- Regulatory agencies.- Quality measures.- The financial aspect of the heart transplant program.- The multi-disciplinary approach.- Administrative support of the program.- Section 12: Special Topics.- Re-transplantation.- Combined Heart transplant with other organ transplantation.- Section 13,Outcomes Data.- Survival data.- Quality of life.- Chronic rejection.- Malignancy after transplant.- Section 14: The future of heart transplantation.- Advances in immunosuppression.- Stem cell therapy.- DCD donor use.- Will we still be doing heart transplants in 10 years.