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Indications and contraindications for cardiac transplantation in adults

Donna Mancini, MD
Section Editor
Sharon A Hunt, MD
Deputy Editor
Susan B Yeon, MD, JD, FACC


Cardiac transplantation is the treatment of choice for many patients with end-stage heart failure (HF) who remain symptomatic despite optimal medical therapy. Risk stratification of patients with end stage HF is pivotal for transplant candidate selection. The primary indications for cardiac transplantation, along with specific inclusion and exclusion criteria, are discussed here.

Treatment of refractory HF and prognosis after cardiac transplantation are discussed separately. (See "Management of refractory heart failure with reduced ejection fraction" and "Prognosis after cardiac transplantation".)  


Non-ischemic cardiomyopathy and coronary artery disease are the disease processes leading to the vast majority of cardiac transplants, though increasing numbers of adults with complex congenital heart disease or requiring re-transplantation are represented (figure 1) [1]. For additional information, see http://www.ishlt.org/registries/slides.asp?slides=heartLungRegistry.


The process of evaluating potential candidates for cardiac transplantation includes the following steps:

Determining whether an indication for listing for cardiac transplantation is present. Patients with an indication for listing should be referred to a transplant center for cardiac transplantation evaluation. (See 'Indications for cardiac transplantation' below.)

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Literature review current through: Nov 2017. | This topic last updated: Jan 03, 2017.
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