Heart Transplant Candidacy Criteria is Updated

Changes to guidelines include consideration of transplantation in patients with HIV, hepatitis
Changes to guidelines include consideration of transplantation in patients with HIV, hepatitis

HealthDay News — The 2006 listing criteria for heart transplantation have been updated and expanded. The new guideline was published online January 7 in the Journal of Heart and Lung Transplantation.

Mandeep R. Mehra, MD, from Harvard Medical School in Boston, and colleagues of behalf of the International Society for Heart Lung Transplantation (ISHLT) reviewed the evidence to develop an update of the 2006 guidelines listing criteria for heart transplantation.

The authors note that changes to the guidelines include recommendation of a body mass index goal of <35 kg/m² for overweight patients with heart failure; this may result in more patients qualifying for transplantation. The ISHLT recommends listing patients solely on Heart Failure Survival Score criteria. All adult candidates are recommended to undergo right heart catheterization in preparation for cardiac transplantation listing and periodically until transplantation; this is not advocated for routine surveillance in children. For patients with potentially reversible or treatable comorbidities, use of mechanical circulatory support should be considered, with subsequent re-evaluation to establish candidacy. Heart transplantation cannot be recommended for patients with severe cognitive-behavioral disabilities or dementia. Assuming strict management principles are adhered to, patients with HIV infection, hepatitis, Chagas disease, and tuberculosis can be considered suitable candidates.

"The new guidelines not only update several of these prior issues, but also tackle the most controversial topics of our times," Mehra said in a statement.

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