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Selection of patients

Authoring team

  • patients have end-stage cardiac disease
  • must consider the likelihood of improved survival with a heart transplantation compared with the expected survival without a transplant. Survival with a transplant is approximately 80%, 70% and 55% at 1, 5 and 10 years respectively. A heart transplant must make a significant difference with respect to expected patient survival.
  • different aetiologies of patients who have heart transplants include:
    • ischaemic heart disease (about 50%)
    • cardiomyopathies (about 40%)
    • valvular and congenital heart defects (about 5%)
  • upper age limit is usually taken at about 60 years of age
  • absolute contraindications include:
    • serious concomitant pulmonary pathology eg pulmonary hypertension, parenchymal pulmonary disease, recent pulmonary embolism/infarction
    • active infection
    • a continued excess alcohol consumption
    • significant cerebral/systemic vascular disease
    • malignancy

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