Alternatives to Heart Transplantation

M. Strüber; R. Lange; J. F. Gummert; F. Beyersdorf; M. Jurmann; C. Schmid; A. El Banayosy; U. C. Hoppe; G. Steinbeck; H. Reichenspurner; A. Liebold; W.-M. Franz; A. Ruhparwar; M. Schmoeckel

doi:10.1055/s-2007-965414

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2007; 55: S147-S167
DOI: 10.1055/s-2007-965414

Position Paper

Alternatives to Heart Transplantation

Symposium of the “Treatment of End-Stage Heart and Lung Failure” Working Group on October 22, 2005 in MunichM. Strüber¹ , R. Lange² , J. F. Gummert³ , F. Beyersdorf⁴ , M. Jurmann⁵ , C. Schmid⁶ , A. El Banayosy⁷ , U. C. Hoppe⁸ , G. Steinbeck⁹ , H. Reichenspurner¹⁰ , A. Liebold¹¹ , W.-M. Franz⁹ , A. Ruhparwar¹ , M. Schmoeckel¹²

¹Herz-, Thorax-, Transplantantions- u. Gefäßchirurgie, Medizinische Hochschule Hannover
²Klinik für Herz- und Gefäßchirurgie, Deutsches Herzzentrum München
³Klinik für Herz- und Thoraxchirurgie, Friedrich-Schiller-Universität Jena
⁴Abteilung für Herz- und Gefäßchirurgie, Universität Freiburg
⁵Klinik für Herz-, Thorax- und Gefäßchirurgie, Deutsches Herzzentrum Berlin
⁶Klinik und Poliklinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Universitätsklinikum Regensburg
⁷Klinik für Thorax- und Gefäßchirurgie, Herz und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen
⁸Klinik III für Innere Medizin, Universität zu Köln
⁹Medizinische Klinik und Poliklinik I Großhadern der Ludwig-Maximilians-Universität München
¹⁰Klinik und Poliklinik für Herz- und Gefäßchirurgie des Universitären Herzzentrums Hamburg
¹¹Klinik und Poliklinik für Herzchirurgie der Universität Rostock
¹²Herzchirurgische Klinik am Klinikum Großhadern, Ludwig-Maximilians-Universität München

Abstract

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Abstract

Heart transplantation is currently the treatment of first choice in patients with end-stage refractory heart failure. But already the demand for donor organs cannot be met, and patients face long waiting times for transplantation. In the future waiting times will become even longer as life expectancy increases and the number of heart-failure patients requiring transplantation grows. Consequently, in view of the poor prognosis of the disease in its advanced stages, alternatives to heart transplantation are increasingly gaining importance. In recent years new innovative treatment methods and techniques have been developed which have already proved clinically successful in patients with end-stage heart failure, especially as bridging measures. Some of these techniques appear suitable for long-term use and could therefore serve as an alternative to heart transplantation in some patients. Interesting new avenues of research may even lead to cardiac cell replacement therapies in the future. These approaches are currently undergoing initial clinical trials. This report presents surgical and cardiologic treatments for end-stage heart failure that have already been clinically investigated as well as techniques that are still in the preclinical stage and discusses their potential as alternatives to heart transplantation.

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References

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PD Dr. M. Strüber

Herz-, Thorax-, Transplantations- und Gefäßchirurgie
Medizinische Hochschule Hannover

Carl-Neuberg-Straße 1

30625 Hannover

Germany

Email: strueber.martin@mh-hannover.de