Cardiac transplantation

Abstract

The incidence of heart failure has increased in the recent years due to increased longevity of population, advances in treatment of acute myocardial infarction with the use of thrombolytics and angioplasty, the expansion of cardiac procedures and improvement in diagnosis of the syndrome. With recently incorporated changes in pharmacological treatment there was a significant improvement in patient survival. However, the development of cardiomyopathy to terminal forms is inexorable by the characteristics of the disease and in these situations the heart transplantation may be the only effective alternative. Heart transplantation is the only effective way to restore hemodynamic function of the patient, but has limitations of different orders and do not apply to all candidates. The shortage of viable organs is one of the biggest factors hindering the development of transplant, especially in those organs that are more susceptible to injuries from the shock and ischemia. In Brazil, despite the great progress made in the law of organ transplants, there is still a lack of an effective health policy aimed at promoting the capture and maintenance of appropriate donor organs. Only then this situation can be reversed. Modern immunosuppression works well in control of rejection episodes, but requires greater specificity. Side effects are still a concern and require the strict control of patients in long term. The quality of donor organs and the serious illness of the applicants who come to transplant centers are the main factors responsible for unsatisfactory results in the immediate postoperative period of heart transplantation. The present study aims to present a review of the principal stages that occur in the heart transplantation.