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Cardiac transplantation and mechanical circulatory support 

Cardiac transplantation and mechanical circulatory support
Chapter:
Cardiac transplantation and mechanical circulatory support
Author(s):

Jayan Parameshwar

, and Steven Tsui

DOI:
10.1093/med/9780198746690.003.0351
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date: 28 July 2021

Cardiac transplantation is the treatment of choice for selected patients with advanced heart failure: median survival approaches 12 years and recipients enjoy an excellent quality of life, but availability is severely limited by shortage of donor organs. The need for lifelong immunosuppression is associated with side effects, including an increased incidence of malignancy. Newer immunosuppressive agents reduce nephrotoxicity and delay the onset of cardiac allograft vasculopathy, but may produce other side effects. Ventricular assist devices are mechanical blood pumps that work in parallel or series with the native ventricles. First-generation volume-displacement pulsatile ventricular assist devices have been superseded by rotary blood pumps that generate continuous flow. Significant complications include bleeding, thromboembolism, device failure due to pump thrombosis, and infection.

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