Abstract
Considering the exponential increase in organ demand with a stable donor supply, cardiac donor management and selection is of utmost importance. The criteria for an acceptable donor have changed dramatically over the last 40 years and transplant teams are accepting older patients, longer ischemic times, donor substance abuse, and sometimes donor infection. Expanding the donor pool to the “increased risk” donors has enforced a more complex balance of donor and recipient components. A risk benefit ratio is commonly explored to provide the best donor to the more stable patient and accept an increased-risk donor in the patient with a shorter life expectancy. Patients with more urgent status designation include those on veno-arterial extracorporeal membrane oxygenation (VA ECMO), with surgically implanted ventricular-assist devices and nondischargeable status or life threatening ventricular arrhythmias. Recently, use of VA ECMO as a bridge to heart transplant has expanded moving patients to the top of the waiting list. The intricacy of this risk-benefit balance will be highlighted in this chapter to provide optimal cardiac transplant outcomes to as many patients as possible and use all resources to their full potential.
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Schultheis, M., Camacho, M. (2019). Matching Donor to Recipient. In: Bogar, L., Stempien-Otero, A. (eds) Contemporary Heart Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-33280-2_9-1
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DOI: https://doi.org/10.1007/978-3-319-33280-2_9-1
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