Cardiac transplantation for the cardiologist not trained in transplantation

This review focuses on selected aspects of the treatment of patients being evaluated for and undergoing cardiac transplantation. Cardiac transplantation is a potential therapeutic option for a variety of irreversible cardiac disorders when the symptomatic status and anticipated survival after transplantation exceeds that of the patientʹs condition. The timing of cardiac transplantation with respect to prognosis is aided by the measurement of baseline hemodynamics and maximal aerobic capacity. Major cardiac problems that occur after transplantation include an increased early risk of acute allograft rejection and, later, the occurrence of allograft coronary artery disease. Furthermore, cardiac transplant recipients have unique “normal” physiologic alterations with respect to intracardiac hemodynamics, exercise capacity, the effects of denervation, and expected electrocardiographic and echocardiographic findings.