{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:09:29Z","timestamp":1790820569741,"version":"4.1.0"},"reference-count":110,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Heart transplantation (HTx) remains the last therapeutic resort for patients with advanced heart failure. The present work is a clinically focused review discussing current issues in heart transplantation. Several factors have been associated with the outcome of HTx, such as ABO and HLA compatibility, graft size, ischemic time, age, infections, and the cause of death, as well as imaging and laboratory tests. In 2018, UNOS changed the organ allocation policy for HTx. The aim of this change was to prioritize patients with a more severe clinical condition resulting in a reduction in mortality of people on the waiting list. Advanced heart failure and resistant angina are among the main indications of HTx, whereas active infection, peripheral vascular disease, malignancies, and increased body mass index (BMI) are important contraindications. The main complications of HTx include graft rejection, graft angiopathy, primary graft failure, infection, neoplasms, and retransplantation. Recent advances in the field of HTx include the first two porcine-to-human xenotransplantations, the inclusion of hepatitis C donors, donation after circulatory death, novel monitoring for acute cellular rejection and antibody-mediated rejection, and advances in donor heart preservation and transportation. Lastly, novel immunosuppression therapies such as daratumumab, belatacept, IL 6 directed therapy, and IgG endopeptidase have shown promising results.<\/jats:p>","DOI":"10.3390\/jcm13020558","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T06:41:22Z","timestamp":1705560082000},"page":"558","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Heart Transplantation"],"prefix":"10.3390","volume":"13","author":[{"given":"Nikolaos","family":"Chrysakis","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5417-6392","authenticated-orcid":false,"given":"Dimitrios E.","family":"Magouliotis","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4332-258X","authenticated-orcid":false,"given":"Kyriakos","family":"Spiliopoulos","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanos","family":"Athanasiou","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-9670","authenticated-orcid":false,"given":"Alexandros","family":"Briasoulis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Faculty of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6433-4016","authenticated-orcid":false,"given":"Filippos","family":"Triposkiadis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7159-2478","authenticated-orcid":false,"given":"John","family":"Skoularigis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9439-3946","authenticated-orcid":false,"given":"Andrew","family":"Xanthopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.ccc.2023.05.004","article-title":"Heart Transplantation-Postoperative Considerations","volume":"40","author":"Demiralp","year":"2024","journal-title":"Crit. Care Clin."},{"key":"ref_2","first-page":"423","article-title":"History of Heart Transplantation: A Hard and Glorious Journey","volume":"32","author":"Stolf","year":"2017","journal-title":"Braz. J. Cardiovasc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.healun.2022.12.019","article-title":"Detection and management of HLA sensitization in candidates for adult heart transplantation","volume":"42","author":"DeFilippis","year":"2023","journal-title":"J. Heart Lung Transplant."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/j.healun.2015.01.008","article-title":"Outcomes after ABO-incompatible heart transplantation in adults: A registry study","volume":"34","author":"Bergenfeldt","year":"2015","journal-title":"J. Heart Lung Transplant."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Firoz, A., Geier, S., Yanagida, R., Hamad, E., Rakita, V., Zhao, H., Kashem, M.M., and Toyoda, Y. (J. Card. Fail., 2023). Heart Transplant Human Leukocyte Antigen Matching in the Modern Era, J. Card. Fail., Epub ahead of print.","DOI":"10.1016\/j.cardfail.2023.06.016"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101706","DOI":"10.1016\/j.trim.2022.101706","article-title":"Significance of HLA-matching and anti-HLA antibodies in heart transplant patients receiving induction therapy?","volume":"75","author":"Gavroy","year":"2022","journal-title":"Transpl. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1007\/s10741-021-10178-7","article-title":"Evaluation of donor heart for transplantation","volume":"27","author":"Tatum","year":"2022","journal-title":"Heart Fail. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1007\/s10741-023-10299-1","article-title":"Choosing wisely: Incorporating appropriate donor-recipient size matching in heart transplantation","volume":"28","author":"Guglin","year":"2023","journal-title":"Heart Fail. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.healun.2018.09.017","article-title":"Predicted heart mass is the optimal metric for size match in heart transplantation","volume":"38","author":"Kransdorf","year":"2019","journal-title":"J. Heart Lung Transplant."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1053\/j.semtcvs.2021.01.001","article-title":"Donor and Recipient Size Matching in Heart Transplantation With Predicted Heart and Lean Body Mass","volume":"34","author":"Miller","year":"2022","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s12055-021-01200-6","article-title":"Oversized donor heart transplantation-clinical experience with an underestimated problem","volume":"37","author":"Kasturi","year":"2021","journal-title":"Indian J. Thorac. Cardiovasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/j.healun.2019.08.004","article-title":"The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Thirty-sixth adult heart transplantation report\u20142019; focus theme: Donor and recipient size match","volume":"38","author":"Khush","year":"2019","journal-title":"J. Heart Lung Transplant."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1097\/MAT.0000000000002001","article-title":"Nonischemic Donor Heart Preservation: New Milestone in Heart Transplantation History","volume":"69","author":"Pradegan","year":"2023","journal-title":"ASAIO J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.jjcc.2022.06.013","article-title":"Interaction between donor obesity and prolonged donor ischemic time in heart transplantation","volume":"80","author":"Kim","year":"2022","journal-title":"J. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.14503\/THIJ-16-6178","article-title":"Effects of Older Donor Age and Cold Ischemic Time on Long-Term Outcomes of Heart Transplantation","volume":"45","author":"Reich","year":"2018","journal-title":"Tex. Heart Inst. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1111\/jocs.16558","article-title":"Determining optimal donor heart ischemic times in adult cardiac transplantation","volume":"37","author":"Tang","year":"2022","journal-title":"J. Card. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2976","DOI":"10.1038\/s41467-020-16782-9","article-title":"A nonrandomized open-label phase 2 trial of nonischemic heart preservation for human heart transplantation","volume":"11","author":"Nilsson","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e642","DOI":"10.1097\/TXD.0000000000001088","article-title":"Impact of New UNOS Allocation Criteria on Heart Transplant Practices and Outcomes","volume":"7","author":"Liu","year":"2021","journal-title":"Transplant. Direct"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Immohr, M.B., Aubin, H., Westenfeld, R., Erbel-Khurtsidze, S., Tudorache, I., Akhyari, P., Lichtenberg, A., and Boeken, U. (2022). Heart Transplantation of the Elderly-Old Donors for Old Recipients: Can We Still Achieve Acceptable Results?. J. Clin. Med., 11.","DOI":"10.3390\/jcm11040929"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.healun.2014.10.006","article-title":"Heart transplantation using allografts from older donors: Multicenter study results","volume":"34","author":"Roig","year":"2015","journal-title":"J. Heart Lung Transplant."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1093\/ejcts\/ezu257","article-title":"Outcome after heart transplantation from older donor age: Expanding the donor pool","volume":"47","author":"Prieto","year":"2015","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s40472-021-00350-1","article-title":"Hepatitis C Positive Organ Donation in Heart Transplantation","volume":"8","author":"Siddiqi","year":"2021","journal-title":"Curr. Transplant. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e029178","DOI":"10.1161\/JAHA.122.029178","article-title":"Outcomes of COVID-19-Positive Donor Heart Transplantation in the United States","volume":"12","author":"Kim","year":"2023","journal-title":"J. Am. Heart Assoc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.ajt.2023.04.026","article-title":"Heart transplantation from donation after circulatory death: Impact on waitlist time and transplant rate","volume":"23","author":"Gernhofer","year":"2023","journal-title":"Am. J. Transplant."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e14942","DOI":"10.1111\/ctr.14942","article-title":"Impact of donation after circulatory death heart transplantation on waitlist outcomes and transplantation activity","volume":"37","author":"Urban","year":"2023","journal-title":"Clin. Transplant."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.cardfail.2023.05.011","article-title":"Impact of Donor Hemodynamics on Recipient Survival in Heart Transplantation","volume":"29","author":"Fu","year":"2023","journal-title":"J. Card. Fail."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.jtcvs.2021.03.031","article-title":"Allocation changes in heart transplantation: What has really changed?","volume":"165","author":"Ganapathi","year":"2023","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/j.cardfail.2022.03.354","article-title":"Increased Opportunities for Transplantation for Women in the New Heart Allocation System","volume":"28","author":"Defilippis","year":"2022","journal-title":"J. Card. Fail."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1093\/ejcts\/ezac559","article-title":"Modern outcomes of heart-lung transplantation: Assessing the impact of the updated US allocation system","volume":"63","author":"Shin","year":"2022","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e14205","DOI":"10.1111\/ctr.14205","article-title":"Increased frequency of heart transplantation, shortened waitlist time and preserved post-transplant survival in adults with congenital heart disease, on the new heart transplant allocation system","volume":"35","author":"Jani","year":"2021","journal-title":"Clin. Transplant."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.healun.2023.02.003","article-title":"Greater geographic sharing and heart transplantation waitlist outcomes following the 2018 heart allocation policy","volume":"42","author":"Golbus","year":"2023","journal-title":"J. Heart Lung Transplant."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.jchf.2020.08.009","article-title":"Heart Transplantation Allocation Under New Policy: Perceived Risk and Gaming the System","volume":"8","author":"Trivedi","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e14459","DOI":"10.1111\/ctr.14459","article-title":"Geographic disparities in heart transplantation persist under the new allocation policy","volume":"35","author":"Hess","year":"2021","journal-title":"Clin. Transplant."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.healun.2021.09.004","article-title":"A challenge to equity in transplantation: Increased center-level variation in short-term mechanical circulatory support use in the context of the updated U.S. heart transplant allocation policy","volume":"41","author":"Cascino","year":"2022","journal-title":"J. Heart Lung Transplant."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1053\/j.jvca.2020.02.044","article-title":"Con: The New United Network for Organ Sharing Heart Allocation System Is Not a Positive Change in Listing Patients for Transplantation","volume":"34","author":"Smeltz","year":"2020","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.healun.2023.01.004","article-title":"Clinical trends, risk factors, and temporal effects of post-transplant dialysis on outcomes following orthotopic heart transplantation in the 2018 United States heart allocation system","volume":"42","author":"Hong","year":"2023","journal-title":"J. Heart Lung Transplant."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e009946","DOI":"10.1161\/CIRCHEARTFAILURE.122.009946","article-title":"Sex-Specific Outcomes of Candidates Listed as the Highest Priority Status for Heart Transplantation","volume":"16","author":"DeFilippis","year":"2023","journal-title":"Circ. Heart Fail."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/j.athoracsur.2020.06.077","article-title":"Outcomes of Ambulatory Axillary Intraaortic Balloon Pump as a Bridge to Heart Transplantation","volume":"111","author":"Nishida","year":"2021","journal-title":"Ann. Thorac. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1097\/MAT.0000000000001679","article-title":"Use of Impella in Patients Listed for Heart Transplantation","volume":"68","author":"Pahwa","year":"2022","journal-title":"ASAIO J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"5081","DOI":"10.1111\/jocs.17209","article-title":"Waitlist and transplant outcomes for patients bridged to heart transplantation with Impella 5.0 and 5.5 devices","volume":"37","author":"Hill","year":"2022","journal-title":"J. Card. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/aor.13816","article-title":"Outcomes of heart transplantation in patients bridged with Impella 5.0: Comparison with native chest transplanted patients without preoperative mechanical circulatory support","volume":"45","author":"Panoulas","year":"2021","journal-title":"Artif. Organs"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e15066","DOI":"10.1111\/ctr.15066","article-title":"Impella 5.5 as a bridge to heart transplantation: Waitlist outcomes in the United States","volume":"37","author":"Cevasco","year":"2023","journal-title":"Clin. Transplant."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1002\/ehf2.12412","article-title":"Minimally invasive biventricular mechanical circulatory support with Impella pumps as a bridge to heart transplantation: A first-in-the-world case report","volume":"6","author":"Varian","year":"2019","journal-title":"ESC Heart Fail."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1016\/j.healun.2023.06.002","article-title":"Utilization of the percutaneous left ventricular support as bridge to heart transplantation across the United States: In-depth UNOS database analysis","volume":"42","author":"Bai","year":"2023","journal-title":"J. Heart Lung Transplant."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.healun.2020.11.004","article-title":"Improved survival after heart transplantation in patients bridged with extracorporeal membrane oxygenation in the new allocation system","volume":"40","author":"Gonzalez","year":"2021","journal-title":"J. Heart Lung Transplant."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1097\/MAT.0000000000001457","article-title":"Extracorporeal Membrane Oxygenation Bridge to Heart-Lung Transplantation","volume":"68","author":"Shudo","year":"2022","journal-title":"ASAIO J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.jtcvs.2021.05.032","article-title":"Risk stratification of patients listed for heart transplantation while supported with extracorporeal membrane oxygenation","volume":"165","author":"Maulion","year":"2023","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.jchf.2020.12.012","article-title":"ECMO as a Bridge to Left Ventricular Assist Device or Heart Transplantation","volume":"9","author":"DeFilippis","year":"2021","journal-title":"JACC Heart Fail."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"535","DOI":"10.4070\/kcj.2022.0348","article-title":"Comparison of Veno-arterial Extracorporeal Membrane Oxygenation Configurations for Patients Listed for Heart Transplantation","volume":"53","author":"Hong","year":"2023","journal-title":"Korean Circ. J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.healun.2018.04.008","article-title":"Incidence of temporary mechanical circulatory support before heart transplantation and impact on post-transplant outcomes","volume":"37","author":"Ouyang","year":"2018","journal-title":"J. Heart Lung Transplant."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1002\/ejhf.956","article-title":"Clinical outcomes of temporary mechanical circulatory support as a direct bridge to heart transplantation: A nationwide Spanish registry","volume":"20","year":"2018","journal-title":"Eur. J. Heart Fail."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"91","DOI":"10.36628\/ijhf.2023.0013","article-title":"Direct Extracorporeal Membrane Oxygenation Bridged Heart Transplantation: The Importance of Multi-Organ Failure","volume":"5","author":"Lim","year":"2023","journal-title":"Int. J. Heart Fail."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1016\/j.jtcvs.2017.10.152","article-title":"Extracorporeal membrane oxygenation as a direct bridge to heart transplantation in adults","volume":"155","author":"Fukuhara","year":"2018","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/j.jacc.2021.12.022","article-title":"Recovery With Temporary Mechanical Circulatory Support While Waitlisted for Heart Transplantation","volume":"79","author":"Topkara","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/MAT.0000000000001387","article-title":"Impact of the Coronavirus Disease 2019 Pandemic on Utilization of Mechanical Circulatory Support As Bridge to Heart Transplantation","volume":"67","author":"Kim","year":"2021","journal-title":"ASAIO J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.healun.2022.08.020","article-title":"Left ventricular assist device bridging to heart transplantation: Comparison of temporary versus durable support","volume":"42","author":"Hess","year":"2023","journal-title":"J. Heart Lung Transplant."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e14493","DOI":"10.1111\/ctr.14493","article-title":"Decreased frequency of transplantation and lower post-transplant survival free of re-transplantation in LVAD patients with the new heart transplant allocation system","volume":"36","author":"Jani","year":"2022","journal-title":"Clin. Transplant."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/MAT.0000000000000329","article-title":"Assessing Consequences of Intraaortic Balloon Counterpulsation Versus Left Ventricular Assist Devices at the Time of Heart Transplantation","volume":"62","author":"Castleberry","year":"2016","journal-title":"ASAIO J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.jtcvs.2021.09.015","article-title":"A bridge-to-bridge approach to heart transplantation using extracorporeal membrane oxygenation and total artificial heart","volume":"165","author":"Noly","year":"2021","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2892","DOI":"10.1016\/j.jacc.2020.04.037","article-title":"Survival After Heart Transplantation in Patients Bridged With Mechanical Circulatory Support","volume":"75","author":"Moonsamy","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1093\/icvts\/ivz155","article-title":"Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: Results from a nationwide Spanish registry","volume":"29","author":"Delgado","year":"2019","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1111\/jocs.14887","article-title":"Bicaval vs biatrial anastomosis techniques in orthotopic heart transplantation: An updated analysis of the UNOS database","volume":"35","author":"Maning","year":"2020","journal-title":"J. Card. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_64","first-page":"1120","article-title":"Adult heart transplant: Indications and outcomes","volume":"6","author":"Alraies","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"E784","DOI":"10.1532\/hsf.4899","article-title":"Predictive Efficacy of the Index of Microcirculatory Resistance for Acute Allograft Rejection and Cardiac Events After Heart Transplantation: A Systematic Review and Meta-Analysis","volume":"25","author":"Lu","year":"2022","journal-title":"Heart Surg. Forum"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1161\/CIRCULATIONAHA.121.057400","article-title":"Donor Macrophages Modulate Rejection After Heart Transplantation","volume":"146","author":"Kopecky","year":"2022","journal-title":"Circulation"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1111\/echo.14544","article-title":"Myocardial deformation and acute cellular rejection after heart transplantation: Impact of inter-vendor variability in diagnostic effectiveness","volume":"36","author":"Delgado","year":"2019","journal-title":"Echocardiography"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1590\/S1679-45082015RW3154","article-title":"Heart transplantation: Review","volume":"13","author":"Mangini","year":"2015","journal-title":"Einstein"},{"key":"ref_69","unstructured":"Yasir, M., Goyal, A., and Sonthalia, S. (2023). Corticosteroid Adverse Effects, StatPearls Publishing."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e13340","DOI":"10.1111\/ctr.13340","article-title":"Duration of corticosteroid use and long-term outcomes after adult heart transplantation: A contemporary analysis of the International Society for Heart and Lung Transplantation Registry","volume":"32","author":"Goldraich","year":"2018","journal-title":"Clin. Transplant."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e31166","DOI":"10.1097\/MD.0000000000031166","article-title":"Diltiazem as a cyclosporine A-sparing agent in heart transplantation: Benefits beyond dose reduction","volume":"101","author":"Alyaydin","year":"2022","journal-title":"Medicine"},{"key":"ref_72","first-page":"1217","article-title":"Advantageous effects of immunosuppression with tacrolimus in comparison with cyclosporine A regarding renal function in patients after heart transplantation","volume":"9","author":"Helmschrott","year":"2015","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1097\/FPC.0000000000000005","article-title":"TPMT genetic variants are associated with increased rejection with azathioprine use in heart transplantation","volume":"23","author":"Liang","year":"2013","journal-title":"Pharmacogenet. Genom."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.transproceed.2015.12.071","article-title":"Malignancy After Heart Transplantation Under Everolimus Versus Mycophenolate Mofetil Immunosuppression","volume":"48","author":"Wang","year":"2016","journal-title":"Transplant. Proc."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"3006","DOI":"10.1111\/ajt.15361","article-title":"Comparing everolimus-based immunosuppression with reduction or withdrawal of calcineurin inhibitor reduction from six months after heart transplantation: The randomized MANDELA study","volume":"19","author":"Barten","year":"2019","journal-title":"Am. J. Transplant."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jchf.2021.01.007","article-title":"Everolimus for the Prevention of Calcineurin-Inhibitor-Induced Left Ventricular Hypertrophy After Heart Transplantation (RADTAC Study)","volume":"9","author":"Anthony","year":"2021","journal-title":"JACC Heart Fail."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e269","DOI":"10.4158\/ACCR-2020-0191","article-title":"Severe Hypertriglyceridemia Associated with Everolimus Treatment after Heart Transplantation","volume":"6","author":"Lo","year":"2020","journal-title":"AACE Clin. Case Rep."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"3734","DOI":"10.1161\/01.CIR.0000149745.83186.89","article-title":"Drug therapy in the heart transplant recipient: Part I: Cardiac rejection and immunosuppressive drugs","volume":"110","author":"Lindenfeld","year":"2004","journal-title":"Circulation"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.tcm.2021.07.002","article-title":"Cardiac allograft vasculopathy after heart transplantation: Pathophysiology, detection approaches, prevention, and treatment management","volume":"32","author":"Spartalis","year":"2022","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"782","DOI":"10.5603\/CJ.a2022.0013","article-title":"Cardiac allograft vasculopathy in a long-term follow-up after heart transplantation: Role of remnant cholesterol in residual inflammation","volume":"29","author":"Alyaydin","year":"2022","journal-title":"Cardiol. J."},{"key":"ref_81","first-page":"237","article-title":"Factors associated with cardiac allograft vasculopathy after heart transplantation","volume":"18","author":"Hawranek","year":"2022","journal-title":"Postep. Kardiol. Interwencyjnej"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.healun.2010.05.034","article-title":"The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients","volume":"29","author":"Costanzo","year":"2010","journal-title":"J. Heart Lung Transplant."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1161\/CIRCULATIONAHA.122.059329","article-title":"Allograft Rejection Surveillance In Heart Transplantation: Is There a Better Way?","volume":"145","author":"Fang","year":"2022","journal-title":"Circulation"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"175768","DOI":"10.1155\/2011\/175768","article-title":"Primary graft failure after heart transplantation","volume":"2011","author":"Iyer","year":"2011","journal-title":"J. Transplant."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"e13557","DOI":"10.1111\/ctr.13557","article-title":"Management of primary graft failure after heart transplantation: Preoperative risks, perioperative events, and postoperative decisions","volume":"33","author":"Truby","year":"2019","journal-title":"Clin. Transplant."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1007\/s11883-023-01169-0","article-title":"Sex Differences in Cardiac Transplantation","volume":"25","author":"Chung","year":"2023","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"ivac102","DOI":"10.1093\/icvts\/ivac102","article-title":"Failure to rescue: Obesity increases the risk of mortality following early graft failure in heart transplantation in UNOS database patients","volume":"35","author":"Herbst","year":"2022","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"890359","DOI":"10.3389\/fcvm.2022.890359","article-title":"Pre-transplant Type 2 Diabetes Mellitus Is Associated With Higher Graft Failure and Increased 5-Year Mortality After Heart Transplantation","volume":"9","author":"Rivinius","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1038\/s41598-023-27482-x","article-title":"Primary isolated right ventricular failure after heart transplantation: Prevalence, right ventricular characteristics, and outcomes","volume":"13","author":"Kaveevorayan","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"4018","DOI":"10.1002\/ehf2.13490","article-title":"Right ventricular hemodynamics and performance in relation to perfusion during first year after heart transplantation","volume":"8","author":"Clemmensen","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.healun.2022.10.002","article-title":"Hemodynamic markers of pulmonary vasculopathy for prediction of early right heart failure and mortality after heart transplantation","volume":"42","author":"Rieth","year":"2023","journal-title":"J. Heart Lung Transplant."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"99","DOI":"10.21037\/acs.2018.12.08","article-title":"Extracorporeal membrane oxygenation as treatment of graft failure after heart transplantation","volume":"8","author":"Mastroianni","year":"2019","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1097\/CRD.0b013e31828da5b7","article-title":"Adenovirus infections in heart transplantation","volume":"21","author":"Florescu","year":"2013","journal-title":"Cardiol. Rev."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"e13215","DOI":"10.1111\/tid.13215","article-title":"Infections due to multidrug-resistant organisms following heart transplantation: Epidemiology, microbiology, and outcomes","volume":"22","author":"Bhatt","year":"2020","journal-title":"Transpl. Infect. Dis."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jacc.2017.10.077","article-title":"Temporal Trends of De Novo Malignancy Development After Heart Transplantation","volume":"71","author":"Youn","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1111\/tri.13827","article-title":"Malignancy following heart transplantation: Differences in incidence and prognosis between sexes\u2014A multicenter cohort study","volume":"34","year":"2021","journal-title":"Transpl. Int."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1111\/jocs.15416","article-title":"High rates of de novo malignancy compromise post-heart transplantation survival","volume":"36","author":"Giuliano","year":"2021","journal-title":"J. Card. Surg."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.intimp.2019.01.035","article-title":"The change of immunosuppressive regimen from calcineurin inhibitors to mammalian target of rapamycin (mTOR) inhibitors and its effect on malignancy following heart transplantation","volume":"69","author":"Nomani","year":"2019","journal-title":"Int. Immunopharmacol."},{"key":"ref_99","first-page":"93","article-title":"Analysis of malignancies in patients after heart transplantation with subsequent immunosuppressive therapy","volume":"9","author":"Rivinius","year":"2015","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/ajt.13418","article-title":"Retransplant and Medical Therapy for Cardiac Allograft Vasculopathy: International Society for Heart and Lung Transplantation Registry Analysis","volume":"16","author":"Goldraich","year":"2016","journal-title":"Am. J. Transplant."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s40472-019-00257-y","article-title":"Heart Retransplantation: Candidacy, Outcomes, and Management","volume":"7","author":"Barghash","year":"2020","journal-title":"Curr. Transplant. Rep."},{"key":"ref_102","first-page":"100223","article-title":"First pig-to-human heart transplantation","volume":"3","author":"Wang","year":"2022","journal-title":"Innovation"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1056\/NEJMoa2201422","article-title":"Genetically Modified Porcine-to-Human Cardiac Xenotransplantation","volume":"387","author":"Griffith","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1093\/eurheartj\/ehac204","article-title":"Heart transplantation: Focus on donor recovery strategies, left ventricular assist devices, and novel therapies","volume":"43","author":"Costanzo","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/j.jacc.2021.11.064","article-title":"Evolving Characteristics of Heart Transplantation Donors and Recipients: JACC Focus Seminar","volume":"79","author":"DeFilippis","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1038\/s41569-023-00902-1","article-title":"Heart transplantation: Advances in expanding the donor pool and xenotransplantation","volume":"21","author":"Jou","year":"2024","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Fedson, S. (Curr. Opin. Cardiol., 2023). Heart transplant donation after circulatory death: Current status and implications, Curr. Opin. Cardiol., Epub ahead of print.","DOI":"10.1097\/HCO.0000000000001109"},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Giarraputo, A., Barison, I., Fedrigo, M., Burrello, J., Castellani, C., Tona, F., Bottio, T., Gerosa, G., Barile, L., and Angelini, A. (2021). A Changing Paradigm in Heart Transplantation: An Integrative Approach for Invasive and Non-Invasive Allograft Rejection Monitoring. Biomolecules, 11.","DOI":"10.3390\/biom11020201"},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Marco, I., Lopez-Azor Garcia, J.C., Gonzalez Martin, J., Severo Sanchez, A., Garcia-Cosio Carmena, M.D., Mancebo Sierra, E., de Juan Baguda, J., Castrodeza Calvo, J., Hernandez Perez, F.J., and Delgado, J.F. (2023). De Novo Donor-Specific Antibodies after Heart Transplantation: A Comprehensive Guide for Clinicians. J. Clin. Med., 12.","DOI":"10.3390\/jcm12237474"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s11897-023-00631-z","article-title":"Towards Allograft Longevity: Leveraging Omics Technologies to Improve Heart Transplant Outcomes","volume":"20","author":"Truby","year":"2023","journal-title":"Curr. Heart Fail. Rep."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/558\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:49:44Z","timestamp":1760104184000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,18]]},"references-count":110,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["jcm13020558"],"URL":"https:\/\/doi.org\/10.3390\/jcm13020558","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,18]]}}}