INDICATIONS OF CARDIAC TRANSPLANTATION AP ART FROM EMERGENCIES

The improved diagnosis in chronic cardiac failure and the lack of dono r hearts have lead to a reexamination of the indications of cardiac tr ansplantation. In the absence of a contraindication, the indication is straightforward in class IV of the NYHA to improve quality of life. I n less sympatomatic patients. the primary objectives are to improve th e prognosis and prevent sudden death : the indication should be consid ered with respect to a range of criteria (the VO2 max and arrhythmogen ic potential are important features) and the rate of progression of th e disease (resistance to treatment, repeated episodes of decompensatio n). This indication may and should be reevaluated to optimise the dist ribution of the rare donor hearts for the benefit of patients with the most to gain.