CARDIAC RETRANSPLANTATION - DETERMINING LIMITS

Objective: Cardiac transplantation has become an acceptable treatment option for end-stage congestive heart failure. Because of the increasi ng demand, there are not enough hearts to supply all patients in need of cardiac transplantation. This significant supply and demand imbalan ce necessitates that rationing decisions be made. This article will ex plore decisions made surrounding cardiac retransplantation. Conclusion s: Early statistics suggest that survival for patients undergoing retr ansplantation is lower than first-time transplant recipients. In addit ion, the question of justice or fairness arises. Patients who are offe red second and third heart transplants may deprive a significant numbe r of patients who have not had their first chance at transplantation. The authors propose, based on medical suitability, respect for autonom y, and the principle of justice, that cardiac transplantation be a one -time treatment option. Retransplantation should not be allowed.