Heterotopic heart transplantation: experimental development and clinical experience

Heterotopic heart transplantation was initially developed in the laboratory for experimental transplantation. While it was more widely utilized in the pre-cyclosporine era to provide adjunct circulatory support in combination with the native heart, associated complications as well as improved long-t erm graft survival have now established orthotopic transplantation as the p rocedure of choice. Heterotopic heart transplantation is currently reserved for highly selected patients. The technique is only performed at selected transplantation centers, and indications include significant donor recipien t size mismatch or irreversible recipient pulmonary hypertension. The fores eeable introduction of clinical porcine xenotransplantation may lead to ren ewed interest in the technique of heterotopic heart transplantation as a br idge to potential native heart recovery or allotransplantation in selected patients. (C) 2000 Elsevier Science B.V. All rights reserved.