Heart transplantation indicated only in the most severely ill patient: Perspectives from the German heart transplant experience

The COCPIT study, performed in a complete national cohort of adult patients consecutively listed for cardiac transplantation in Germany in 1997, found a beneficial effect only in the group that was at high risk of dying from heart failure without transplantation. If these results can be reproduced i n other countries, the discussion on the respective roles of pharmacologica l and organ-saving surgical therapies for advanced heart failure, medical u rgency and waiting time as heart transplantation allocation criteria, and t he feasibility of a randomized clinical trial testing the survival benefit of transplantation must be reopened. Curr Opin Cardiol 2001, 16:97-104 (C) 2001 Lippincott Williams & Wilkins, Inc.