CLINICAL OUTCOMES, QUALITY-OF-LIFE, AND COST OUTCOMES AFTER CARDIAC TRANSPLANTATION

Cardiac transplantation improves survival in patients with advanced he art failure, especially those who are dependent on intravenous inotrop ic support or mechanical assistance. However, cardiac transplantation remains a treatment modality rather than a curative procedure, and thu s, necessitates long-term care and indefinite immunosuppression. Altho ugh quality of life is improved for most cardiac transplant recipients , concerted effort is necessary for long-term care and follow-up of th e transplanted heart. The economics of cardiac transplantation are rec eiving increased scrutiny, especially because of the increasing pretra nsplant hospital expenditures that have resulted from transplantation in more patients in the hospital who require intravenous inotropic sup port or mechanical devices. This shift ultimately is related to the re duced supply of donors relative to the demand. The ultimate impact of managed care on cardiac transplantation is not clear, hut it probably will continue to reduce expenditures in the near term.