ABSTRACT
Patients with heart failure refractory to medical, surgical, and device therapy who have
a high risk of mortality in one year can have both their survival and functional status
improved by orthotopic heart transplantation. Advances in the care of the advanced heart
failure patient prior to and following transplantation have improved both the quality and
duration of life of cardiac transplant recipients; however, the limited number of available
donor organs remains a major constraint on the utilization of this therapy. Thus, the
recognition of the heart failure patient sick enough to require referral for transplantation,
the evaluation of the potential transplantation candidate and the management of the patient
awaiting transplantation are important skills for the cardiologist caring for heart
failure patients.
