Management of Heart Transplant Recipients: Reference for Primary Care Physicians

Abstract

Heart transplantation is the treatment of choice for a select group of patients with end–stage heart failure. Survival rates have increased and complication rates have decreased due to better immunosuppressive agents, improvement in organ procurement and surgical technique, and overall increase in experience for performing heart transplantation. Involvement from primary care physicians is very important to optimize postoperative management of heart transplant recipients. In this article, we discuss the indications for heart transplantation, physiology of the denervated heart, the standard postoperative care of adult heart transplant recipients, and long–term complications. Primary care physicians must play an increasing role in the management of heart transplant recipients in the age of managed care and increasing survival rates.

Keywords:

• heart transplantation
• immunosuppression
• rejection
• cardiac allograft vasculopathy
• drug interactions