In this interview with Dr. JoAnn Lindenfeld, director of heart failure and heart transplantation at Vanderbilt, she explains the organ allocation process, which was recently updated to better prioritize the sickest patients. She then explores the challenges in selecting both donors and recipients. She emphasizes the importance of balancing transplant success with using limited donor resources effectively. Additionally, Dr. Lindenfeld discusses how innovations such as the use of hepatitis C-positive donors and the expansion of the donor pool through techniques like ex vivo perfusion and DCD (donation after circulatory death) are improving heart transplant outcomes.

The conversation also covers post-transplant management, including the immediate concerns of graft dysfunction, infections, and the longer-term challenges such as coronary allograft vasculopathy, renal failure, and malignancy. Dr. Lindenfeld highlights the complexities of immunosuppressive medications and the need for careful monitoring to avoid drug interactions, particularly with statins and calcineurin inhibitors. As heart transplantation continues to evolve, Dr. Lindenfeld emphasizes the collaborative efforts of transplant teams and the ongoing innovations that are expanding the donor pool and improving patient care.

Reference: Gupta R, Huston J. 16. HF part 5: Heart transplantation 101 with Dr. JoAnn Lindenfeld​. CardioNerds. Published February 26, 2020. Accessed September 12, 2024. https://www.cardionerds.com/16-hf-part-5-heart-transplantation-101-with-dr-joann-lindenfeld%e2%80%8b/