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Patient Criteria


                                                                                  Heart Transplantation: Version 7.0


Patient Criteria

The following Patient Selection Criteria elements have changed little over the past few years although centers may vary in their emphasis on certain criteria and increasingly may be more apt to use physiologic age than chronological age, and to accept more severe clinical findings.

Indications for transplantation include:
    •    Peak VO2 < 10 ml/kg/min with achievement of anaerobic metabolism,
    •    Severe ischemia limiting routine activity, which is not amenable to angioplasty
         or bypass surgery and
    •    Recurrent symptomatic ventricular arrhythmias refractory to all accepted
         therapeutic interventions.

To be considered for transplantation, patients will have:
    •    Pulmonary vascular resistance of less than four Wood units
    •    Age younger than 60-65 years
    •    Ability to comply with medical follow-up care

Relative indications include:
    •    Peak VO2 10-14 ml/kg/min and major limitation of daily activities
    •    Recurrent, unstable ischemia not amenable to standard interventional measures

The following criteria are not indications for transplantation:
    •    Ejection fraction < 20 percent alone
    •    History of functional class III symptoms of heart failure alone
    •    Previous ventricular arrhythmias alone
    •    Maximum VO2 ≥ 15 ml/kg/min alone