Cardiac transplantation: A review of current status and emerging innovations

Table 1 Stepwise evaluation process for heart transplant eligibility

Step	Criteria	Consideration	Outcomes
Initial assessment	End-stage heart failure	Failure of medical and surgical therapies	Proceed to next step if criteria met
	Severe functional limitations (NYHA class III-IV)	Patient quality of life severely affected
Evaluation of comorbidities	Presence of comorbid conditions (e.g., diabetes, renal failure)	Impact of comorbidities on transplant success	Disqualify if comorbidities are too severe
Psychosocial assessment	Mental health status	Ability to adhere to the posttransplant regimen	Disqualify if psychosocial factors are a risk
	Support system availability	Long-term care and support from family or caregivers
Evaluation of contraindications	Active substance abuse	Risk of noncompliance	Disqualify if contraindications present
	Advanced age	Reduced life expectancy
Cardiopulmonary assessment	Pulmonary vascular resistance	Risk of right heart failure posttransplant	Proceed to next step if criteria met
	Lung function tests	Determine compatibility and function
Risk-benefit analysis	Risk of surgical complications	Comparison of survival with and without transplant	Approve if benefits outweigh risks
	Expected posttransplant survival	Evaluation of patient’s overall health status
Final review by transplant committee	Comprehensive review of all assessments	Multidisciplinary team decision	Final decision: Approve or disqualify

NYHA: New York Heart Association.