Sundararaju U, Rachoori S, Mohammad A, Rajakumar HK. Cardiac transplantation: A review of current status and emerging innovations. World J Transplant 2025; 15(2): 100460 [DOI: 10.5500/wjt.v15.i2.100460]
Corresponding Author of This Article
Hamrish Kumar Rajakumar, Department of General Surgery, Government Medical College, Omandurar Government Estate, No. 169 Wallahjah Road, Police Quarters, Chennai 600002, Tamil Nādu, India. hamrishkumar2003@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Umashri Sundararaju, Srinivas Rachoori, Hamrish Kumar Rajakumar, Department of General Surgery, Government Medical College, Omandurar Government Estate, Chennai 600002, Tamil Nādu, India
Abdulkader Mohammad, Department of Medicine, University of Novi Sad, Novi Sad 21000, Serbia
Author contributions: Sundararaju U contributed to the conceptualization, created the visualizations, and provided resources; Rachoori S contributed to the conceptualization, investigation, drafting of the manuscript, and visualizations; Mohammed A was involved in the conceptualization, methodology, investigation; Rajakumar HK conceptualized and designed the study, developed the methodology, supervised the project, and provided necessary resources; Sundararaju U and Rajakumar HK conducted the investigation, managed administration; Sundararaju U, Mohammed A, and Rajakumar HK drafted the original manuscript; and all authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hamrish Kumar Rajakumar, Department of General Surgery, Government Medical College, Omandurar Government Estate, No. 169 Wallahjah Road, Police Quarters, Chennai 600002, Tamil Nādu, India. hamrishkumar2003@gmail.com
Received: August 19, 2024 Revised: December 20, 2024 Accepted: December 27, 2024 Published online: June 18, 2025 Processing time: 188 Days and 12.7 Hours
Abstract
Heart transplantation (HTx) is a life-saving procedure for patients with end-stage heart failure and has undergone remarkable advancements since the first successful transplant in 1967. The introduction of cyclosporine in the 1970s significantly improved patient outcomes, leading to a global increase in transplants, including in India, where the practice has grown despite initial challenges. This review provides an extensive overview of HTx, focusing on current practices, technological advancements, and the ongoing challenges the field faces today. It explores the evolution of surgical techniques, such as minimally invasive and robotic-assisted procedures, and the management of posttransplant rejection through tailored immunosuppressive strategies, including new monoclonal antibodies and personalized therapies. The review also highlights emerging innovations such as mechanical circulatory support devices and xenotransplantation as potential solutions to donor shortages while acknowledging the ethical and logistical challenges these approaches entail. Furthermore, the analysis delves into the implications of using extended-criteria donors and the role of multidisciplinary teams in evaluating absolute and relative contraindications. Despite the progress made, the persistent issues of organ scarcity and ethical concerns underscore the need for ongoing research and innovation to further enhance the efficacy, safety, and accessibility of HTx.
Core Tip: Cardiac transplantation remains a vital treatment for end-stage heart disease. Recent advancements in artificial hearts, mechanical circulatory support devices, and xenotransplantation have tackled both technological and ethical challenges, providing new solutions for managing severe heart failure and addressing organ shortages. Innovations in regenerative medicine and stem cell therapy are offering fresh approaches to cardiac repair, while remote monitoring technologies are improving post-operative care and outcomes. Ongoing research is transforming heart transplantation, aiming to enhance patient prognosis and quality of life while addressing existing limitations, and shaping the future of this crucial field.
