Heart transplant, current state and future

master's thesis

• Title (croatian): Transplantacija srca, trenutno stanje i budućnost
• Author: Avi Shechter
• Mentor: Igor Rudež (mentor)
• Committee member: Igor Rudež (predsjednik povjerenstva)
• Committee member: Joško Bulum (član povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2021-10-28, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

A heart transplant is a procedure in which a damaged or diseased heart is removed and replaced with a healthy one. The healthy heart comes from a deceased donor. It is the last resort for people with heart failure when all other treatments have failed. Heart failure might have been caused by coronary artery disease, damaged heart valves or heart muscles, a weakening of the heart muscle (cardiomyopathy), congenital heart defects, dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments, viral infections of the heart or failure of a previous heart transplant.
Although a heart transplant surgery carries many risks, the survival rate has greatly improved in recent years. Technological and pharmaceutical achievements, proper patient selection, superb medical management, meticulous operative care, vigilant surveillance and responsive long-term follow-up can all be credited for the continuing success of heart transplantation.
Nowadays, there is a need to search for and understand the alternative approaches for heart failure therapy. Further advances in immunosuppression, immune tolerance and personalized medicine hold the key for future gains. The introduction of mechanical circulatory support (MCS) has largely contributed to the advancement in treatment of end stage heart failure. Also, clinical experiences have already suggested the potential therapeutic effects of stem cell therapy. Finally, whole organ engineering is on the horizon as new techniques have opened the way for this to proceed. In this paper I will present both the current state and the future of heart transplantation.

Abstract (croatian)

Transplantacija srca je postupak u kojem se oštećeno ili bolesno srce uklanja i zamjenjuje zdravim. Zdravo srce dolazi od preminulog darivatelja. To je zadnja opcija za osobe sa zatajenjem srca kada svi drugi tretmani ne uspiju. Zatajenje srca moglo je biti uzrokovano koronarnom arterijskom bolešću, oštećenim srčanim zaliscima ili srčanim mišićima, slabljenjem srčanog mišića (kardiomiopatija), prirođenim srčanim manama, opasnim ponavljajućim abnormalnim srčanim ritmovima (ventrikularne aritmije) koje nisu kontrolirane drugim tretmanima, virusnim infekcijama srca ili zatajenja prethodne transplantacije srca.
Iako operacija transplantacije srca nosi mnoge rizike, stopa preživljavanja uvelike se poboljšala posljednjih godina. Tehnološka i farmaceutska dostignuća, pravilan odabir pacijenata, vrhunsko medicinsko upravljanje, pedantna operativna njega, pažljiv nadzor i odgovorno dugoročno praćenje mogu biti zaslužni za kontinuirani uspjeh transplantacije srca.
U današnje vrijeme postoji potreba za traženjem i razumijevanjem alternativnih pristupa liječenju zatajenja srca. Daljnji napredak u imunosupresiji, imunološkoj toleranciji i personaliziranoj medicini ključ je budućih uspjeha. Uvođenje mehaničke cirkulacijske potpore (MCS) uvelike je pridonijelo napretku u liječenju zatajenja srca u završnoj fazi. Također, klinička iskustva su već sugerirala potencijalne terapijske učinke terapije matičnim stanicama. Konačno, cjelokupno inženjerstvo organa je na vidiku jer su nove tehnike otvorile put za to. U ovom radu predstavit ću kako trenutno stanje tako i budućnost transplantacije srca.

• Keywords: heart transplant; heart failure; immunosuppression; mechanical circulatory support (MCS); stem cell therapy
• Keywords (croatian): transplantacija srca; zatajenje srca; imunosupresija; mehanička cirkulacijska potpora (MCS); terapija matičnim stanicama
• Language: english
• URN:NBN: urn:nbn:hr:105:533715
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-12-29 08:42:52