University Medical Center Utrecht, Utrecht, the Netherlands.
Neth Heart J. 2008;16(3):79-87. doi: 10.1007/BF03086123.
Based on the changes in the field of heart transplantation and the treatment and prognosis of patients with heart failure, these updated guidelines were composed by a committee under the supervision of both the Netherlands Society of Cardiology and the Netherlands Association for Cardiothoracic surgery (NVVC and NVT).THE INDICATION FOR HEART TRANSPLANTATION IS DEFINED AS: 'End-stage heart disease not remediable by more conservative measures'.CONTRAINDICATIONS ARE: irreversible pulmonary hypertension/elevated pulmonary vascular resistance; active systemic infection; active malignancy or history of malignancy with probability of recurrence; inability to comply with complex medical regimen; severe peripheral or cerebrovascular disease and irreversible dysfunction of another organ, including diseases that may limit prognosis after heart transplantation.Considering the difficulties in defining end-stage heart failure, estimating prognosis in the individual patient and the continuing evolution of available therapies, the present criteria are broadly defined. The final acceptance is done by the transplant team which has extensive knowledge of the treatment of patients with advanced heart failure on the one hand and thorough experience with heart transplantation and mechanical circulatory support on the other hand. (Neth Heart J 2008;16:79-87.).
基于心脏移植领域的变化以及心力衰竭患者的治疗和预后，这些更新的指南由荷兰心脏病学会和荷兰心胸外科学会（NVVC 和 NVT）监督下的一个委员会编写。心脏移植的适应证定义为：“无法通过更保守的措施治疗的晚期心脏病”。禁忌证为：不可逆性肺动脉高压/肺血管阻力升高；全身活动性感染；活动性恶性肿瘤或有复发可能的恶性肿瘤病史；无法遵守复杂的医疗方案；严重的外周或脑血管疾病以及另一个器官的不可逆功能障碍，包括可能限制心脏移植后预后的疾病。考虑到定义晚期心力衰竭的困难、估计个体患者的预后以及现有治疗方法的不断发展，目前的标准定义宽泛。最终的接受由移植团队决定，该团队一方面对晚期心力衰竭患者的治疗有广泛的了解，另一方面对心脏移植和机械循环支持有深入的经验。（荷兰心脏杂志 2008 年；16:79-87.）。
