Marcondes-Braga Fabiana G, Bonatto Marcely Gimenes, Andrade Caio Ribeiro Alves, Bacal Fernando
Heart Transplantation Department, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil.
Heart Transplantation Department, Santa Casa de Misericórdia Hospital, Curitiba, PR, Brazil.
Curr Heart Fail Rep. 2019 Feb;16(1):7-11. doi: 10.1007/s11897-019-0418-z.
Heart transplantation is the gold standard treatment for advanced heart failure. Left ventricular assist devices (LVADs), despite being a good option for these patients, are not quite available in developing countries. Time spent in heart transplant waiting list has increased lately even in regions where the number of transplants has also risen showing that a new strategy should be sought.
Transplant process organization combined with multidisciplinary work are linked to better outcomes while improvement in donor's care and in pre-transplant evaluation might be opportunities to change the long waiting list scenario. For the first time in Brazil, a survey with the most expressive heart transplant centers has been made, which allows an overview of treatment of advanced heart failure in a developing country. We also described a model of heart transplant team, which has proved to be a success when compared to the largest heart transplant centers in Latin America.
心脏移植是晚期心力衰竭的金标准治疗方法。尽管左心室辅助装置（LVADs）对这些患者来说是一个不错的选择，但在发展中国家却不太容易获得。即使在心脏移植数量有所增加的地区，在心脏移植等待名单上花费的时间最近也有所增加，这表明应该寻求一种新的策略。
移植过程的组织与多学科合作与更好的结果相关联，而改善供体护理和移植前评估可能是改变长等待名单情况的机会。在巴西首次对最具代表性的心脏移植中心进行了一项调查，这使得我们能够对一个发展中国家晚期心力衰竭的治疗情况有一个全面的了解。我们还描述了一个心脏移植团队的模式，与拉丁美洲最大的心脏移植中心相比，该模式已被证明是成功的。
