Key Challenges in Heart Transplantation and Their Solutions
A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".
Deadline for manuscript submissions: 20 December 2025 | Viewed by 55
Special Issue Editor
Interests: general surgery; cardiac surgery; reconstructive surgery; anatomical variations in surgery; heart transplantation
Special Issues, Collections and Topics in MDPI journals
Special Issue Information
Dear Colleagues,
Heart transplantation is one of the most life-saving procedures in medicine, yet it faces numerous challenges that limit its accessibility and long-term success. Addressing these challenges requires innovation in technology, policy, and clinical practice.
1. Organ Shortage
The shortage of donor organs is a significant issue, with demand far exceeding supply. To expand the donor pool, criteria for heart donors can be broadened to include older or DCD (donation after circulatory death) donors. Technologies like the TransMedics Organ Care System improve organ preservation, allowing for longer transport times. Additionally, research into xenotransplantation and 3D-printed organs offers future hope. AI can help optimize donor–recipient matching to maximize organ use.
2. Rejection and Immune Complications
Even with immunosuppressants, organ rejection remains a risk. Chronic rejection, especially cardiac allograft vasculopathy, contributes to long-term graft failure. Personalized immunosuppressive regimens, guided by genetic and immune profiling, can reduce side effects. Machine learning tools may enable the early detection of rejection by analyzing patient data, while non-invasive monitoring tools like AlloMap could replace traditional biopsies.
3. Allocation and Matching
Current heart allocation systems can be inefficient and inequitable, with disparities in access based on geography and patient condition. AI-driven models that predict survival benefit and prioritize patients dynamically could improve this. Additionally, optimizing organ transport logistics to reduce ischemic time is crucial for increasing graft viability.
4. Pediatric Transplantation
Pediatric heart transplantation faces additional challenges due to the limited availability of suitable organs. Mechanical circulatory support devices, such as the Berlin Heart, are often used as a bridge to transplant. Research into immune tolerance and machine learning tools for decision-making may improve outcomes in pediatric patients by reducing reliance on immunosuppressive drugs.
5. Long-Term Graft Survival
While short-term survival rates have improved, long-term graft survival remains an issue, with chronic rejection being a major cause of late graft failure. Wearable devices and AI-driven health monitoring could provide early warning signals for graft complications, improving long-term care.
6. Global Access
Access to heart transplantation is disproportionately available in high-income countries. Expanding transplant infrastructure, increasing global collaboration, and implementing telemedicine for remote areas could help improve access to transplantation worldwide.
We invite you to contribute original research, systematic reviews, and meta-analyses focusing on heart transplantation.
Dr. Elizabeth J. Maynes
Guest Editor
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Keywords
- heart transplantation
- heart failure
- cardiac surgery
- minimally invasive techniques
- general surgery
- heart diseases
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