Heart Transplantation—Recent Clinical Advances

Dear Colleagues,

Heart transplantation remains the treatment of choice for carefully selected patients with end-stage heart failure. Although continuous advances in donor selection, surgical techniques, perioperative management, and recipient care have improved early post-transplant outcomes, long-term survival continues to be limited by complications related to allograft rejection and chronic immunosuppressive therapy. Cardiac allograft vasculopathy, opportunistic infections, malignancies, chronic kidney disease, hypertension, diabetes mellitus, and other metabolic complications remain major causes of morbidity and mortality after transplantation. Despite continuous optimization of immunosuppressive protocols, maintenance therapy is still based largely on pharmacological agents that have been used in routine clinical practice for many years. Although novel immunomodulatory strategies are currently under investigation, they have not yet become part of standard clinical care. Therefore, further research is required to improve graft surveillance, optimize immunosuppressive therapy, and reduce treatment-related complications.

This Special Issue aims to present and disseminate the most recent advances related to recent clinical advances in heart transplantation, with particular emphasis on novel approaches to the diagnosis and monitoring of cardiac allograft rejection. We welcome original research and review articles addressing both established diagnostic markers evaluated using contemporary analytical methods and emerging biomarkers that may improve the assessment of graft injury, immune activation, and long-term allograft function.

A particular focus will be placed on biomarkers reflecting the immunological status of heart transplant recipients. Studies investigating markers that allow assessment of the overall degree of immunosuppression, identification of patients at increased risk of acute or chronic rejection, or prediction of infectious complications are especially encouraged.

Another important topic is therapeutic drug monitoring. We invite contributions presenting novel analytical methods for measuring immunosuppressive drug concentrations, including rapid point-of-care technologies that may be performed at the patient's bedside. Such approaches may facilitate individualized immunosuppressive therapy and improve the safety and effectiveness of long-term post-transplant management.

This Special Issue also welcomes manuscripts addressing cardiac allograft vasculopathy, chronic allograft dysfunction, optimization of immunosuppressive treatment, precision medicine, and other emerging diagnostic and therapeutic strategies in heart transplantation. By bringing together current clinical and translational research, this Special Issue aims to provide an updated overview of recent advances and future directions in the care of heart transplant recipients.

Prof. Dr. Piotr Przybyłowski
Dr. Tomasz Hrapkowicz
Dr. Agnieszka Kuczaj
Dr. Szymon Pawlak
Guest Editors

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