Heart and lung transplantation

The incidence of heart failure is increasing as the population ages and coronary artery disease, hypertension and obesity rise. Current medical therapy, including resynchronisation pacemakers and implantable defibrillators, is effective in improving symptoms and survival but many will develop end-stage disease for which heart transplantation remains the gold standard surgical treatment. The presence of circulating antibodies against the allograft owing to pregnancy, blood transfusion, previous transplantation and the use of ventricular assist devices is associated with worse outcomes and candidates are likely to have an extended waiting time to find a compatible donor. Current generation devices use continuous non-pulsatile flow technology, which permits small device size, has the rotor as the only moving part and uses electrical rather than the more bulky pneumatic power delivery.