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Editorial comment

Indication for mechanical circulatory support in high urgent heart transplant candidates

Department of Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany

Received 6 August 2008; received in revised form 23 August 2008; accepted 23 August 2008.

^_* Corresponding author. Tel.: +49 5 11/5 32 3435; fax: +49 5 11/ 5 32 84 52. (Email: strueber.martin@mh-hannover.de).

Key Words: Heart transplantation • Urgency criteria • Bridge to transplant

The first 20% of the full text of this article appears below.

Two years ago the Heidelberg Heart Transplant Group published a very optimistic view of the high urgency heart allocation system in Germany allowing for the avoidance of mechanical circulatory support as a bridge to transplant with an excellent patient survival rate.

Now Kamiya and co-workers update their experience over a 7-year period: since 20% of their patients died while waiting as high urgent transplant candidates the parameters required for high urgency listing are analysed to identify a patient cohort for pretransplant mechanical circulatory support (MCS) as a bridge to transplant.

However, it is not the ‘Eurotransplant High Urgency (HU) Heart Transplantation Program’ as stated in the manuscript, but national allocation rules for heart transplantation in Germany, which are carried out by Eurotransplant. This has to be differentiated to allow the correct context of the discussion: Eurotransplant has to maintain an import/export balance for organs between participating countries, so that the available donor organs in a country almost equals . . . [Full Text of this Article]