Nearly 30 years ago, Christian Barnard performed the first human-to-human heart transplant. With more than 40 000 heart transplants having been performed since 1967, recipients have an almost 90 per cent chance of survival at 1 year post-transplant, and approximately 75 per cent are alive at 5 years. Since the operation has changed very little through the years, the perioperative management of these patients must correlate directly with the observed improvement in survival. Non-operative advances include the advent of cyclosporine (cyclosporin) in the 1980s, more standardized donor and recipient selection criteria, and increased physician experience and expertise in postoperative management of problems peculiar to heart transplant recipients. Tab.!®! lists general criteria for acceptable donor hearts. These criteria serve as flexible guidelines for the procurement process. The selection criteria for candidates for heart transplantation are listed in Tibie 2. These criteria serve as general guidelines for the transplant center, but may be altered depending on individual patient presentation.

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Table 1 Heart donor criteria

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