TableĀ 1.

Indications for Heart Transplant Waitlisting6-7

IndicationsContraindications
Cardiogenic shock requiring intravenous inotropes (dobutamine, milrinone, etc)Refractory cardiogenic shock requiring IABP or LVADPeak VO2 <10 mL/kg/minNYHA III or IV despite maximal medical or resynchronization therapyRecurrent life-threatening left ventricular arrhythmias despite use of ICD, antiarrhythmic therapy, or catheter-based ablationEnd-stage congenital heart failure without evidence of pulmonary hypertensionRefractory angina without potential medical or surgical therapeutic optionsAbsolute contraindicationsIrreversible liver diseaseIrreversible pulmonary parenchymal disease (or FEV1 <1 L/min)Irreversible pulmonary artery hypertension (PASP >60 mmHg, PVR >5 Wood units despite use of vasodilators)Clinically severe symptomatic cerebrovascular diseaseHistory of solid organ or hematologic malignancySevere irreversible multisystem disease processRelative contraindicationsAge >70 years Severe obesity (BMI >35 kg/m2) or cachexia Diabetes with end organ damage other than nonproliferative retinopathy or persistent poor glycemic control (HbA1c >7.5% or 58 mmol/mol) despite best effortIrreversible renal dysfunction (GFR <30 mL/min/1.73 m2)Severe peripheral vascular diseaseSevere cerebrovascular diseaseSevere osteoporosisAcute pulmonary embolism (within 6 to 8 weeks)Active infection (excluding LVAD-related infections)Psychological instability Substance abuse within 6 months (alcohol, cocaine, opioids, tobacco products)Lack of social support or sufficient resources to permit ongoing access to immunosuppressive medication and frequent medical follow-upInability to comply with drug therapy on multiple occasions
  • BMI, body mass index; FEV1, forced expiratory volume in the first second of expiration; GFR, glomerular filtration rate; HbA1C, hemoglobin A1c; IABP, intraaortic balloon pump; ICD, implantable cardioverter-defibrillator; LVAD, left ventricular assist device; NYHA, New York Heart Association; PASP, pulmonary artery systolic pressure; PVR, pulmonary vascular resistance; VO2, oxygen consumption.