Fast Five Quiz: Heart Failure Management

Yasmine S. Ali, MD

Disclosures

September 11, 2019

In its 2016 listing criteria for heart transplantation, the ISHLT guideline recommendations were updated to note that "clinically severe, symptomatic cerebrovascular disease may be considered a relative contraindication to heart transplantation." The guideline recommendations also indicate that PVD may be considered a relative contraindication to heart transplant "when its presence limits rehabilitation and when revascularization is not an option."

Other relative contraindications to heart transplantation include the following:

  • Diabetes with end-organ damage (does not include nonproliferative retinopathy)

  • Persistent poor glycemic control with an A1c ≥ 7.5% or 58 mmol/mol)

  • Irreversible renal dysfunction with an estimated glomerular filtration rate < 30 mL/min/1.73 m2)

A remote history of smoking, drug, and/or alcohol abuse; diabetes with or without end-organ damage, and reversible renal dysfunction are not relative contraindications to heart transplantation.

For more on criteria and contraindications for heart transplantation, read here.

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