Summary of the International Society for Heart and Lung Transplantation (ISHLT) Consensus Conference on Graft Dysfunction within the First 72 hours after Heart Transplantation: A 10-year Update.

Key Takeaways

• 1
  December 3, 1967, marked the world's first human heart transplant performed by Dr. Christiaan Barnard in Cape Town, South Africa.
• 2
  Over 150,000 patients globally have received a heart transplant since 1967, which restores quality of life and extends survival by a median of 14 years.
• 3
  The field faced an unofficial moratorium in 1970 due to universally poor outcomes, highlighting early needs for better rejection diagnostics, donor heart procurement techniques, and societal acceptance of brain death definitions.
• 4
  The clinical introduction of cyclosporine in the early 1980s revolutionized immunosuppression, dramatically improved survival rates (such as achieving 80% one-year survival at Papworth), and made mechanical circulatory support a viable bridge to transplant.
• 5
  A landmark study on donation after circulatory death (DCD) heart transplantation showed that 90-day post-transplant survival was not significantly different compared to traditional donation after brain death (DBD) transplants.
• 6
  Current and future challenges in the field include managing the toxicities of life-long immunosuppression, preventing late cardiac allograft vasculopathy, and expanding the donor pool via DCD, xenotransplantation, and mechanical therapies.