Heart transplant management involves complex, multidisciplinary decision-making regarding donor selection, procurement strategies, and perioperative care. Donor evaluation requires balancing age, size, and function, with Donation after Circulatory Death (DCD) increasingly expanding the donor pool despite concerns regarding primary graft dysfunction. Effective perioperative management centers on optimizing hemodynamics, often requiring a delicate balance of vasoactive agents and mechanical circulatory support to manage right ventricular function. Clinical teams must remain vigilant for complications like pericardial effusions and tamponade, which can mimic right heart failure. Long-term success relies on aggressive immunosuppression protocols, though practices vary significantly between institutions. Ultimately, the field is evolving through novel organ preservation techniques and collaborative team-based approaches, aiming to improve patient outcomes and reduce waitlist mortality while navigating the inherent physiological stresses of transplantation.
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