الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Despite improvements in medical treatment and alternative surgical approaches such as coronary revascularization in ischemic cardiomyopathy, valve reconstruction and ventricular restoration in dilated cardiomyopathy , heart failure is still the major cause of death . Heart transplantation is a widely accepted therapy for the treatment of the end - stage heart failure and can be performed with adequate success rates .
Nowadays, most transplantation centers are reporting asurvival rate ˃ 85 % at one year and 50 – 60 % at 10 years and 25 % of patients live for more than 18 years. Improvement of the quality of life is an other benefit, while the patients were in NYHA class III-IV preoperatively, nearly all of them have an improved functional status with NYHA class I-II after transplantation .
However , heart transplantation is limited by the huge discrepancy between the number of available donors and the number of patients suffering from end-stage heart failure . At this point , expanding the donor pool becomes crucial and standard donor criteria can be significantly liberalized to increase the available donor pool by accepting ‘ marginal donors’ who would normally be rejected . Limitations in organ donation also lead to increase researches on alternative treatment methods. There are ongoing investigations on new medications, assisted circulation devices, dual-chamber pacing, genetic therapy methods and xenograft transplantation .