Heart Transplantation in Congenital Heart Disease: In Whom to Consider and When?

Table 3

Contraindications for heart transplantation in adult congenital heart disease.

Absolute contraindications
Active infections (active hepatitis C and viral replication)
Severe metabolic disease
Other multiple severe congenital anomalies
Multisystem organ failure
Active malignancy
Cognitive/behavioral disability that interferes with compliance
Relative contraindications with increased morbidity
Diabetes with end-organ dysfunction
Irreversible renal dysfunction
Symptomatic cerebrovascular or peripheral vascular disease not amenable to revascularization
Obesity with a pretransplant BMI >30 kg/m^2
Active tobacco smoking and substance abuse
Elevated PVR
HIV positivity
Asplenia in right atrial isomerism
Residual shunts (high-output heart failure post-transplant)

BMI: body mass index; PVR: pulmonary vascular resistance; HIV: human immunodeficiency virus.