Risk Stratification Prior to Heart Transplantation

Over the past years, the growing burden of heart failure has had a major impact on health economics. Due to demographic developments and advances in the treatment of the underlying cardiac diseases, statistical projections await an increase of heart failure patients of up to 60% over the next 30 years. Though the number of affected patients is rapidly increasing, the number of heart transplantations stagnates due to the limited number of donated organs currently available. Thus, the decision on which patient to give preference to remains one of the largest challenges of heart transplantation medicine. This article reviews novel developments in the field of risk stratification before heart transplantation, discusses both benefits and pitfalls of currently available tools for risk assessment and demonstrates their practical applications in the daily routine of an outpatient heart failure clinic of a University hospital.