Evaluation for Heart Transplantation and LVAD Implantation: JACC Council Perspectives

ACC Heart Failure and Transplant Member Section and Leadership Council

Research output: Contribution to journalReview article


Timely referrals for transplantation and left ventricular assist device implantation play a key role in favorable outcomes in patients with advanced heart failure. Nonetheless, evaluation usually occurs at advanced heart failure centers and is obscured from referring physicians. The purposes of this review are to explain the decision-making process for candidacy for advanced therapies and to describe the potential impact of the new organ allocation algorithm on center decision making. The document first addresses the signs of advanced heart failure, specifically focusing on the importance of the syndrome of low cardiac output as a key feature of advanced heart failure, and then summarizes the evaluation as a 3-step process addressing the following questions: 1) Is transplantation or durable assist device placement indicated? 2) Are there contraindications to either intervention? 3) How can one choose between transplantation and left ventricular assist device implantation if advanced therapies are indicated and not contraindicated?

Original languageEnglish (US)
Pages (from-to)1471-1487
Number of pages17
JournalJournal of the American College of Cardiology
Issue number12
StatePublished - Mar 31 2020



  • heart failure
  • heart transplantation
  • left ventricular assist device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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