Question 7#

All of the following are absolute contraindications in considering a candidate for orthotopic cardiac transplantation EXCEPT:

A. Active infection
B. Age over 65 years
C. History of medical noncompliance
D. Severe pulmonary hypertension

Correct Answer is B


In general terms, contraindications to a liver transplant include insufficient cardiopulmonary reserve, uncontrolled malignancy or infection, and refractory noncompliance. Older age is only a relative contraindication: carefully selected recipients older than 70 years can achieve satisfactory outcomes. Patients with reduced cardiopulmonary reserve are unlikely to survive a liver transplant. Candidates should have a normal ejection fraction. If coronary arterial disease is present, they should undergo revascularization pretransplant. Severe chronic obstructive pulmonary disease (COPD) with oxygen dependence is a contraindication. Severe pulmonary hypertension with a mean pulmonary artery pressure greater than 35 mm Hg that is refractory to medical therapy is also a contraindication. Candidates with pulmonary hypertension should be evaluated with a right heart catheterization.