*4.2.1 Indications for heart transplantation*

Severe heart disease that cannot be expected to save or prolong life with conventional treatment methods such as dilated cardiomyopathy (DCM), dilated phase hypertrophic cardiomyopathy (dHCM), ischemic myocardial disease, restrictive cardiomyopathy, secondary cardiomyopathy (post myocarditis, drug-induced and postpartum), and congenital heart disease that cannot be surgically repaired, etc.

The indicated diseases in Europe and the U.S.A are divided into cardiomyopathy and ischemic heart disease, which is different from cardiomyopathy accounting for more than 90% of registered cases in Japan. According to various statistics, the number of patients eligible for heart transplantation in Japan is estimated to be 228- 670 per year, and the prognosis of these patients is poor, with a 1-year survival rate of around 50%.

## *4.2.2 Eligible conditions for heart transplantation*

Eligible conditions include (a) heart failure requiring long-term or repeated hospitalization for incurable terminal conditions; (b) NYHA grade III-IV heart failure that does not improve with conventional therapy including beta-blockers and ACE inhibitors; (c) patients with fatal severe arrhythmia who are ineffective against any existing treatment. The patient should be under the age of 60 at listing.

## *4.2.3 Exclusion criteria for heart transplantation*

(a) Severe disease other than the heart (hepatorenal dysfunction, chronic obstructive pulmonary disease, malignant tumor, severe autoimmune disease, etc.), (b) Active peptic ulcer or infection, severe diabetes, severe obesity, and severe osteoporosis (c) alcoholism, drug addiction, neuropsychiatric disease, and (d) severe pulmonary hypertension (recent pulmonary infarction, severe irreversible pulmonary vascular disease, etc., drug (prostaglandin, nitroprusside)), a pulmonary vascular resistance coefficient of 6 units or more, or a transpulmonary artery pressure gradient of 15 mmHg or more, even if oxygen or nitric oxide is used) are not indicated.

*Heart Transplantation and Mechanical Circulatory Support in Japan – Past, Current and Future… DOI: http://dx.doi.org/10.5772/intechopen.113730*
