Preface

Since the first heart transplantation was performed by Dr. Christiaan Barnard in South Africa in 1967 [1], there has been steady progress in terms of recipient selection, donor selection and management, surgical technique, preoperative management, and immunosuppression regimen as well as mechanical circulatory support during the wait for heart transplantation. The rapid progress in these areas is associated with steady improvement in outcomes before and after heart transplantation.

Medical therapy, including self-care management, has greatly improved outcomes in end-stage heart failure patients who will not receive heart transplants. A cardiac reshaping net for dilated cardiomyopathy is currently being investigated as an alternative method for heart transplantation.

The development of mechanical circulatory support has also changed therapeutic strategies for stage D heart failure patients. After the first total artificial heart as a bridge to transplant (BTT) was done at the Texas Heart Institute in 1972 [2], the extracorporeal left ventricular assist device (LVAD) was introduced to BTT in 1978 and the Novacor LVAD (Baxter Health Corp., Oakland, CA) was first implanted for BTT at Stanford University [3]. The Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) study [4] revealed that implantable pulsatile LVAD had clinically meaningful survival benefits and improved quality of life in Stage D heart failure patients in 1999; thus, destination therapy took off worldwide.

This book includes eight chapters that provide recent evolutive information on end-stage therapy and heart transplantation.

The "Advanced Heart Failure" section includes Chapter 1, "Self-Care of Patients with Advanced Stage Heart Failure", and Chapter 2, "Cardiac Reshaping Net for Dilated Cardiomyopathy".

The "Mechanical Circulatory Support" section includes Chapter 3, "Extracorporeal Membrane Oxygenation (ECMO) Use in Heart Transplantation", Chapter 4, "Exploring Standard and Alternative Sites for Left Ventricular Assist Device Inflow Cannula and Outflow Graft Placement", and Chapter 5, "LVAD Continuing Care: A Comprehensive Guide to Long-Term Support and Management".

The final section on "Heart Transplantation" includes Chapter 6, "Establishing a Heart Transplantation Program in a Middle East Country: Requirements, Logistics, and Implementation Strategies", Chapter 7, "Heart Preservation Techniques for Transplantation", and Chapter 8, "Heart Transplantation and Mechanical Circulatory Support in Japan – Past, Current and Future Aspects".

I would also like to thank all the contributors for their help in making this special book useful and interesting.

> **Norihide Fukushima** Professor, Senri Kinran University Graduate School of Nursing, Suita, Japan

> > Visiting Director, National Cerebral and Cardiovascular Center, Suita, Japan
