In the last two decades, tremendous strides in the field of mechanical support have extended the lives of countless sufferers of congestive heart failure, who total close to 1% of the US population. This technology has saved the lives of patients with acute heart failure due to heart attacks, dilated cardiomyopathies and post-cardiotomy shock and sustained patients with end stage congestive heart failure until a precious donor organ has become available for transplantation. In an attempt to address the growing imbalance between demand and supply of donor hearts, and armed with great hope and excitement, investigators are now examining these devices as potential alternatives to cardiac transplantation. This book describes in detail the historical evolution, current knowledge, and future trends in the field of mechanical circulatory support. It will be of greatest interest to cardiologists, circulatory physiologists, cardiac anaesthesiologists, critical care physicians, cardiac surgeons, and other healthcare professionals who are challenged daily with the care of patients with acute and chronic heart failure.

Textbook of Transplantation and Mechanical Support for End-Stage Heart and Lung Disease Comprehensive textbook covering all aspects of the care of patients with advanced heart or lung diseaseTransplantation and Mechanical Support for End-Stage Heart and Lung Disease is the most comprehensive and contemporary textbook available that addresses the medical and surgical treatment options for patients with end-stage heart and lung disease. All facets of these complex and resource-intensive therapies are covered by leading experts — including the basics of transplant immunology, databases, regulatory and ethical aspects of transplantation and conventional and new modalities of donor organ harvest.Transplantation and Mechanical Support for End-Stage Heart and Lung Disease includes further information on topics such as: Historical developments that facilitated heart and lung transplantation; engineering advances in continuous flow technologiesTransplant organizations, oversight, structure, process, databases and registries in the thoracic transplants and MCS fieldCurrent strategies in immune modulation, desensitization protocols and mechanisms of allograft rejection and tolerance/immunosenescenceDetailed descriptions of donor and recipient surgical procedures as well as comprehensive implantation techniques for all available short- and long-term mechanical circulatory support devices, including ECMOOrgan allocation and prioritization, donor evaluation, high risk donors, marginal donors, and risk assessmentRichly enhanced with summary tables and color illustrations to provide an engaging and supportive learning experience, the book will serve as a highly valuable source of contemporary knowledge for medical students, residents, nurses, perfusionists, physicians and surgeons involved in the care of these desperately ill group of patients.“This comprehensive book covers all aspects of advanced heart and lung failure treatment, including shock, short-term and durable mechanical assistance, as well as transplantation. The in-depth information will be welcome by newcomers in the field as well as seasoned veterans.”—Andreas Zuckermann, M.D Vice-Chair, Department of Cardiac Surgery, Director of Cardiac Transplantation Program, Medical University of Vienna, Vienna General Hospital“This comprehensive tour-de-force compendium covers practical issues of clinical administration, program development, care pathways, ongoing challenges and opportunities in each treatment area as a must go-to reference for guidance in the rapidly evolving fields of mechanical circulatory support and transplantation.”—Mandeep R. Mehra, MBBS, MSc, FRCP Executive Director, Center for Advanced Heart Disease, Brigham and Women’s Hospital, Harvard Medical School“This unique textbook authored by key opinion leaders is a refreshing 'wind of change' in our field, one that will well serve all professionals involved in the care of end-stage heart and lung patients for many years to come.”—Marcelo Cypel MD, MSc, FACS, FRCSC Surgical Director Ajmera Transplant Centre at UHN , University of Toronto

Textbook of Transplantation and Mechanical Support for End-Stage Heart and Lung Disease

Comprehensive textbook covering all aspects of the care of patients with advanced heart or lung disease

Transplantation and Mechanical Support for End-Stage Heart and Lung Disease is the most comprehensive and contemporary textbook available that addresses the medical and surgical treatment options for patients with end-stage heart and lung disease. All facets of these complex and resource-intensive therapies are covered by leading experts — including the basics of transplant immunology, databases, regulatory and ethical aspects of transplantation and conventional and new modalities of donor organ harvest.

Transplantation and Mechanical Support for End-Stage Heart and Lung Disease includes further information on topics such as:

Historical developments that facilitated heart and lung transplantation; engineering advances in continuous flow technologies Transplant organizations, oversight, structure, process, databases and registries in the thoracic transplants and MCS field Current strategies in immune modulation, desensitization protocols and mechanisms of allograft rejection and tolerance/immunosenescence Detailed descriptions of donor and recipient surgical procedures as well as comprehensive implantation techniques for all available short- and long-term mechanical circulatory support devices, including ECMO Organ allocation and prioritization, donor evaluation, high risk donors, marginal donors, and risk assessment

Richly enhanced with summary tables and color illustrations to provide an engaging and supportive learning experience, the book will serve as a highly valuable source of contemporary knowledge for medical students, residents, nurses, perfusionists, physicians and surgeons involved in the care of these desperately ill group of patients.

“This comprehensive book covers all aspects of advanced heart and lung failure treatment, including shock, short-term and durable mechanical assistance, as well as transplantation. The in-depth information will be welcome by newcomers in the field as well as seasoned veterans.” —Andreas Zuckermann, M.D Vice-Chair, Department of Cardiac Surgery, Director of Cardiac Transplantation Program, Medical University of Vienna, Vienna General Hospital

“This comprehensive tour-de-force compendium covers practical issues of clinical administration, program development, care pathways, ongoing challenges and opportunities in each treatment area as a must go-to reference for guidance in the rapidly evolving fields of mechanical circulatory support and transplantation.” —Mandeep R. Mehra, MBBS, MSc, FRCP Executive Director, Center for Advanced Heart Disease, Brigham and Women’s Hospital, Harvard Medical School

“This unique textbook authored by key opinion leaders is a refreshing ''wind of change'' in our field, one that will well serve all professionals involved in the care of end-stage heart and lung patients for many years to come.” —Marcelo Cypel MD, MSc, FACS, FRCSC Surgical Director Ajmera Transplant Centre at UHN , University of Toronto

Textbook of Transplantation and Mechanical Support for End-Stage Heart and Lung Disease

Comprehensive textbook covering all aspects of the care of patients with advanced heart or lung disease

Transplantation and Mechanical Support for End-Stage Heart and Lung Disease is the most comprehensive and contemporary textbook available that addresses the medical and surgical treatment options for patients with end-stage heart and lung disease. All facets of these complex and resource-intensive therapies are covered by leading experts — including the basics of transplant immunology, databases, regulatory and ethical aspects of transplantation and conventional and new modalities of donor organ harvest.

Transplantation and Mechanical Support for End-Stage Heart and Lung Disease includes further information on topics such as:

Historical developments that facilitated heart and lung transplantation; engineering advances in continuous flow technologies Transplant organizations, oversight, structure, process, databases and registries in the thoracic transplants and MCS field Current strategies in immune modulation, desensitization protocols and mechanisms of allograft rejection and tolerance/immunosenescence Detailed descriptions of donor and recipient surgical procedures as well as comprehensive implantation techniques for all available short- and long-term mechanical circulatory support devices, including ECMO Organ allocation and prioritization, donor evaluation, high risk donors, marginal donors, and risk assessment

Richly enhanced with summary tables and color illustrations to provide an engaging and supportive learning experience, the book will serve as a highly valuable source of contemporary knowledge for medical students, residents, nurses, perfusionists, physicians and surgeons involved in the care of these desperately ill group of patients.

“This comprehensive book covers all aspects of advanced heart and lung failure treatment, including shock, short-term and durable mechanical assistance, as well as transplantation. The in-depth information will be welcome by newcomers in the field as well as seasoned veterans.” —Andreas Zuckermann, M.D Vice-Chair, Department of Cardiac Surgery, Director of Cardiac Transplantation Program, Medical University of Vienna, Vienna General Hospital

“This comprehensive tour-de-force compendium covers practical issues of clinical administration, program development, care pathways, ongoing challenges and opportunities in each treatment area as a must go-to reference for guidance in the rapidly evolving fields of mechanical circulatory support and transplantation.” —Mandeep R. Mehra, MBBS, MSc, FRCP Executive Director, Center for Advanced Heart Disease, Brigham and Women’s Hospital, Harvard Medical School

“This unique textbook authored by key opinion leaders is a refreshing ''wind of change'' in our field, one that will well serve all professionals involved in the care of end-stage heart and lung patients for many years to come.” —Marcelo Cypel MD, MSc, FACS, FRCSC Surgical Director Ajmera Transplant Centre at UHN , University of Toronto

In 1962, Thomas Kuhne coined the term “paradigm shift” while arguing that human knowledge advances by quantum leaps with interspersed smaller steps. Preparation for the major advance is generally not a concerted effort by thought leaders. Rather, a few (or one) visionaries gain insights into a process and are able to definitely demonstrate the accuracy of their worldview. Often, the epiphany does not occur during the intellectual lifetime of the discoverers. Medicine has had numerous such “paradigm shifts” including the compelling reworking of Galen’s concepts of the body. Of note, the scientific world of the time explained the new views by arguing that the human body must have changed between the time of ancient Greece and modern Europe. The inauguration of cardiac surgery itself required profound shifts in medicine’s view of physiology. Yet, over the ensuing 40 years, the field was fine tuned so we could provide greater than 95% success rates in elective surgery with low cost and short h- pital stays. In some parts of the world, the procedures were viewed as commodities and prices dropped as providers were unable to differentiate the quality of their work. As patients and their physicians became more demanding, the desire to make the procedures “minimally invasive” grew. In effect, what we were really searching for was a life saving procedure that also preserved quality of life. In short, “minimally invasive” has really been a code phrase for procedures that disrupt our quality of life the least.

In 1962, Thomas Kuhne coined the term “paradigm shift” while arguing that human knowledge advances by quantum leaps with interspersed smaller steps. Preparation for the major advance is generally not a concerted effort by thought leaders. Rather, a few (or one) visionaries gain insights into a process and are able to definitely demonstrate the accuracy of their worldview. Often, the epiphany does not occur during the intellectual lifetime of the discoverers. Medicine has had numerous such “paradigm shifts” including the compelling reworking of Galen’s concepts of the body. Of note, the scientific world of the time explained the new views by arguing that the human body must have changed between the time of ancient Greece and modern Europe. The inauguration of cardiac surgery itself required profound shifts in medicine’s view of physiology. Yet, over the ensuing 40 years, the field was fine tuned so we could provide greater than 95% success rates in elective surgery with low cost and short h- pital stays. In some parts of the world, the procedures were viewed as commodities and prices dropped as providers were unable to differentiate the quality of their work. As patients and their physicians became more demanding, the desire to make the procedures “minimally invasive” grew. In effect, what we were really searching for was a life saving procedure that also preserved quality of life. In short, “minimally invasive” has really been a code phrase for procedures that disrupt our quality of life the least.

In 1962, Thomas Kuhne coined the term “paradigm shift” while arguing that human knowledge advances by quantum leaps with interspersed smaller steps. Preparation for the major advance is generally not a concerted effort by thought leaders. Rather, a few (or one) visionaries gain insights into a process and are able to definitely demonstrate the accuracy of their worldview. Often, the epiphany does not occur during the intellectual lifetime of the discoverers. Medicine has had numerous such “paradigm shifts” including the compelling reworking of Galen’s concepts of the body. Of note, the scientific world of the time explained the new views by arguing that the human body must have changed between the time of ancient Greece and modern Europe. The inauguration of cardiac surgery itself required profound shifts in medicine’s view of physiology. Yet, over the ensuing 40 years, the field was fine tuned so we could provide greater than 95% success rates in elective surgery with low cost and short h- pital stays. In some parts of the world, the procedures were viewed as commodities and prices dropped as providers were unable to differentiate the quality of their work. As patients and their physicians became more demanding, the desire to make the procedures “minimally invasive” grew. In effect, what we were really searching for was a life saving procedure that also preserved quality of life. In short, “minimally invasive” has really been a code phrase for procedures that disrupt our quality of life the least.

In the last two decades, tremendous strides in the field of mechanical support have extended the lives of countless sufferers of congestive heart failure, who total close to 1% of the US population. This technology has saved the lives of patients with acute heart failure due to heart attacks, dilated cardiomyopathies and post-cardiotomy shock and sustained patients with end stage congestive heart failure until a precious donor organ has become available for transplantation. In an attempt to address the growing imbalance between demand and supply of donor hearts, and armed with great hope and excitement, investigators are now examining these devices as potential alternatives to cardiac transplantation. This book describes in detail the historical evolution, current knowledge, and future trends in the field of mechanical circulatory support. It will be of greatest interest to cardiologists, circulatory physiologists, cardiac anaesthesiologists, critical care physicians, cardiac surgeons, and other healthcare professionals who are challenged daily with the care of patients with acute and chronic heart failure.

Textbook of Transplantation and Mechanical Support for End-Stage Heart and Lung Disease Comprehensive textbook covering all aspects of the care of patients with advanced heart or lung diseaseTransplantation and Mechanical Support for End-Stage Heart and Lung Disease is the most comprehensive and contemporary textbook available that addresses the medical and surgical treatment options for patients with end-stage heart and lung disease. All facets of these complex and resource-intensive therapies are covered by leading experts — including the basics of transplant immunology, databases, regulatory and ethical aspects of transplantation and conventional and new modalities of donor organ harvest.Transplantation and Mechanical Support for End-Stage Heart and Lung Disease includes further information on topics such as: Historical developments that facilitated heart and lung transplantation; engineering advances in continuous flow technologiesTransplant organizations, oversight, structure, process, databases and registries in the thoracic transplants and MCS fieldCurrent strategies in immune modulation, desensitization protocols and mechanisms of allograft rejection and tolerance/immunosenescenceDetailed descriptions of donor and recipient surgical procedures as well as comprehensive implantation techniques for all available short- and long-term mechanical circulatory support devices, including ECMOOrgan allocation and prioritization, donor evaluation, high risk donors, marginal donors, and risk assessmentRichly enhanced with summary tables and color illustrations to provide an engaging and supportive learning experience, the book will serve as a highly valuable source of contemporary knowledge for medical students, residents, nurses, perfusionists, physicians and surgeons involved in the care of these desperately ill group of patients.“This comprehensive book covers all aspects of advanced heart and lung failure treatment, including shock, short-term and durable mechanical assistance, as well as transplantation. The in-depth information will be welcome by newcomers in the field as well as seasoned veterans.”—Andreas Zuckermann, M.D Vice-Chair, Department of Cardiac Surgery, Director of Cardiac Transplantation Program, Medical University of Vienna, Vienna General Hospital“This comprehensive tour-de-force compendium covers practical issues of clinical administration, program development, care pathways, ongoing challenges and opportunities in each treatment area as a must go-to reference for guidance in the rapidly evolving fields of mechanical circulatory support and transplantation.”—Mandeep R. Mehra, MBBS, MSc, FRCP Executive Director, Center for Advanced Heart Disease, Brigham and Women’s Hospital, Harvard Medical School“This unique textbook authored by key opinion leaders is a refreshing 'wind of change' in our field, one that will well serve all professionals involved in the care of end-stage heart and lung patients for many years to come.”—Marcelo Cypel MD, MSc, FACS, FRCSC Surgical Director Ajmera Transplant Centre at UHN , University of Toronto

Textbook of Transplantation and Mechanical Support for End-Stage Heart and Lung Disease

Comprehensive textbook covering all aspects of the care of patients with advanced heart or lung disease

Transplantation and Mechanical Support for End-Stage Heart and Lung Disease is the most comprehensive and contemporary textbook available that addresses the medical and surgical treatment options for patients with end-stage heart and lung disease. All facets of these complex and resource-intensive therapies are covered by leading experts — including the basics of transplant immunology, databases, regulatory and ethical aspects of transplantation and conventional and new modalities of donor organ harvest.

Transplantation and Mechanical Support for End-Stage Heart and Lung Disease includes further information on topics such as:

Historical developments that facilitated heart and lung transplantation; engineering advances in continuous flow technologies Transplant organizations, oversight, structure, process, databases and registries in the thoracic transplants and MCS field Current strategies in immune modulation, desensitization protocols and mechanisms of allograft rejection and tolerance/immunosenescence Detailed descriptions of donor and recipient surgical procedures as well as comprehensive implantation techniques for all available short- and long-term mechanical circulatory support devices, including ECMO Organ allocation and prioritization, donor evaluation, high risk donors, marginal donors, and risk assessment

Richly enhanced with summary tables and color illustrations to provide an engaging and supportive learning experience, the book will serve as a highly valuable source of contemporary knowledge for medical students, residents, nurses, perfusionists, physicians and surgeons involved in the care of these desperately ill group of patients.

“This comprehensive book covers all aspects of advanced heart and lung failure treatment, including shock, short-term and durable mechanical assistance, as well as transplantation. The in-depth information will be welcome by newcomers in the field as well as seasoned veterans.” —Andreas Zuckermann, M.D Vice-Chair, Department of Cardiac Surgery, Director of Cardiac Transplantation Program, Medical University of Vienna, Vienna General Hospital

“This comprehensive tour-de-force compendium covers practical issues of clinical administration, program development, care pathways, ongoing challenges and opportunities in each treatment area as a must go-to reference for guidance in the rapidly evolving fields of mechanical circulatory support and transplantation.” —Mandeep R. Mehra, MBBS, MSc, FRCP Executive Director, Center for Advanced Heart Disease, Brigham and Women’s Hospital, Harvard Medical School

“This unique textbook authored by key opinion leaders is a refreshing ''wind of change'' in our field, one that will well serve all professionals involved in the care of end-stage heart and lung patients for many years to come.” —Marcelo Cypel MD, MSc, FACS, FRCSC Surgical Director Ajmera Transplant Centre at UHN , University of Toronto

Textbook of Transplantation and Mechanical Support for End-Stage Heart and Lung Disease

Comprehensive textbook covering all aspects of the care of patients with advanced heart or lung disease

Transplantation and Mechanical Support for End-Stage Heart and Lung Disease is the most comprehensive and contemporary textbook available that addresses the medical and surgical treatment options for patients with end-stage heart and lung disease. All facets of these complex and resource-intensive therapies are covered by leading experts — including the basics of transplant immunology, databases, regulatory and ethical aspects of transplantation and conventional and new modalities of donor organ harvest.

Transplantation and Mechanical Support for End-Stage Heart and Lung Disease includes further information on topics such as:

Historical developments that facilitated heart and lung transplantation; engineering advances in continuous flow technologies Transplant organizations, oversight, structure, process, databases and registries in the thoracic transplants and MCS field Current strategies in immune modulation, desensitization protocols and mechanisms of allograft rejection and tolerance/immunosenescence Detailed descriptions of donor and recipient surgical procedures as well as comprehensive implantation techniques for all available short- and long-term mechanical circulatory support devices, including ECMO Organ allocation and prioritization, donor evaluation, high risk donors, marginal donors, and risk assessment

Richly enhanced with summary tables and color illustrations to provide an engaging and supportive learning experience, the book will serve as a highly valuable source of contemporary knowledge for medical students, residents, nurses, perfusionists, physicians and surgeons involved in the care of these desperately ill group of patients.

“This comprehensive book covers all aspects of advanced heart and lung failure treatment, including shock, short-term and durable mechanical assistance, as well as transplantation. The in-depth information will be welcome by newcomers in the field as well as seasoned veterans.” —Andreas Zuckermann, M.D Vice-Chair, Department of Cardiac Surgery, Director of Cardiac Transplantation Program, Medical University of Vienna, Vienna General Hospital

“This comprehensive tour-de-force compendium covers practical issues of clinical administration, program development, care pathways, ongoing challenges and opportunities in each treatment area as a must go-to reference for guidance in the rapidly evolving fields of mechanical circulatory support and transplantation.” —Mandeep R. Mehra, MBBS, MSc, FRCP Executive Director, Center for Advanced Heart Disease, Brigham and Women’s Hospital, Harvard Medical School

“This unique textbook authored by key opinion leaders is a refreshing ''wind of change'' in our field, one that will well serve all professionals involved in the care of end-stage heart and lung patients for many years to come.” —Marcelo Cypel MD, MSc, FACS, FRCSC Surgical Director Ajmera Transplant Centre at UHN , University of Toronto

In 1962, Thomas Kuhne coined the term “paradigm shift” while arguing that human knowledge advances by quantum leaps with interspersed smaller steps. Preparation for the major advance is generally not a concerted effort by thought leaders. Rather, a few (or one) visionaries gain insights into a process and are able to definitely demonstrate the accuracy of their worldview. Often, the epiphany does not occur during the intellectual lifetime of the discoverers. Medicine has had numerous such “paradigm shifts” including the compelling reworking of Galen’s concepts of the body. Of note, the scientific world of the time explained the new views by arguing that the human body must have changed between the time of ancient Greece and modern Europe. The inauguration of cardiac surgery itself required profound shifts in medicine’s view of physiology. Yet, over the ensuing 40 years, the field was fine tuned so we could provide greater than 95% success rates in elective surgery with low cost and short h- pital stays. In some parts of the world, the procedures were viewed as commodities and prices dropped as providers were unable to differentiate the quality of their work. As patients and their physicians became more demanding, the desire to make the procedures “minimally invasive” grew. In effect, what we were really searching for was a life saving procedure that also preserved quality of life. In short, “minimally invasive” has really been a code phrase for procedures that disrupt our quality of life the least.

In 1962, Thomas Kuhne coined the term “paradigm shift” while arguing that human knowledge advances by quantum leaps with interspersed smaller steps. Preparation for the major advance is generally not a concerted effort by thought leaders. Rather, a few (or one) visionaries gain insights into a process and are able to definitely demonstrate the accuracy of their worldview. Often, the epiphany does not occur during the intellectual lifetime of the discoverers. Medicine has had numerous such “paradigm shifts” including the compelling reworking of Galen’s concepts of the body. Of note, the scientific world of the time explained the new views by arguing that the human body must have changed between the time of ancient Greece and modern Europe. The inauguration of cardiac surgery itself required profound shifts in medicine’s view of physiology. Yet, over the ensuing 40 years, the field was fine tuned so we could provide greater than 95% success rates in elective surgery with low cost and short h- pital stays. In some parts of the world, the procedures were viewed as commodities and prices dropped as providers were unable to differentiate the quality of their work. As patients and their physicians became more demanding, the desire to make the procedures “minimally invasive” grew. In effect, what we were really searching for was a life saving procedure that also preserved quality of life. In short, “minimally invasive” has really been a code phrase for procedures that disrupt our quality of life the least.

In 1962, Thomas Kuhne coined the term “paradigm shift” while arguing that human knowledge advances by quantum leaps with interspersed smaller steps. Preparation for the major advance is generally not a concerted effort by thought leaders. Rather, a few (or one) visionaries gain insights into a process and are able to definitely demonstrate the accuracy of their worldview. Often, the epiphany does not occur during the intellectual lifetime of the discoverers. Medicine has had numerous such “paradigm shifts” including the compelling reworking of Galen’s concepts of the body. Of note, the scientific world of the time explained the new views by arguing that the human body must have changed between the time of ancient Greece and modern Europe. The inauguration of cardiac surgery itself required profound shifts in medicine’s view of physiology. Yet, over the ensuing 40 years, the field was fine tuned so we could provide greater than 95% success rates in elective surgery with low cost and short h- pital stays. In some parts of the world, the procedures were viewed as commodities and prices dropped as providers were unable to differentiate the quality of their work. As patients and their physicians became more demanding, the desire to make the procedures “minimally invasive” grew. In effect, what we were really searching for was a life saving procedure that also preserved quality of life. In short, “minimally invasive” has really been a code phrase for procedures that disrupt our quality of life the least.