Innovation in Heart Transplantation

Heart transplantation remains a cornerstone therapy for advanced heart failure and a field defined by ongoing innovation. Since the first human heart transplant over 50 years ago, advances in immunosuppression, rejection surveillance, and multidisciplinary care have significantly improved outcomes. However, important challenges remain, including the need to expand the donor pool.

This session will highlight current and emerging innovations poised to transform heart transplantation, including novel immunosuppressive strategies, advanced rejection surveillance techniques that may reduce the need for biopsy, approaches to mitigate allosensitization and antibody-mediated rejection, and strategies to expand the donor pool through donation after circulatory death (DCD) and xenotransplantation.

The focus will be on practical, forward-looking approaches to advance the field, with insights from leaders in transplantation. The session aims to inspire engagement in novel clinical trials and continued innovation in heart failure and transplant care.

Learning Objectives

• Evaluate emerging immunosuppressive strategies and novel approaches to rejection management, including therapies to reduce allosensitization and antibody-mediated rejection, and their potential to improve long-term graft survival.
• Compare contemporary and emerging rejection surveillance modalities that enhance diagnostic accuracy while reducing reliance on routine endomyocardial biopsy, and determine how to incorporate these tools into clinical practice.
• Discuss new approaches to reduce allosensitization and antibody-mediated rejection.
• Review the data regarding deprioritizing LVAD patient sfor transplant with the 2018 UNOS allocation changes and discuss the newly implemented UNOS allocation update to re-prioritize LVAD patients.