Current status and challenges of cardiac transplantation in the MENA region: A narrative review

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology Pub Date : 2024-11-05 DOI:10.1016/j.cpcardiol.2024.102920

Mohammad Tanashat , Ahmed Zayed MD , Mohammed Ayyad MD , Mouath Abu Daoud , Mohammad Tabbalat , Obieda Altobaishat , Jana Nusier , F.N.U. Deepak , Yazan A. Al-Ajlouni MD, MPhil

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引用次数: 0

Abstract

Introduction

Cardiac transplantation has progressed markedly since 1967, with advances in immunosuppression, surgical techniques, and postoperative care that improve outcomes. However, challenges persist in the Middle East and North Africa (MENA) region due to unique cultural, economic, and infrastructural barriers. This review explores the status, innovations, and challenges of cardiac transplantation within MENA countries, comparing outcomes with global standards.

Methodology

A comprehensive literature search was conducted across PubMed, Web of Science, and Cochrane databases, including studies from inception to May 2024. Search terms targeted heart transplantation practices, challenges, and innovations in the MENA region. Articles not in English, non-human studies, and duplicates were excluded. Data extraction focused on patient demographics, transplantation outcomes, and barriers specific to the MENA context.

Results

Cardiac transplantation in MENA has made strides, with established programs in Saudi Arabia, the UAE, and Lebanon. Innovations like ex-vivo perfusion and Left Ventricular Assist Devices (LVAD) are improving transplant outcomes, yet organ shortages remain critical. Cultural and religious beliefs influence donation rates, and infrastructure varies widely, with disparities in healthcare resources across countries. Key barriers include low donor registration, inconsistent brain death definitions, and limited public awareness. Economic and infrastructure limitations further complicate access to advanced transplantation techniques.

Conclusion

While cardiac transplantation has evolved in MENA, significant barriers hinder widespread adoption. Enhancing public awareness, developing regional networks, and implementing standardized protocols can improve outcomes. Targeted immunosuppressive therapies and continued innovation in organ preservation are essential to advance cardiac transplantation in MENA.

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中东和北非地区心脏移植的现状与挑战：叙述性综述。

导言：自 1967 年以来，心脏移植手术取得了显著进展，免疫抑制、手术技术和术后护理方面的进步改善了手术效果。然而，由于独特的文化、经济和基础设施障碍，中东和北非地区（MENA）仍然面临着挑战。本综述探讨了中东和北非国家心脏移植的现状、创新和挑战，并将结果与全球标准进行了比较：在 PubMed、Web of Science 和 Cochrane 数据库中进行了全面的文献检索，包括从开始到 2024 年 5 月的研究。检索词针对中东和北非地区的心脏移植实践、挑战和创新。排除了非英语文章、非人类研究和重复文章。数据提取侧重于患者人口统计学、移植结果以及中东和北非地区特有的障碍：结果：中东和北非地区的心脏移植手术取得了长足进步，沙特阿拉伯、阿联酋和黎巴嫩都建立了心脏移植项目。体外灌注和左心室辅助装置（LVAD）等创新技术正在改善移植效果，但器官短缺问题依然严峻。文化和宗教信仰影响着捐献率，基础设施也大相径庭，各国的医疗资源也不尽相同。主要障碍包括捐赠者登记率低、脑死亡定义不一致以及公众意识有限。经济和基础设施的限制使先进的移植技术更加复杂：结论：虽然心脏移植在中东和北非地区得到了发展，但广泛采用仍面临重大障碍。提高公众意识、发展地区网络和实施标准化方案可以改善治疗效果。有针对性的免疫抑制疗法和器官保存方面的持续创新对于推动中东和北非地区的心脏移植至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cardiology 医学-心血管系统

CiteScore

4.80

自引率

2.40%

发文量

392

审稿时长

6 days

期刊介绍： Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.