Intrathoracic organ transplantation has received little attention from the CICM examiners, with the exception of one SAQ (Question 22 from the first paper of 2009) which asks the candidate to "discuss the clinical issues specific to the heart lung transplant" in a patient with pneumonia.
LITFL have an excellent heart transplant overview, with a focus on ICU-level management. Additionally, there is a chapter on this topic in Oh's Manual (Ch.102, pp. 1053) put together by Macdonald and Jansz. This chapter offers some blue boxes full of donation criteria, and a series of protocols detailing the exact doses and timings of the immunomodulators and antimicrobial prophylaxis.
A more detailed summary of complications of combined heart and lung transplantation, focusing on the physiological derangements associated with a long-term transpant, is also available. Specifically, the infectious complications of heart-lung transplantation receive some attention in the Infectious Diseases part of the Required Reading section.
The following brief summary is an attempt to synthesise the most memorable points in Oh's Manual together with the pearls offered by LITFL.
Survival rates for cardiac transplantation:
Notes on cardiac donation
While waiting for a transplant:
In brief summary:
The CCC entry from LITFL lists an excellent series of freely available articles which frustrate the time-poor fellowship candidate with their detailed treatment of this topic. They are as follows:
Lindenfeld, JoAnn, et al. "Drug therapy in the heart transplant recipient part I: cardiac rejection and immunosuppressive drugs." Circulation 110.24 (2004): 3734-3740.
Burgess, M. I. "The role of echocardiography in evaluation of the cardiac transplant recipient." Minerva cardioangiologica 51.6 (2003): 677-987.
Mancini, Donna, and Katherine Lietz. "Selection of cardiac transplantation candidates in 2010." Circulation 122.2 (2010): 173-183.
Ramakrishna, Harish, Dawn E. Jaroszewski, and Francisco A. Arabia. "Adult cardiac transplantation: A review of perioperative management Part-I." Annals of cardiac anaesthesia 12.1 (2009): 71.
Ramakrishna, Harish, Dawn E. Jaroszewski, and Francisco A. Arabia. "Adult cardiac transplantation: a review of perioperative management (part-II)." Annals of cardiac anaesthesia 12.2 (2009): 155.
Futterman, Laurie G., and Louis Lemberg. "Cardiac transplantation: a second chance for extending life." American Journal of Critical Care 17.2 (2008): 168-172.
Deng, Mario C. "Cardiac transplantation." Heart 87.2 (2002): 177-184.
Knisely, Barbara L., et al. "Imaging of cardiac transplantation complications."Radiographics: a review publication of the Radiological Society of North America, Inc 19.2 (1998): 321-39.
Additionally, there is a series of recommendations regarding extracorporeal support:
Feldman, David, et al. "The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support: executive summary." The Journal of Heart and Lung Transplantation 32.2 (2013): 157-187.
Maheshwari, Arun, and Monish S. Raut. "Perioperative Management of Heart Transplantation." Anesthesia for Transplant Surgery (2014): 14.
Costanzo, Maria Rosa, et al. "The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients." The Journal of Heart and Lung Transplantation 29.8 (2010): 914-956.
Question 22 from the first paper of 2009 also fields the following references:
Cisneros, J. M., et al. "Pneumonia after heart transplantation: a multiinstitutional study." Clinical infectious diseases 27.2 (1998): 324-331.
Reichenspurner, Hermann, et al. "Stanford experience with obliterative bronchiolitis after lung and heart-lung transplantation." The Annals of thoracic surgery 62.5 (1996): 1467-1473.
Gao, Shao-Zhou, et al. "Accelerated coronary vascular disease in the heart transplant patient: coronary arteriographic findings." Journal of the American College of Cardiology 12.2 (1988): 334-340.
Yusuf, S. A. L. I. M., et al. "Increased sensitivity of the denervated transplanted human heart to isoprenaline both before and after beta-adrenergic blockade."Circulation 75.4 (1987): 696-704.