ABSTRACT
Diagnosis of acute and late cardiotoxicity from cancer therapeutics has become increasingly important as the scope of cardio-oncology increases exponentially, both in terms of the number of people affected and the types of therapies it encompasses. Cardiac magnetic resonance (CMR) is a tool that can offer unparalleled diagnostic information compared with other imaging modalities, but its utilization is often delayed, at the expense of patient care, due to the need for insurance pre-authorization. This paper highlights situations in which CMR is preferred as the diagnostic modality and provides examples of diagnoses more likely to be approved by insurance companies. It also provides specific cardio-oncology diagnoses or questions to help the clinical cardio-oncologist navigate the pre-authorization process.
ABSTRACT
The first successful human heart transplantation was reported on 3 December 1967, by Christiaan Barnard in South Africa. Since then this life-saving procedure has been performed in over 120 000 patients. A limitation to the performance of this procedure is the availability of donor hearts with as many as 20% of patients dying before a donor's heart is available for transplant. Today, hearts for transplantation are procured from individuals experiencing donation after brain death (DBD). Interestingly, this, however, was not always the case as the first heart transplants occurred after circulatory death. Revisiting the availability of hearts for transplant from those experiencing donation after circulatory death (DCD) could further expand the number of hearts suitable for transplantation. There are several considerations pertinent to transplanting hearts from those undergoing circulatory death. In this review, we summarize the main distinctions between DBD and DCD heart donation and discuss the research relevant to increasing the number of hearts available for transplantation by including individual's hearts that experience circulatory death.
