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Introduction: Heart transplantation (HTx) has emerged as a pivotal intervention for end-stage heart failure, offering significant improvements in survival and quality of life. This manuscript elucidates the landscape of HTx across Latin America (LATAM) from its advent in 1968 through December 2022, shedding light on its evolution, current practices, and regional disparities., Methods: We distributed a structured questionnaire to the national coordinators or representatives of the Interamerican Council of Heart Failure and Pulmonary Hypertension, collating responses from 20 LATAM nations. This approach facilitated a comprehensive aggregation of regional HTx data., Results: A total of 12,374 HTx were performed in 166 centers across 16 LATAM countries, with Brazil, Argentina, and Colombia accounting for the majority of procedures. Pediatric transplants represented 9% of the total caseload, and combined organ transplants were reported in 62.5% of the participating countries, underscoring the complexity and breadth of transplant services in the region., Conclusion: Despite facing infrastructural and logistical challenges, LATAM has demonstrated a robust capacity to conduct high-complexity transplant procedures. The establishment of a structured, regional HTx registry is imperative to enhance data collection and analysis, which in turn can inform clinical decision-making and policy development, ultimately improving patient outcomes across the continent., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Acute heart failure (HF) is associated with poor prognosis. After the acute event, there is a vulnerable period during which the patient has a marked risk of readmission or death. Therefore, early optimization of treatment is mandatory during the vulnerable period. The objective of this article is to provide recommendations to address the management of patients with HF during the vulnerable period from a practical point of view. A group of Mexican experts met to prepare a consensus document. The vulnerable period, with a duration of up to 6 months after the acute event - either hospitalization, visit to the emergency department or the outpatient clinic/day hospital - represents a real window of opportunity to improve outcomes for these patients. To best individualize the recommendations, the management strategies were divided into three periods (early, intermediate and late vulnerable period), including not only therapeutic options but also evaluation and education. Importantly, the recommendations are addressed to the entire cardiology team, including physicians and nurses, but also other specialists implicated in the management of these patients. In conclusion, this document represents an opportunity to improve the management of this population at high risk, with the aim of reducing the burden of HF., Competing Interests: Disclosure and potential conflicts of interest: JAMS: speaker, advisor and researcher for AstraZeneca, Bayer México S.A., M8, Novartis, Roche, Servier, Silanes. The author received no compensation or commercial guidance for the creation of this manuscript. JACL: speaker, advisor and researcher for AstraZeneca, Pfizer, Bayer México S.A., M8, Novartis, Roche, Silanes, Armstrong. The author received no compensation or commercial guidance for the creation of this manuscript. ACM has worked advising Bayer and other laboratories on issues regarding heart failure. JBIM is speaker or advisor for AstraZeneca, M8, Novartis, Servier, Merck. GHMZ is speaker or advisor for AstraZeneca, Bayer, Boehringer Ingelheim, Eli-Lilly, Novartis, Servier. LOD is speaker for Novartis, Amgen. GML is speaker or advisor for AstraZeneca, Bayer, Boehringer Ingelheim, Eli-Lilly, Novartis, Servier. LFAM has worked advising Bayer and other laboratories on issues regarding heart failure. PLNE: speaker for Menarini and Novartis. SACL, JEPB, EHHG, RPM declare no conflict of interest in relation to this article. None of the authors have received compensation or commercial guidance for the creation of this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2023/12/dic.2023-8-1-COI.pdf, (Copyright © 2024 Magaña Serrano JA, Cigarroa López JA, Chávez Mendoza A, Ivey-Miranda JB, Mendoza Zavala GH, Olmos Domínguez L, Chávez Leal SA, Pombo Bartelt JE, Herrera-Garza EH, Mercado Leal G, Parra Michel R, Aguilera Mora LF, Nuriulu Escobar PL.)

End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed., (Copyright © 2015. Published by Elsevier Ireland Ltd.)

Heart failure constantly increases its incidence and prevalence in our society, it was imperative to start a heart transplant program to improve the survival rates of patients with end stages of the disease. Legal issues made impossible to transplant patients out of Mexico City until recent years. Even with an acute hemodynamic and clinic improvement after the transplant, these patients frequently develop complications such as graft rejection or opportunistic infections due to the immunosuppressive schemes increasing the morbidity and mortality of the procedure. In the present article we report the experience acquired with 65 heart transplant patients from 4 transplant programs in Monterrey, Nuevo Leon, one of them from the socialized system and the other three from private hospitals. Our program not only has successfully transplanted patients with advanced age but, for the first time in Latin America we have transplanted patients assisted with the ambulatory Thoratec TLC II system. Even that we have faced obstacles like a newly started donation culture in our population and limited resources, our patient's survival rate push us to continue working with these very ill population.