Timely referrals for transplantation and left ventricular assist device implantation play a key role in favorable outcomes in patients with advanced heart failure. Nonetheless, evaluation usually occurs at advanced heart failure centers and is obscured from referring physicians. The purposes of this review are to explain the decision-making process for candidacy for advanced therapies and to describe the potential impact of the new organ allocation algorithm on center decision making. The document first addresses the signs of advanced heart failure, specifically focusing on the importance of the syndrome of low cardiac output as a key feature of advanced heart failure, and then summarizes the evaluation as a 3-step process addressing the following questions: 1) Is transplantation or durable assist device placement indicated? 2) Are there contraindications to either intervention? 3) How can one choose between transplantation and left ventricular assist device implantation if advanced therapies are indicated and not contraindicated?

中文翻译：

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心脏移植和 LVAD 植入的评估

及时转诊进行移植和左心室辅助装置植入对晚期心力衰竭患者的良好预后起着关键作用。尽管如此，评估通常发生在先进的心力衰竭中心，并且被转诊医生掩盖。本综述的目的是解释先进疗法候选的决策过程，并描述新器官分配算法对中心决策的潜在影响。该文件首先阐述了晚期心力衰竭的迹象，特别强调了低心输出量综合征作为晚期心力衰竭一个关键特征的重要性，然后将评估总结为解决以下问题的 3 个步骤：1) 是否需要移植或放置耐用辅助装置？2) 这两种干预是否存在禁忌症？3) 如果有适应症且无禁忌症，如何在移植和左心室辅助装置植入之间做出选择？