Abstract Body (Do not enter title and authors here): Background: Cardiac transplantation has significantly evolved since its inception in 1967. While the USA and Europe lead in transplant numbers and innovations, the Middle East and North Africa (MENA) region is progressively developing its programs. Countries such as Saudi Arabia, Turkey, the UAE, and Jordan have made notable advancements; however, challenges including donor organ shortages, cultural and religious barriers, and economic constraints persist.
Research Question: What is the current status of cardiac transplantation in the MENA region, and what are the main challenges and advancements faced by these programs?
Goals: This narrative review aims to provide a comprehensive overview of the development, challenges, and outcomes of cardiac transplantation programs in the MENA region.
Methods: A thorough literature review was conducted, examining scholarly articles, clinical reports, and data from national and international transplant registries. Key topics reviewed include the establishment and growth of cardiac transplant centers, advancements in surgical techniques and immunosuppressive therapies, patient outcomes, and barriers specific to the MENA region.
Results: The review found variability in the development and outcomes of cardiac transplantation programs across the MENA region. Saudi Arabia has one of the most developed programs, with 1-year survival rates of 85% and 5-year rates of 75%. Turkey reports 1-year survival rates of approximately 80%. The UAE has recently expanded its transplant capabilities, yet faces challenges in donor organ availability and long-term patient follow-up. Jordan’s program shows promising outcomes with a 1-year survival rate of around 80%, but financial constraints are significant hurdles.
Common challenges include low donor registration rates, lack of public awareness about organ donation, and high operational costs. Disparities in healthcare infrastructure also hinder progress. Innovations such as ex-vivo heart perfusion and new immunosuppressive therapies are being adopted selectively, with Saudi Arabia and Turkey at the forefront.
Conclusions: Enhancing public education on organ donation, establishing robust organ procurement systems, and developing specialized heart failure clinics are crucial. Addressing these issues could potentially improve cardiac transplantation success, leading to a subsequent reduction of cardiovascular disease burden in the MENA region.