The Heart Transplant Prioritization System in Brazil: Challenges and Perspectives on the Use of Home Inotropes

Introduction

Despite advances in the treatment of heart failure with reduced ejection fraction (HFrEF), the disease still represents a significant clinical challenge, especially in advanced stages. It is estimated that up to 13% of patients do not respond to conventional therapies, progressing to severe forms of the syndrome, which are associated with high morbidity and mortality.^,

Globally, about 64 million people live with HF, and in Brazil, 941,576 hospitalizations due to HF were recorded between 2019 and 2023, with a progressive increase during this period. In 2023, the incidence was 101.83 cases per 100,000 inhabitants. These numbers reflect not only the magnitude of the problem but also the burden it imposes on the healthcare system.

[…]