Heart failure is one of the most pressing public health challenges of our time. An estimated 64 million people live with it worldwide, and in the United States the number of adults affected is projected to approach 9 million by 2030. For most patients, guideline-directed medications, implantable defibrillators, and cardiac resynchronization therapy can slow the disease for years. But for a meaningful minority, the heart keeps weakening despite the best treatment. This is advanced, or stage D, heart failure, marked by relentless fatigue, breathlessness at rest, repeated hospitalizations, and failing organs.
For decades, the only definitive answer was a heart transpl...
