ТРАНСПЛАНТАЦИЈАТА НА СРЦЕ КАКО ВРВ НА СОВРЕМЕНАТА КАРДИОХИРУРГИЈА: МЕДИЦИНСКИ, ЕТИЧКИ И КЛИНИЧКИ АСПЕКТИ
HEART TRANSPLANTATION AS THE PEAK OF MODERN CARDIAC SURGERY: MEDICAL, ETHICAL AND CLINICAL ASPECTS

Summary/Abstract: Heart transplantation is much more than a high-risk surgical procedure; it is a complex and lengthy process that involves a series of medical, clinical and ethical aspects. Starting from the strict selection of donors and recipients, continuing with the performance of the surgical intervention and postoperative intensive care, up to the continuous long-term monitoring and implementation of immunosuppressive therapy, each segment requires a multidisciplinary approach, a high level of professional expertise and precise coordination. In addition to the clinical challenges, heart transplantation inevitably raises significant ethical issues, especially with regard to organ donation, fairness in the distribution of limited resources and the protection of the dignity of the donor and recipient. These aspects are an integral part of modern transplant medicine and have an essential role in ensuring transparency and trust in the healthcare system. The aim of this research is to present heart transplantation as the ultimate achievement of modern cardiac surgery, through a comprehensive analysis of its medical, clinical and ethical dimensions. With a systematic and analytical approach, the significance of this procedure is emphasized not only as an effective therapeutic option, but also as a complex medical-ethical process that significantly improves survival and quality of life in patients with terminal heart failure. In conditions of limited availability of donor organs and a continuous increase in the number of patients with advanced heart failure, heart transplantation represents a serious clinical, organizational and social challenge for modern healthcare systems. The selection of candidates for heart transplantation in the Republic of North Macedonia is carried out through the official National Transplant List, which includes patients with previously performed HLA-typing and completed necessary documentation. This process is clearly defined and strictly controlled, using established medical, immunological and clinical parameters, in order to enable optimal matching between the donor and the recipient and to achieve the best possible therapeutic result.

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