Heart failure is a global disease with significant morbidity. Heart transplant (HT) can be a lifesaving therapy for select patients with end-stage heart failure. In 2020, over 7000 HTs were performed globally; 90% of HTs were performed in the United States and Western Europe, with only 10% throughout the rest of the world. In this article, we offer an overview of the global landscape of HT, exploring challenges and prospects worldwide. We review HT practices, rates and post-HT outcomes, underscoring the differences between countries within each region. We review limitations hindering HT expansion, such as sociocultural factors, as seen in Japan and Israel; health care funding, in countries like India and South Africa; socioeconomic disparities in access, like the United States; and shortage in organ supply, as seen in China and Saudi Arabia. This review underscores the need to address limitations and highlights opportunities to enhance global HT accessibility, especially in lower- and middle-income countries.
Keywords: heart failure; heart transplantation; low and middle income countries; socioeconomic disparities.