The case was for a male patient at the age of 26 who was hospitalized by cardiac failure for the first time. He was diagnosed as DCM with EF 21% and catecholamine dependency continued for 2 months. CPX at the time of discharge indicated Peak VO2 9.3 ml/kg/min and determined medical indication of heart transplant. However, he left from the hospital without permission twice and could not follow the rules or the compliance. He was discharged at the level of NYHAIII when it did not reach to a judgement for social indication of heart transplant. He visited the hospital as an outpatient every 2 weeks after the discharge and a self-care program was thoroughly conducted. The adherence was gradually improved through a participation in self-treatment. Then, he was hospitalized again after 2 months due to exacerbation of heart failure. However, unlike the first hospitalization, he was referred to a transplant facility due to his request for heart transplant. Both medical indication and social indication will be required for determining heart transplant. For young patient with severe heart failure, it would be difficult to gain adherence for heart transplant in a short period of time. The present case demonstrated that compliance could be improved in a short period of time by actively introducing self-care and participating in self-treatment.
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