Destination therapy (DT) is the indication to implant a left ventricular assist device (LVAD) in a patient with stage D heart failure who is not a candidate for heart transplantation. The implantable LVAD has been utilized in Japan since 2011 under the indication of bridge to transplant (BTT). After almost 10 year lag, DT has finally been approved and reimbursed in May 2021 in Japan. To initiate the DT program in Japan, revision of the LVAD indication from BTT is necessary. Also, in-depth discussion of caregiver issues as well as end-of-life care is indispensable. For that purpose, we assembled a DT committee of multidisciplinary members in August 2020, and started monthly discussions via web-based communication during the COVID-19 pandemic. This is a summary of the consensus reached after 6 months’ discussion, and we have included as many relevant topics as possible. Clinical application of DT has just started, and we are willing to revise this consensus to meet the forthcoming issues raised during real-world clinical experience.

目的地治疗 (DT) 是指在不适合心脏移植的 D 期心力衰竭患者中植入左心室辅助装置 (LVAD)。自 2011 年以来，植入式 LVAD 已在移植桥接 (BTT) 的指示下在日本使用。经过近 10 年的滞后，DT 终于于 2021 年 5 月在日本获得批准和报销。为了在日本启动 DT 计划，有必要修改 BTT 的 LVAD 指示。此外，对护理人员问题以及临终关怀的深入讨论也是必不可少的。为此，我们于 2020 年 8 月组建了一个由多学科成员组成的 DT 委员会，并在 COVID-19 大流行期间通过基于网络的交流开始每月讨论。这是经过6个月讨论达成的共识的总结，我们已经包含了尽可能多的相关主题。DT 的临床应用才刚刚开始，我们愿意修改这一共识，以满足现实世界临床经验中即将提出的问题。