Pediatric cardiac transplantation

Semin Pediatr Surg. 2017 Aug;26(4):206-212. doi: 10.1053/j.sempedsurg.2017.07.012. Epub 2017 Jul 26.

Abstract

Heart transplantation in pediatric patients generally arises as a treatment option of last resort, that is, the indication is for patients with heart failure of various etiologies, with potential or actual end-organ dysfunction, in whom there are no reasonable, long-term options for life-prolonging therapy. The concept of heart failure is complex in a pediatric population, particularly those with congenital heart disease. While heart failure may refer simply to systolic dysfunction leading to low cardiac output, it can also encompass: diastolic dysfunction in restrictive cardiomyopathy; single ventricle physiology without an option for stable palliation. A good candidate should have a predicted life expectancy less than the median lifetime of a transplanted heart. Significant improvement in survival has been observed over time with 1- and 5-year survival approximately 90% and 80% in the contemporary era.

Keywords: Heart; Pediatric; Transplantation.

Publication types

  • Review

MeSH terms

  • Child
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / mortality
  • Heart Defects, Congenital / surgery
  • Heart Failure / etiology
  • Heart Failure / mortality
  • Heart Failure / surgery*
  • Heart Transplantation* / methods
  • Humans
  • Perioperative Care / methods
  • Referral and Consultation
  • Survival Rate
  • Treatment Outcome
  • Waiting Lists