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Updated: Jul 13, 2026
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Somatic growth in infant heart transplant recipients
1Department of Pediatrics, Loma Linda University Children's Hospital and Medical Center and Loma Linda University School of Medicine, California 92354, USA. Richard_Chinnock@ccmail.llu.edu
Insights
Infant heart transplant recipients experience poor growth before surgery, but show significant catch-up growth post-transplant. Most children achieve normal weight and height by five years, influenced by early illness, rejection, and genetics.
Area of Science:
- Pediatric Cardiology
- Transplantation Medicine
- Growth and Development
Background:
- Infant heart transplantation is a growing field with over a decade of clinical practice.
- Understanding long-term somatic growth is crucial for assessing the overall success of infant heart transplantation.
Purpose of the Study:
- To analyze growth patterns in infants following heart transplantation.
- To identify factors influencing growth in the early and late post-transplant periods.
Main Methods:
- Retrospective analysis of growth velocity from birth to 12 months post-transplant in 77 infants.
- Evaluation of growth parameters beyond 5 years in 51 long-term survivors.
- Statistical analysis of factors affecting late height attainment.
Main Results:
- Significant improvements in weight and length velocity were observed within 3 months post-transplantation (p<0.01 for weight, p=0.04 for length).
- At a median of 6.8 years post-transplant, 88% of survivors had weight and height within the normal range.
- Factors like hospital days, rejection episodes, mid-parental height, and GFR influenced late height attainment.
Conclusions:
- Infants experience poor growth prior to heart transplantation but demonstrate adequate catch-up growth.
- Most infant heart transplant recipients achieve normal growth by five years post-transplant.
- Early illness, subsequent rejection episodes, and genetic potential are key determinants of final height.
Unlabelled:
Infant heart transplantation is now entering its second decade of clinical experience. To understand better issues relating to somatic growth, this retrospective study will describe growth patterns in a group of infant heart transplant recipients. Early growth: growth velocity from birth to transplantation in 77 infants transplanted before 6 months of age was compared with growth velocity from transplant to 3 months. Growth from 3 to 6 months and from 6 to 12 months after transplantation is described. Growth velocities (mean +/- SD) for weight (g/d) and length (cm/yr) for these 4 time periods respectively were: 7+/-14 and 27+/-22, 32+/-9 and 35+/-14, 17+/-7 and 24+/-10, 12+/-6 and 17+/-8. Growth velocities for both weight (p<0.01) and length (p = 0.04) were significantly improved in the first 3 months after transplantation. Late growth: Growth beyond 5 yr post-transplantation was described in a group of 51 infants transplanted in the first year of life and who survived at least 5 yr (median 6.8 yr, range 5.0 to 10.9). Most recent growth parameters (z-score; mean +/- SD) were: weight -0.55+/-1.2, height -0.48+/-0.97 and weight for height -0.16+/-0.96. Factors (with significant p-values) evaluated for their possible influence on late height (<5th percentile vs. > or =5th percentile) were: age at transplant, hospital days from transplant to discharge, hospital days 1st year after transplantation (p = 0.019), hospital days after 1st year, rejection episodes 1st year, rejection episodes 1-5 yr (p = 0.02) mid-parental height (p = 0.008) and isotopic glomerular filtration rate (p = 0.055).
Conclusion:
Growth while awaiting infant heart transplantation is poor, but adequate catch-up growth does occur. Beyond 5 yr most (88%) infant heart transplant recipients have weight and height in the normal range. Early illness, late rejection and genetic growth potential may play the largest role in later height attainment.
