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Ten-year follow-up after pediatric transplantation
F Parisi1, C Squitieri, A Carotti
1Pediatric Heart and Lung Transplant Program, Ospedale Bambino Gesù, Rome, Italy.
Insights
Pediatric heart transplantation outcomes show a 68% 1-year survival rate. Most pediatric heart transplant recipients experience normal growth and development post-surgery.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Transplantation Medicine
Background:
- Heart transplantation is a critical treatment for end-stage heart failure in children.
- Long-term outcomes and survival rates in pediatric heart transplant recipients require ongoing evaluation.
Purpose of the Study:
- To analyze the outcomes of pediatric heart transplantation.
- To determine survival rates and long-term results in patients aged 1 day to 18 years.
Main Methods:
- Retrospective analysis of 128 pediatric patients listed for heart transplant between November 1985 and December 1996.
- Evaluation of waiting times, transplant procedures, retransplantation, and actuarial survival rates.
- Assessment of patient follow-up duration and long-term outcomes including growth, development, and neurologic status.
Main Results:
- Of 128 patients, 47 died while waiting, and 62 underwent heart transplantation.
- Actuarial survival rates at 1, 5, and 11 years post-transplant were 68%, 62%, and 42%, respectively.
- 36 patients, including 2 with retransplantation, are alive with most showing normal growth, development, and neurologic outcomes.
Conclusions:
- Pediatric heart transplantation offers a viable option for critically ill children with end-stage heart disease.
- While challenges exist, including waiting list mortality, a significant proportion of recipients achieve long-term survival and positive developmental outcomes.
Abstract:
From November 1985 through December 1996, 128 patients aged 1 day to 18 years (mean age, 4.7 yrs; median, 3 years) were listed for heart transplant. Forty-seven (36.1%) died after a mean wait of 3.1 months, and 62 underwent transplant after a mean wait of 4 months. Two patients underwent retransplantation. The 1-, 5-, and 11-year actuarial survival rate for the patients who underwent heart transplantation is 68%, 62%, and 42%, respectively. The follow-up ranges from O to 132 months, with a mean follow-up of 39 months. At present, 36 patients, including the 2 who received a retransplant, are alive. Most of them have normal growth, development, and neurologic outcome.