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Updated: Jul 29, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Clinical outcome 10 years after infant heart transplantation
Insights
Pediatric heart transplantation is feasible, with 64% survival at 13 years. While many infant heart transplant survivors experience mild developmental delays, most achieve good functional outcomes and integrate well into society.
Area of Science:
- Pediatric Cardiology
- Transplant Surgery
- Developmental Pediatrics
Background:
- Infant heart transplantation feasibility is established.
- Clinical outcome data is crucial for improving care and informing families.
- Long-term outcomes for infant heart transplant recipients require detailed analysis.
Purpose of the Study:
- To describe the clinical outcomes of infant heart transplant recipients surviving at least 10 years.
- To identify areas for improvement in infant heart transplantation protocols.
- To provide data for counseling families considering this procedure.
Main Methods:
- Retrospective analysis of a transplant database.
- Inclusion of data from referring physicians.
- Parental questionnaires assessing developmental and functional status.
Main Results:
- Overall patient survival is 64% at 13 years.
- 55% of children are developmentally normal; 3 had severe outcomes.
- 88% have normal somatic growth; all are NYHA class I.
- Renal function is generally preserved; no dialysis required.
- No post-transplant lymphoproliferative disease beyond 10 years.
- 4 experienced rejection beyond 10 years, with 1 mortality.
Conclusions:
- Infant heart transplantation is technically feasible with good survival rates.
- Many survivors experience mild learning disabilities but function well socially.
- Improvements in surgical techniques may enhance developmental outcomes.
- Immunosuppression side effects are manageable, leading to good functional outcomes for most survivors.
Abstract:
The feasibility of heart transplantation for infants has now been established. Clinical outcome data is necessary to assist in targeting areas for improvement and for counseling families considering this option. This report describes clinical outcome in 29 infant heart transplant recipients who have survived at least 10 years. A query of the transplant database, referring physicians and parental questionnaire was performed. Patient survival for the overall infant population is 64% at 13 years. Parents of 19/29 (55%) children described them as developmentally normal. Three children have had a severe developmental outcome. Sixteen of 29 children are in mainstream school environments. Four have repeated one grade in school. Speech delay was present in 10/26 (38%). Somatic growth is normal in 88%. All children are NYHA class I. Renal function shows only modest insufficiency with most recent BUN (mean+/-S.D.)=25+/-7 mg/dl and serum creatinine=0.8+/-0.2 mg/dl. Only four children have creatinine levels >1 mg/dl. No child requires dialysis. No children have developed post-transplant lymphoproliferative disease beyond 10 years. Four children have experienced rejection beyond 10 years with one mortality due to rejection and transplant coronary artery disease. Conclusion: Heart transplantation during infancy is technically feasible and results in good survival. Many children have some degree of learning disability but most are mild and the children function well in society. Improvements in surgical techniques may improve developmental outcome. Other side-effects of immunosuppression are manageable and most survivors have a good functional outcome.
