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Infant heart transplantation at Stanford: growth and neurodevelopmental outcome
Barry E Fleisher1, David Baum, Ginger Brudos
1Department of Pediatrics. Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California, USA.barry.fleisher@stanford.edu
Insights
Infants receiving heart transplants before age two experienced more growth and neurodevelopmental issues, including speech, language, and hearing delays. Further research is needed to assess long-term outcomes and intervention needs.
Area of Science:
- Pediatric Cardiology
- Developmental Pediatrics
- Transplant Surgery
Background:
- Heart transplantation in infants is a life-saving procedure, but its long-term impact on neurodevelopment requires thorough investigation.
- Early childhood development is critical, and factors affecting growth and neurological function post-transplant need to be understood.
Purpose of the Study:
- To evaluate the growth and neurodevelopmental outcomes of pediatric patients who underwent heart transplantation before their second birthday.
- To compare the outcomes of heart transplant recipients with age-matched controls who had other heart surgeries involving cardiopulmonary bypass.
Main Methods:
- A cohort of 18 infant heart transplant survivors was assessed for growth and neurodevelopmental status.
- Outcomes were compared against a control group of children who underwent different cardiac surgeries utilizing cardiopulmonary bypass.
Main Results:
- Heart transplant recipients showed a higher incidence of growth difficulties and developmental delays compared to the control group.
- Neurologic abnormalities, speech and language delays, and hearing impairments were more prevalent in the infant heart transplant cohort.
Conclusions:
- Infants undergoing heart transplantation before age two face significant challenges in growth and neurodevelopment.
- Multicenter, prospective, longitudinal studies are essential for evaluating management protocols and long-term outcomes in infant heart transplant recipients.
- Early intervention services may be crucial for addressing the identified developmental needs of these children.
Objective:
To evaluate the growth and neurodevelopmental outcome of 18 surviving Stanford patients who received heart transplantations before their second birthday.
Methods:
We compared the growth and neurodevelopmental outcome of these 18 patients with a second group of age-matched comparison patients who underwent other heart surgery requiring cardiopulmonary bypass.
Results:
Difficulties with growth and development were more common in the transplant group as were neurologic abnormalities. Speech and language delays as well as hearing problems were also more common in the transplant group.
Conclusion:
Multicenter prospective longitudinal neurodevelopmental outcome studies of infant heart transplant patients should be conducted to provide a more efficient basis for evaluating management protocols and assessment of long-term outcomes and of the need for early intervention services.