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Updated: Sep 23, 2026
A Simplified Model for Heterotopic Heart Valve Transplantation in Rodents
Published on: September 21, 2021
[Heart transplantation in children]
1Dĕtské kardiocentrum 2. LF UK a FNM, Praha. tomas.tlaskal@lfmotol.cuni.cz
Insights
Pediatric heart transplantation offers a life-saving option for intractable heart diseases. Improving immunosuppression and addressing donor shortages are key to enhancing long-term survival and quality of life.
Area of Science:
- Cardiology
- Pediatric Surgery
- Immunology
Context:
- Heart transplantation is the definitive treatment for pediatric end-stage heart disease.
- Common indications include cardiomyopathy, congenital heart defects, and post-surgical heart failure.
- Hypoplastic left heart syndrome is a leading reason for transplantation in neonates and infants.
Purpose:
- To review current pediatric heart transplantation practices, outcomes, and challenges.
- To highlight common complications and factors influencing long-term survival.
- To identify areas for future research and improvement in pediatric heart transplantation.
Summary:
- Pediatric heart transplantation survival rates are 80% at one year and 50% at ten years, with better outcomes in neonates.
- Graft failure, rejection, and infection are primary causes of mortality.
- Post-transplant graft vasculopathy is a critical late complication requiring retransplantation.
- Steroid-free immunosuppression is often used in infants, with withdrawal at 6-12 months post-transplant.
Impact:
- Enhanced transplantation programs can improve survival rates and quality of life.
- Further research is needed for safer, more effective immunosuppressive therapies and to address donor scarcity.
- Investigating mechanical support and xenotransplantation holds potential for future advancements.
Abstract:
Heart transplantation represents the only effective method of treatment of intractable heart diseases. Cardiomyopathy with heart dilation, inoperable congenital heart diseases and heart failure after the heart surgery represent the most common indications for heart transplantation in pediatrics. Hypoplastic left heart syndrome is the most frequent indication for the heart transplantation in neonates and infants. In infants steroids-free immunosuppression is used or steroids are withdrawn 6 to 12 months after the transplantation. Graft failure, acute rejection and infection are the most common causes of death after transplantation. Long-term results and the quality of life depend on the occurrence of rejection, infection, graft vasculopathy, lymphoproliferative disease and side effects of immunosuppression. Posttransplant graft vasculopathy, however, represents the most dangerous late complication, which requires retransplantation. Improvement of the transplantation program improves the survival rate as well as the quality of life after transplantation. Survival after heart transplantation is 80% in one year and 50% in ten years interval. Better results can be achieved in neonates. Lack of donors, demanding economical and organisational conditions and the unresolved legislation problems preclude wider use of heart transplantation in children. Research for more effective, safer and cheaper pharmacotherapy in the prevention and treatment of rejection, infection and complications of immunosuppression is required. Long-term effects and the quality of life after heart transplantation in children, as well as possibilities of mechanical heart support and xenotransplantation must be also studied.
