[Neonatal heart transplantation. First results]

Area of Science:

• Cardiology
• Pediatric Surgery
• Immunology

Context:

• Hypoplastic left heart syndrome (HLHS) is a severe congenital heart defect requiring intervention.
• Orthotopic heart transplantation is a potential treatment for neonates with inoperable HLHS.
• This study evaluates outcomes in two neonates undergoing heart transplantation for HLHS.

Purpose:

• To assess the feasibility and outcomes of orthotopic heart transplantation in neonates with HLHS.
• To evaluate the short- and mid-term results of neonatal heart transplantation.
• To examine the safety and efficacy of the immunosuppressive protocol used.

Summary:

• Two neonates with HLHS underwent orthotopic heart transplantation with significant donor-recipient weight discrepancies and moderate ischemic times.
• An immunosuppressive protocol involving thymoglobulin induction and a 3-drug regimen with rapid prednisone tapering was employed.
• Both infants experienced one episode of acute rejection, successfully treated, and are currently doing well with normal renal function and growth at 43 and 10 months post-transplant.

Impact:

• Neonatal heart transplantation is a viable option for neonates with inoperable congenital heart defects.
• The study demonstrates good short- and mid-term graft survival and patient well-being.
• Despite ethical considerations, heart transplantation offers significant hope for improving outcomes in this critical patient population.