Related Experiment Video
Updated: Jul 20, 2026
A High-Fidelity Porcine Model of Orthotopic Heart Transplantation Following Donation after Circulatory Death
Published on: June 6, 2025
Single-center experience of pediatric heart transplantation in taiwan
1Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan.
Insights
Pediatric heart transplantation (HTx) shows good long-term survival rates for children with end-stage heart failure or congenital defects. A high donor to recipient body weight ratio (over 3) is acceptable after careful evaluation.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Transplantation Medicine
Background:
- Heart transplantation (HTx) is a critical treatment for pediatric end-stage heart failure and complex congenital heart defects.
- Long-term survival and the impact of donor-to-recipient body weight (D/R BW) ratio require further investigation in pediatric HTx.
- Idiopathic dilated cardiomyopathy, congenital heart disease, and Kawasaki disease are primary indications for pediatric HTx.
Purpose of the Study:
- To evaluate the long-term survival rates following pediatric heart transplantation.
- To determine the safety and feasibility of utilizing a high donor-to-recipient body weight ratio in pediatric HTx.
- To analyze the outcomes of HTx in children with different underlying cardiac conditions.
Main Methods:
- A retrospective analysis of 14 pediatric patients who underwent HTx between March 1995 and May 2004.
- Assessment of donor-to-recipient body weight ratios, ranging from 0.89 to 3.9.
- Evaluation of actuarial survival rates and causes of mortality post-transplantation.
Main Results:
- Actuarial survival rate was 92.9% at 5 years post-transplantation.
- The primary cause of mortality was early primary graft failure in one patient with Kawasaki disease.
- A high D/R BW ratio (greater than 3) was observed in one case without adverse events, aside from 'big heart syndrome' in that instance.
Conclusions:
- Pediatric heart transplantation is a viable treatment option offering good long-term survival for children with severe heart conditions.
- A high donor-to-recipient body weight ratio, exceeding 3, can be safely utilized in pediatric HTx following thorough pre-transplant assessment.
- Careful patient selection and evaluation are crucial for successful outcomes in pediatric heart transplantation.
Abstract:
Heart transplantation (HTx) is a treatment for end-stage heart failure or a complex or inoperable congenital defect. The long-term survival and the adequate donor to recipient body weight (D/R BW) ratio remain to be determined. From March 1995 to May 2004, 14 children (6 months-16 years of age) underwent HTx due to underlying diseases of idiopathic dilated cardiomyopathy (n = 10; 71.4%), congenital heart disease (n = 3; 21.4%), and Kawasaki disease (n = 1; 7.1%). Donor-recipient body weight ratio ranged from 0.89 to 3.9. Big heart syndrome was present in one patient when D/R BW ratio was more than 3. Actuarial survival was 92.9% at 5 years after transplantation. Only the one patient who had Kawasaki disease died due to early primary graft failure. HTx is a feasible method with good long-term survival rates for end-stage heart failure or for complex or inoperable congenital defects. After careful pretransplant evaluation, a high D/R BW ratio (more than 3) is acceptable.
