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Updated: Jul 10, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Heart transplantation in children: clinical outcomes in a single center
Yanto Sandy Tjang1, Ute Blanz, Lech Hornik
1Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center, North Rhine Westphalia/University Hospital of Bochum, Bad Oeynhausen, Germany. ystjang@hotmail.com
Insights
Pediatric heart transplantation offers a durable treatment for end-stage heart disease, with encouraging long-term outcomes and quality of life. Survival rates at 1, 5, 10, and 15 years were 83%, 74%, 63%, and 50% respectively.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Transplantation Medicine
Background:
- Heart transplantation is the optimal treatment for end-stage heart disease in children.
- Long-term benefits of pediatric heart transplantation are debated.
- This study evaluates clinical experience with pediatric heart transplantation.
Purpose of the Study:
- To assess the clinical outcomes and long-term benefits of heart transplantation in pediatric patients.
- To analyze survival rates and identify factors influencing outcomes in children undergoing heart transplantation.
Main Methods:
- A retrospective analysis of 93 pediatric heart transplantations performed between March 1989 and December 1999.
- Data collected from a computerized database with 100% follow-up completion.
- Analysis included indications, early and late mortality, survival rates, and associated risk factors.
Main Results:
- Dilated cardiomyopathy (68%) and congenital heart disease (31%) were primary indications.
- Early mortality was 14%, with primary graft failure as the main cause.
- 1-, 5-, 10-, and 15-year survival rates were 83%, 74%, 63%, and 50%.
- Factors associated with decreased survival included recipient age <1 year and ischemia time >300 minutes.
- Late mortality causes included acute rejection (43%) and allograft vasculopathy (26%).
Conclusions:
- Pediatric heart transplantation is a viable and effective treatment for end-stage heart conditions.
- Long-term outcomes and quality of life for pediatric heart transplant recipients are positive.
- Further research may focus on mitigating risks like rejection and vasculopathy.
Background:
Despite being accepted as the best treatment for end-stage heart diseases, the long-term benefit of heart transplantation in children remains a matter of controversial debate. This study aimed to evaluate our clinical experience with heart transplantation in children.
Methods:
From March 1989 to December 1999, 93 consecutive orthotopic heart transplantations in children (less than 18 years of age) were performed at the Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW in Bad Oeynhausen, Germany. Clinical data were retrieved from a computerized database. Follow-up information was 100% completed.
Results:
The main indications for heart transplantation were dilated cardiomyopathy (68%) and congenital heart disease (31%). Early mortality risk was 14% +/- 3.6%. Primary graft failure (39%) was the main cause of early death. Total follow-up time was 694 patient-years (mean, 104.1 +/- 42.8 months). Twenty-three patients died during follow-up, resulting in 33 of 1,000 patient-years of late mortality rate. Acute rejection (43%) and allograft vasculopathy (26%) were attributed to late mortality. The 1-, 5-, 10-, and 15-year survival was 83%, 74%, 63%, and 50%, respectively. Recipient age less than one year (p = 0.02) and ischemia time greater than 300 minutes (p = 0.04) were associated with decreased survival. Social activities at the end of follow-up were school (69%), working (19%), and at home (12%).
Conclusions:
Heart transplantation is a rational and durable treatment option for children with end-stage heart diseases. The long-term outcomes and quality of life after heart transplantation in children are encouraging.
