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Heart transplantation in children
W H Merrill1, W H Frist, J R Stewart
1Department of Cardiac and Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Annals of Surgery
|May 1, 1991
Summary
Pediatric cardiac transplantation offers a viable treatment for end-stage heart conditions in children. Long-term survivors demonstrate excellent rehabilitation potential and remain active.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Immunology
Background:
- Congenital heart disease and cardiomyopathy represent significant challenges in pediatric cardiology.
- Orthotopic cardiac transplantation is a critical intervention for end-stage pediatric heart failure.
Purpose of the Study:
- To evaluate the efficacy and outcomes of orthotopic cardiac transplantation in neonates and children.
- To assess long-term survival, rejection rates, and functional status post-transplantation.
Main Methods:
- Retrospective analysis of 15 pediatric patients undergoing orthotopic cardiac transplantation since 1987.
- Patients managed with specific immunosuppression protocols (cyclosporine +/- azathioprine) based on age.
- Monitoring for rejection utilized serial echocardiography (younger) and biopsies (older patients).
Main Results:
- Twelve of fifteen patients survived the operation with follow-up ranging from 1 to 45 months.
- Actuarial freedom from rejection was 26% at 3 months; 47% were infection-free at 6 months.
- Three-year actuarial survival reached 79%, with all long-term survivors asymptomatic and fully active.
Conclusions:
- Orthotopic cardiac transplantation is an effective treatment for neonates and children with end-stage heart disease.
- Pediatric cardiac transplant recipients show excellent potential for full rehabilitation and an active life.