Pediatric heart transplantation

Heart transplantation has been performed successfully in the pediatric age group for just over 10 years, yet early results are encouraging, and this procedure has moved from the realm of experimental therapy to that of accepted medical practice for certain specific conditions. In infants and children with cardiomyopathies or with congenital heart disease for which no reasonable standard surgical alternative exists, heart transplantation offers the best hope for long-term survival. Most important, in those patients surviving heart transplantation, rehabilitation has been almost universally complete. Although the long-term prospects for pediatric heart transplant patients are still unknown, we have now accumulated sufficient experience in adults suggesting the potential for decades-long survival. Future improvements in diagnosis and treatment of rejection and prevention of the complications of immunosuppressive therapy will continue to improve the prospects for lifelong survival in these patients.