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Updated: May 1, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Heart transplantation in pediatric and congenital heart disease: a single-center experience
Santuri Rungan1, Kirsten Finucane, Tom Gentles
1Green Lane Pediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand.
Insights
Heart transplantation in New Zealand for pediatric patients and those with congenital heart disease (CHD) shows favorable survival rates. Careful selection ensures successful outcomes for these complex cases.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Transplantation Medicine
Background:
- Heart transplantation (HT) is a critical treatment for end-stage heart failure.
- Pediatric patients and those with congenital heart disease (CHD) present unique challenges for HT.
- Outcomes in geographically isolated regions require specific evaluation.
Purpose of the Study:
- To detail the indications for heart transplantation in pediatric patients and those with congenital heart disease (CHD) in New Zealand.
- To report the outcomes of heart transplantation (HT) in these specific patient populations.
- To assess the feasibility and success of HT in a unique, isolated healthcare setting.
Main Methods:
- Retrospective audit of 253 heart transplantations performed between 1987 and 2012.
- Analysis of 37 patients with pediatric heart disease (PHD) or congenital heart disease (CHD).
- Collection of demographic and clinical data to establish patient outcomes.
Main Results:
- Overall actuarial survival for PHD/CHD patients was 92% at one year and 52% at ten years.
- The pediatric heart disease (PHD) group (n=22) had one-year survival of 91% and five-year survival of 79%.
- The congenital heart disease (CHD) group (n=21) demonstrated excellent outcomes with 95% one-year and 85% ten-year survival; all five patients with pre-HT Fontan circulation survived.
Conclusions:
- Heart transplantation is a viable and successful treatment for carefully selected pediatric patients and those with congenital heart disease (CHD).
- Favorable outcomes can be achieved even within a geographically isolated medical unit.
- This study highlights the importance of specialized HT programs for complex pediatric cardiac conditions.
Purpose:
To describe the indications and outcomes for pediatric patients and patients with congenital heart disease (CHD) undergoing heart transplantation (HT) in New Zealand.
Methods:
A retrospective audit of 253 patients who underwent HT from 1987 to end 2012 was undertaken. Thirty-seven patients were subdivided into two groups, those aged <18 years--pediatric heart disease (PHD) and those with CHD. Six patients aged <18 years were included in both the analyses. Demographic and clinical information were collected and outcomes established.
Results:
Overall actuarial survival of 37 patients with PHD or CHD was 92% at one year, 85% at five years, and 52% at ten years. The PHD group comprised 22 (8.7%) patients, median age 14 years (range 6-17), 14 (64%) male, with cardiomyopathy in 13, CHD in 6, and rheumatic heart disease in 3. At follow-up, 11 patients had died. Actuarial survival was 91% at one year and 79% at five years. Of the four patients with a mechanical assist device to bridge, three were transplanted and alive at follow-up. The CHD group comprised 21 (8.3%) patients, median age 25 years (range 6-48) and 19 (90%) were male. At follow-up, three patients had died. Actuarial survival was 95% at one year, 94% at five years, and 85% at ten years. All five patients with pre-HT Fontan circulation were alive a median of eight years following HT.
Conclusion:
Heart transplantation for carefully selected pediatric patients and patients with CHD can be successfully performed with favorable outcomes in a geographically isolated unit.
