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Heart transplantation in children
V A Starnes1, D Bernstein, P E Oyer
1Department of Cardiovascular Surgery, Stanford University Medical Center, California 94305.
The Journal of Heart Transplantation
|January 1, 1989
Summary
Pediatric heart transplantation is effective, but immunosuppressive drugs cause significant morbidity. Long-term outcomes show normal hemodynamics and kidney function, with full rehabilitation in survivors.
Area of Science:
- Pediatric Cardiology
- Transplant Surgery
- Immunology
Background:
- Pediatric heart transplantation is increasingly common.
- Key challenges include rejection, graft atherosclerosis, and growth issues.
Purpose of the Study:
- To evaluate the outcomes of heart transplantation in pediatric patients.
- To identify long-term complications and rehabilitation success.
Main Methods:
- Retrospective analysis of 17 children undergoing heart transplantation since 1981.
- Immunosuppression regimen included cyclosporine, azathioprine, and prednisone.
- Preoperative diagnoses included cardiomyopathy, congenital heart disease, and endocardial fibroelastosis.
Main Results:
- 13 of 17 children survived, with four hospital deaths (infection, rejection, graft failure).
- Rejection rates are similar to adults; two children required retransplantation.
- Delayed growth was observed in 2/5 younger children; kidney function remained stable.
- 100% rehabilitation among discharged patients.
Conclusions:
- Pediatric heart transplantation is an effective therapy.
- Current immunosuppressive agents contribute significantly to morbidity in young heart transplant recipients.