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A Simplified Model for Heterotopic Heart Valve Transplantation in Rodents
Published on: September 21, 2021
A contemporary review of paediatric heart transplantation and mechanical circulatory support
Steven J Kindel1, Melanie D Everitt2
11Department of Pediatric Cardiology,Children's Hospital of Wisconsin,Medical College of Wisconsin,Milwaukee,Wisconsin,United States of America.
Insights
Advances in pediatric heart care mean more children survive advanced heart failure. This review covers recent progress in pediatric heart transplantation and mechanical circulatory support for end-stage heart disease.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Transplantation Medicine
Background:
- Improved treatments increase survival rates for children with heart conditions, leading to more cases of advanced heart failure.
- Mechanical circulatory support (MCS) offers new hope for children awaiting heart transplants, improving outcomes.
- Increased survival in pediatric heart failure drives demand for limited donor organs for transplantation.
Purpose of the Study:
- To review recent advancements in pediatric end-stage heart failure management.
- To highlight key publications on pediatric heart transplantation and MCS from the last three years.
- To discuss evolving understanding, diagnosis, and treatment of pediatric heart failure.
Main Methods:
- Review of recent (last 3 years) high-impact publications.
- Analysis of trends in pediatric heart failure, transplantation, and MCS.
- Focus on challenges and advancements in the field.
Main Results:
- Growing population of children with end-stage heart failure requiring advanced therapies.
- Identification of persistent barriers to heart transplantation, including PVR, adherence, re-transplantation, Fontan failure, and MCS bridging.
- Trend towards pushing therapeutic limits for this population.
Conclusions:
- Pediatric heart transplantation and MCS are evolving rapidly.
- Addressing barriers to transplantation is crucial for improving outcomes.
- Continued research is vital for managing children with end-stage heart disease.
Abstract:
Improvements in the care of children with cardiomyopathy, CHDs, and acquired heart disease have led to an increased number of children surviving with advanced heart failure. In addition, the advent of more durable mechanical circulatory support options in children has changed the outcome for many patients who otherwise would have succumbed while waiting for heart transplantation. As a result, more children with end-stage heart failure are being referred for heart transplantation, and there is increased demand for a limited donor organ supply. A review of important publications in the recent years related to paediatric heart failure, transplantation, and mechanical circulatory support show a trend towards pushing the limits of the current therapies to address the needs of this growing population. There have been a number of publications focussing on previously published risk factors perceived as barriers to successful heart transplantation, including elevated pulmonary vascular resistance, medication non-adherence, re-transplantation, transplantation of the failed Fontan patient, and transplantation in an infant or child bridged with mechanical circulatory support. This review will highlight some of these key articles from the last 3 years and describe recent advances in the understanding, diagnosis, and management of children with end-stage heart disease.
