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Updated: Feb 26, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
[Results of a national program of pediatric heart transplantation: strengths and weakness]
Pedro Becker1, Santiago Besa2, Sergio Riveros2
1División de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Pediatric heart transplantation offers effective treatment for advanced heart failure in children. However, 33.3% of children died while awaiting a transplant, highlighting critical challenges in pediatric heart transplantation access and outcomes.
Area of Science:
- Pediatric Cardiology
- Transplantation Medicine
- Cardiovascular Surgery
Background:
- Advanced heart failure in children necessitates complex treatment strategies.
- Pediatric heart transplantation is a vital therapeutic option for eligible children.
- Understanding outcomes for pediatric heart transplant candidates is crucial for improving care.
Purpose of the Study:
- To evaluate the immediate and mid-term results of pediatric patients undergoing evaluation for heart transplantation.
- To analyze survival rates, waiting times, and complications in pediatric heart transplant candidates.
Main Methods:
- Retrospective review of pediatric patients (October 2001-July 2016) on the heart transplant protocol.
- Analysis of demographic data, diagnoses, listing status, waiting times, donor information, mechanical support use, and mortality.
- Assessment of post-transplant complications and long-term survival.
Main Results:
- Thirty pediatric patients (mean age 9.4 years) were analyzed, with dilated cardiomyopathy being the most common diagnosis (80%).
- 33.3% of patients died on the waiting list, with a significant portion listed under urgent status.
- 46.7% of patients were transplanted, experiencing a median waiting time of 199.6 days; 1-year and 5-year survival rates were 93% and 74%, respectively.
Conclusions:
- The study program achieved a 50% transplantation rate with favorable medium-term survival.
- A substantial number of pediatric patients were listed as medical emergencies, underscoring the urgency.
- High mortality rates on the waiting list necessitate strategies to improve access to pediatric heart transplantation.
Abstract:
Pediatric heart transplantation is an effective therapy to treat advanced heart failure in children.
Objectives:
To analyze the immediate and mid-term results of pediatric patients listed for heart transplantation.
Patients And Methods:
Registration of patients admitted to our transplant protocol between October 2001 and July 2016 were reviewed, analyzing demographic data, diagnosis, status at the time of listing, waiting time until transplantation, donor data, use of ventricular assist device, hemodynamic data, complications and global mortality.
Results:
Thirthy patients where included with a mean age of 9.4 years (1 month to 15 years). The most frequent diagnosis was dilated cardiomyopathy in 24 patients (80%). The status was I (urgency) in 19 cases and II in 11 cases. Ten patients died on the waiting list (33.3%) at an average of 52 days (13-139 days). Fourteen were transplanted (46.7%), with a waiting time of 199.6 days (4-586 days). Nine patients required mechanical support (30%). All patients received triple association of immunosuppression. One patient died 16 days post transplant due to primary graft failure (7.1%). The average follow-up was 43 months (0.5-159 months). Two patients died later on (82 and 55 months), both due to secondary rejection because of voluntary cessation of immunosuppressive therapy. Survival at 1 and 5 years was 93% and 74%, respectively.
Conclusions:
Our program has successfully transplanted 50% of patients enrolled, with good medium-term survival. A significant proportion of patients were listed as a medical emergency and 34.5% died on the waiting list.
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