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Transplantation in the single ventricle population
Louise A Kenny1, Fabrizio DeRita1, Mohamed Nassar1,2
1Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle Upon Tyne, UK.
Annals of Cardiothoracic Surgery
|March 2, 2018
Summary
Single ventricle heart transplantation is increasingly common and complex. Careful multidisciplinary planning is crucial for managing high-risk patients, including those with hypoplastic left heart syndrome.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Transplantation Medicine
Background:
- Single ventricle (SV) patients represent a complex and growing group undergoing heart transplantation.
- Advancements in palliative surgical strategies have altered the SV population composition, increasing cases like hypoplastic left heart syndrome (HLHS) and Fontan failure.
Purpose of the Study:
- To review the evolving landscape of heart transplantation for single ventricle conditions.
- To share institutional experience and contemporary literature on SV transplantation.
Main Methods:
- Retrospective review of institutional practice for single ventricle heart transplantation.
- Comprehensive literature review of current research and trends in SV transplantation.
Main Results:
- SV patients present unique challenges including complex anatomy, physiology, and high peri-operative risks due to prior surgeries and multi-organ involvement.
- Careful pre-operative planning by a multidisciplinary team is essential to mitigate risks, including donor organ selection and managing post-operative complications like pulmonary vascular resistance.
Conclusions:
- Heart transplantation for single ventricle patients is a rapidly growing and complex field requiring specialized management.
- Optimal timing for transplantation in SV patients remains an area for further research, with understanding alternative surgical risks aiding listing decisions.
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