[Extracorporeal life support and heart-lung transplant in children]

Area of Science:

• Pediatric Cardiology
• Cardiovascular Surgery
• Transplant Medicine

Background:

• Extracorporeal life support and heart/lung transplant are last resorts for children with end-stage cardiac/pulmonary failure.
• Current circulatory support serves as a bridge to recovery or transplant, not destination therapy.
• The Excor Berlin Heart is a long-lasting external pneumatic ventricular assist system available for all ages.

Purpose of the Study:

• To review the current landscape of pediatric mechanical circulatory support.
• To discuss the long-term outcomes and challenges associated with pediatric heart and/or lung transplantation.
• To highlight future directions in pediatric ventricular assistance.

Main Methods:

• Literature review of current pediatric mechanical circulatory support systems.
• Analysis of long-term prognosis factors following pediatric cardiac and/or pulmonary transplant.
• Discussion of criteria for selecting transplant candidates.

Main Results:

• Long-term prognosis after pediatric transplant is affected by graft failure, coronary disease, viral infections, and bronchiolitis obliterans.
• Graft scarcity and rejection risk necessitate careful patient selection based on psychosocial and biological criteria.
• The Excor Berlin Heart offers prolonged support from infancy to adulthood.

Conclusions:

• Mechanical circulatory support is crucial for pediatric end-stage heart and/or lung failure.
• Advances in ventricular assist devices are essential for improving long-term outcomes and patient quality of life.
• Future developments focus on enhanced autonomy and home-based ventricular assistance for pediatric patients.