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Updated: Jun 25, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Ten-Year Pediatric Heart Transplantation: Insights and Outcomes From a Leading Center in Iran
Mohammad Mahdavi1, Maziar Gholampour Dehaki1, Alireza Yaghoubi2
1Congenital Heart Disease Resarch Center, Rajaie Cardiovascular Institute, Tehran, Iran.
Insights
Pediatric heart transplants have shown improved survival rates over the last decade. Key factors influencing mortality include donor age, male donor gender, and Rituximab treatment, requiring further research for better outcomes.
Area of Science:
- Pediatric Cardiology
- Transplant Surgery
- Immunology
Background:
- Congenital heart failure in children necessitates advanced treatments like heart transplantation.
- This study reviews a decade of pediatric heart transplant experiences at a single institution.
Purpose of the Study:
- To evaluate outcomes and complications of pediatric heart transplantation over a 10-year period.
- To identify risk factors affecting survival in pediatric heart transplant recipients.
Main Methods:
- Retrospective analysis of pediatric heart transplant cases from 2012 to 2021.
- Assessment of recipient and donor characteristics, post-transplant complications, and survival rates.
- Median follow-up of 2 years.
Main Results:
- 225 pediatric heart transplants were performed; recipients' mean age was 10.8 years.
- Common diagnoses included dilated (83.6%) and restrictive (8.0%) cardiomyopathy.
- Post-transplant complications: Renal failure (15.7%), CNS issues (16.9%), Cytomegalovirus (24.9%), Epstein-Barr virus (21.8%).
- 1, 3, and 5-year survival rates were 85.7%, 79.7%, and 73.9%, respectively.
Conclusions:
- Pediatric heart transplant outcomes have significantly improved over the last decade.
- Donor age, male donor gender, and Rituximab treatment are identified as risk factors for mortality.
- Mitigating identified risks is crucial for enhancing post-transplant survival rates.
Introduction:
Heart transplantation is the definitive treatment for infants and children with nine advanced stages of congenital heart failure. This study presents the experiences of a single medical center regarding pediatric heart transplants conducted over a decade.
Methods:
Baseline characteristics of recipients and donors of pediatric heart transplant patients from 2012 to 2021 were recorded. Post-transplant complications and survival rates were assessed during a median follow-up period of 2 years.
Results:
The study, which spanned a decade and included 225 transplants, revealed several key findings. The mean age of recipients was 10.8 years, with a majority being boys. The most common diagnoses were dilated cardiomyopathy (83.6%) and restrictive cardiomyopathy (8.0%). Donors, with a mean age of 21.4 years, were predominantly male. The primary causes of donor death were head trauma/motor vehicle accidents (56.9%). Notably, post-transplant complications included Renal failure requiring dialysis (15.7%), Central Nervous System (16.9%), Cytomegalovirus infections (24.9%), and Epstein-Barr virus infections (21.8%). During the follow-up, 48 deaths were recorded, yielding a crude mortality rate of 7.4 per 100 person-years. The 1-year, 3-year, and 5-year survival rates, which were 85.7%, 79.7%, and 73.9%, respectively, demonstrate the significant progress in pediatric heart transplant outcomes over the past decade.
Conclusion:
Pediatric heart transplant outcomes have improved over the past decade, although challenges remain. Significant risk factors for mortality include donor age, male donor gender, and 28 Rituximab treatment. Strategies to mitigate these risks could enhance survival rates post-transplant.
