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Updated: Apr 23, 2026
A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
Published on: February 14, 2022
Cardiac catheterization activity in pediatric cardiac transplantation. Can catheterization needs be predicted?
Andrea Freixa-Benavente1, Paola Dolader2, Ferran Gran2
1Unitat Hemodinàmica Pediàtrica, Cardiologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, España Unitat Hemodinàmica Pediàtrica Cardiologia Pediàtrica Hospital Universitari Vall d'Hebron Barcelona España.
Insights
Pediatric heart transplant recipients undergo numerous cardiac catheterizations (CCs), primarily for rejection surveillance. Univentricular congenital heart disease patients require more post-transplant CCs, highlighting the need for optimized follow-up protocols.
Area of Science:
- Pediatric Cardiology
- Transplantation Medicine
- Interventional Cardiology
Background:
- Cardiac catheterization (CC) is integral to pediatric heart transplantation (HT).
- Protocols and evidence regarding the necessity and impact of CC procedures in pediatric HT recipients are lacking.
- Understanding factors influencing CC frequency is crucial for optimizing patient care.
Purpose of the Study:
- To analyze cardiac catheterization activity in pediatric heart transplant recipients at a tertiary center.
- To identify risk factors associated with a higher number of post-HT CC procedures.
Main Methods:
- Retrospective study utilizing medical reports and image files.
- Sample included pediatric patients with cardiomyopathies and congenital heart diseases (CHD).
- Risk factor analysis employed linear regression and ANOVA tests.
Main Results:
- 61 children were included; 36.07% had CHD, with a higher pre-HT CC rate.
- Post-HT, 389 CCs (608 procedures) were performed, predominantly for rejection surveillance (92.75%).
- Univentricular CHD subgroup showed a significantly higher number of post-HT CCs (P = .03).
Conclusions:
- Pediatric HT recipients experience significant morbidity from frequent CC procedures.
- Developing standardized protocols for follow-up and rejection surveillance is essential.
- Minimizing interventions can improve long-term outcomes for these patients.
Introduction And Objectives:
Although cardiac catheterization (CC) has become a routine practice in pediatric heart transplantation (HT), there is still a shortage of widely used protocols and strong evidence on the number of procedures required and their impact on HT outcomes, as well as the need for further CC. This study aimed to analyze CC activity in pediatric HT recipients in a tertiary center and describe risk factors for a higher number of post-HT procedures.
Methods:
This retrospective study obtained data from medical reports and image files. The sample was composed of patients with cardiomyopathies and congenital heart diseases (CHD). Risk factor analysis for CCs was conducted with linear regression and the ANOVA test.
Results:
The sample included 61 children (36.07% with CHD). The CHD group had a higher mean number of CCs prior to HT. The most frequent activities prior to HT were diagnostic catheterizations, followed by endomyocardial biopsies for cardiomyopathies and aortopulmonary collaterals in CHD patients. There were 389 post-HT CCs (608 procedures). Most CCs were performed for rejection surveillance, accounting for 92.75% of procedures. The univentricular CHD subgroup was associated with a higher number of CC after HT (P = .03).
Conclusions:
Despite long life expectancy, pediatric HT recipients have substantial morbidity due to these procedures. Therefore, it is necessary to establish protocols for follow-up and rejection surveillance to minimize the interventions required by these patients.
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