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A Porcine Heterotopic Heart Transplantation Protocol for Delivery of Therapeutics to a Cardiac Allograft
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Cardiomyopathy as indication for pediatric heart transplantation

Alireza Raissadati1, Drishti Tolani2, Elizabeth L Profita1

  • 1Department of Pediatrics (Cardiology), Stanford University, Palo Alto, California.

JHLT Open
|August 22, 2025
PubMed

Insights

Pediatric cardiomyopathy (CMP) is a serious heart condition in children, often leading to heart failure and the need for transplantation. Ventricular assist devices (VADs) improve survival rates for these young patients.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Research
  • Transplantation Medicine

Background:

  • Pediatric cardiomyopathy (CMP) affects 1 in 100,000 children, frequently progressing to end-stage heart failure.
  • CMP is the leading cause for pediatric heart transplantation, necessitating careful management of etiologies and listing criteria.
  • Navigating waitlist complexities and understanding specific CMP subtypes are crucial for successful outcomes.

Purpose of the Study:

  • To provide a comprehensive review of pediatric cardiomyopathy progressing to end-stage heart failure requiring transplantation.
  • To synthesize current knowledge on CMP etiologies, clinical presentations, and transplant evaluation.
  • To highlight the impact of ventricular assist devices (VADs) and contemporary post-transplant management.

Main Methods:

  • Literature review synthesizing current knowledge on pediatric cardiomyopathy and heart transplantation.
  • Analysis of etiologies, clinical presentations, and transplant evaluation strategies.
  • Examination of the role of mechanical circulatory support, specifically VADs, in bridging to transplant.

Main Results:

  • Pediatric CMP is a critical challenge, often leading to heart failure and transplantation.
  • Ventricular assist devices (VADs) have significantly improved survival rates for pediatric heart transplant candidates.
  • Post-transplant outcomes show continuous improvement with refined long-term management strategies.

Conclusions:

  • This review offers an updated framework for clinicians managing pediatric cardiomyopathy and heart failure.
  • Optimizing decision-making for transplant evaluation and VAD use is essential for this high-risk population.
  • Continued advancements in post-transplant care are improving survival and quality of life.

Keywords:
dilated cardiomyopathyheart failureheart transplanthypertrophic cardiomyopathypediatricrestrictive cardiomyopathy

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