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Updated: Sep 6, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 17, 2014
Newborn and infant heart transplantation
1Division of Cardiology, Children's Hospital of Pittsburgh, PA 15213, USA.
Insights
Neonatal heart transplantation survival lags behind older children, posing challenges for pediatric cardiologists. Research focuses on donor availability, infant care, and immunologic tolerance strategies, including xenotransplantation.
Area of Science:
- Pediatric cardiology
- Transplantation immunology
- Congenital heart disease surgery
Background:
- Neonatal heart transplantation for hypoplastic left heart syndrome has advanced over the past decade.
- Infants represent a growing proportion of pediatric heart transplant recipients, yet survival rates are lower compared to older children.
- Key challenges include limited donor organ availability, complex pre- and post-transplant management, and advancements in alternative palliative surgical options.
Purpose of the Study:
- To review current challenges and advancements in neonatal heart transplantation.
- To highlight recent findings on donor availability, waiting times, and post-transplant outcomes.
- To discuss strategies for improving infant heart transplant success, including immunologic tolerance and xenotransplantation.
Main Methods:
- Review of recent literature on pediatric heart transplantation outcomes.
- Analysis of data regarding donor availability and waiting times for infant recipients.
- Examination of laboratory investigations into immunologic tolerance and xenotransplantation.
Main Results:
- Survival rates for neonates and infants undergoing heart transplantation remain inferior to those in older pediatric populations.
- Recent research provides insights into donor organ availability, transplant waiting times, and outcomes.
- Ongoing laboratory studies explore methods for inducing immunologic tolerance and the potential of xenotransplantation.
Conclusions:
- Improving survival in infant heart transplantation requires addressing donor limitations and optimizing management strategies.
- Further research into immunologic tolerance and alternative approaches like xenotransplantation is crucial for advancing the field.
- Pediatric cardiologists face unique challenges in infant heart transplantation, necessitating continued innovation and investigation.
Abstract:
Over a decade has passed since the first successful neonatal heart transplant was performed for palliation of hypoplastic left heart syndrome. Although neonates and infants represent a growing group of pediatric heart transplant recipients, survival remains inferior to that in older children. Decisions regarding transplantation in infancy pose unique problems for the pediatric cardiologist, including limited donor availability, pre-and posttransplant management, and improving results of alternative palliative surgery for hypoplastic left heart syndrome. A number of recent articles provide important information about donor availability, waiting times to transplantation, and outcome after listing and transplantation. Other studies focus on the treatment of infants awaiting transplantation. Important laboratory investigations reported this year focus on strategies for inducing immunologic tolerance (the "Holy Grail" of the transplant physician) as well as ongoing research in the controversial area of xenotransplantation.
