RT Book, Section
A1 Rahm, Amy L.
A1 Hasaniya, Nahidh W.
A1 Bailey, Leonard L.
A1 Razzouk, Anees J.
A1 Chinnock, Richard E.
A2 Yuh, David D.
A2 Vricella, Luca A.
A2 Yang, Stephen C.
A2 Doty, John R.
SR Print(0)
ID 1104599629
T1 Pediatric Cardiac Transplantation
T2 Johns Hopkins Textbook of Cardiothoracic Surgery
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-166350-2
LK accesssurgery.mhmedical.com/content.aspx?aid=1104599629
RD 2024/04/20
AB EpidemiologySince  1982,  over  8000  pediatric  heart  transplants  have  been  recorded  in  the  Registry  of  the  International  Society  of  Heart  and  Lung  Transplantation.  The  current  number  of  reported  pediatric  heart  transplants  is  about  450  per  year,  which  originate  in  80  global  centers.IndicationsHeart  transplantation  is  the  most  effective  and  often  the  only  treatment  for  end-stage  pediatric  heart  disease.  Complex  congenital  heart  disease  is  the  main  indication  for  heart  transplantation  in  infants,  whereas  end-stage  cardiomyopathy  is  the  main  indication  after  the  first  year  of  life.ContraindicationsThe  main  contraindication  is  elevated  pulmonary  vascular  resistance  that  is  unresponsive  to  oxygen  and  vasodilators.TechniquesHeart  transplantation  is  performed  using  either  biatrial  or  bicaval  techniques,  depending  on  the  size  of  the  recipient  child.  Graft  procurement  and  implantation  are  modified  to  accommodate  the  specific  anatomic  variations  present  in  recipients  with  congenital  heart  disease.OutcomesMortality  while  waiting  for  a  donor  is  12  to  40  percent.  The  overall  actuarial  survival  at  10  years  is  66  percent.  It  is  74  percent  for  newborn  recipients.  Causes  of  mortality  include  graft  rejection  and  failure,  infection,  cardiac  allograft  vasculopathy  (CAV)  (16  percent),  and  malignancy  (8  percent).