Paediatric heart transplantation: an update

• Published in: Archives of disease in childhood Vol. 104; no. 12; pp. 1216 - 1222
• Main Author: Reinhardt, Zdenka
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.12.2019; BMJ Publishing Group LTD
• Subjects: Adolescent; Age; Cardiac arrhythmia; Cardiovascular disease; Cardiovascular diseases; CAV; Child; Child, Preschool; Congenital diseases; Coronary artery disease; Eligibility; Female; Graft rejection; Heart diseases; Heart Diseases - mortality; Heart Diseases - surgery; Heart Disorders; Heart failure; Heart transplantation; Heart Transplantation - mortality; Heart Transplantation - trends; Heart transplants; Humans; Immunoproliferative diseases; Immunosuppressive agents; Immunosuppressive Agents - therapeutic use; Infant; Lymphocytes; Male; Medical waiting lists; Mortality; paediatric heart transplantation; Patient Selection; Patients; Pediatrics; Postoperative Complications - mortality; Preservation; PTLD; Pulmonary arteries; Quality of Life; rejection; Renal failure; Review; Survival; Tissue and Organ Procurement; Transplantation; Transplants & implants; Vascular diseases; United Kingdom > UK; heart failure; CAV; PTLD; paediatric heart transplantation; rejection
• ISSN: 0003-9888; 1468-2044; 1468-2044
• DOI: 10.1136/archdischild-2018-315682

Heart transplantation is a standard treatment for selected paediatric patients with end-stage heart disease. With improvement in surgical techniques, organ procurement and preservation strategies, immunosuppressive drugs, and more sophisticated monitoring strategies, survival following transplantation has increased over time. However, rejection, infection, renal failure, post-transplant lymphoproliferative disease and post-transplant cardiac allograft vasculopathy still preclude long-term survival. Therefore, continued multidisciplinary scientific efforts are needed for future gains. This review focuses on the current status, outcomes and ongoing challenges including patient selection, indications and contraindications, national and international survivals, post-transplant complications and quality of life.