Pediatric heart transplantation in infants and small children under 3 years of age: Single center experience - Early and long-term results

Rosenthal, Lily; Ulrich, Sarah Marie; Zimmerling, Linda; Brenner, Paolo; Mueller, Christoph; Michel, Sebastian; Horer, Juergen; Netz, Heinrich; Haas, Nikolaus A. und Hagl, Christian (2022): Pediatric heart transplantation in infants and small children under 3 years of age: Single center experience - Early and long-term results. In: International Journal of Cardiology, Bd. 356: S. 45-50

Abstract

Objectives: We analyzed the early and long-term survival after ABO-compatible heart transplantation in children under 3 years of age from 1991 to 2021 at our center. This retrospective and descriptive study aimed to identify serious adverse events associated with mortality after pediatric heart transplantation.& nbsp;Patients and methods: 46 patients with congenital heart failure (37%) in end-stage heart failure have undergone a pediatric heart transplantation. Primary outcome of interest was survival at follow-up time.& nbsp;Results: Median (IQR) follow-up time (y), age (y), body-weight (kg) and BMI (kg/cm2) were 13.2 (5.7-19.5), 0.9 (0.2-2.0), 6.8 (4.3-10.0) and 14.2 (12.3-15.7). Twenty-four (52%) patients were male. 15 patients (33%) had a single ventricle physiology. At 30-days survival rate was 94 +/-& nbsp;4%. Survival rate at 1, 5, 10 and 15 years post HTx was 87 +/-& nbsp;5%, 84 +/-& nbsp;6%, 79 +/-& nbsp;6% and 63 +/-& nbsp;8%. One child underwent re-transplantation after 4 years, and another one after 11 years - in both cases due to graft failure. Higher early mortality in patients under 3 months of age and in patients with single ventricle physiology. Transplant free survival at 15 years was in children with cardiomyopathy better (71 +/-& nbsp;10%) than in those with congenital heart disease (50 +/-& nbsp;13%). One or more previous heart surgeries prior to HTx (n = 21) were associated to more mortality.& nbsp;Conclusion: Pediatric heart transplantation has acceptable long-term results and is still the best therapeutic option in children with end-stage cardiac failure. Underlying anomalies and single ventricle physiology, age below 3 months had a significant impact on survival.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0167-5273
• Sprache: Englisch