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Review
. 2014 Aug;6(8):1080-96.
doi: 10.3978/j.issn.2072-1439.2014.06.16.

Pediatric heart transplantation-indications and outcomes in the current era

Philip T Thrush  1 , Timothy M Hoffman  1
Affiliations
Review

Pediatric heart transplantation-indications and outcomes in the current era

Philip T Thrush et al. J Thorac Dis. 2014 Aug.

Abstract

Pediatric heart transplantation (HTx) remains an important treatment option in the care of children with end-stage heart disease, whether it is secondary to cardiomyopathy or congenital heart disease (CHD). As surgical outcomes for CHD have improved, the indications for pediatric HTx have had to be dynamic, not only for children with CHD but also for the growing population of adults with CHD. As the field of pediatric HTx has evolved, the outcomes for children undergoing HTx have improved. This is undoubtedly due to the continued research efforts of both single-center studies, as well as research collaboratives such as the International Society for Heart and Lung Transplantation (ISHLT) and the Pediatric Heart Transplant Study (PHTS) group. Research collaboratives are increasingly important in pediatric HTx as single center studies for a limited patient population may not elicit strong enough evidence for practice evolution. Similarly, complications that limit the long term graft survival may occur in a minority of patients thus pooled experience is essential. This review focuses on the indications and outcomes for pediatric HTx, with a special emphasis on studies generated by these research collaboratives.

Keywords: Heart transplantation (HTx); cardiomyopathy; congenital heart defects; graft rejection; graft survival; pediatrics.

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Figures

Figure 1
Figure 1
(A) Median patient survival for pediatric heart transplant recipients, birth—17 years of age; (B) median patient survival for pediatric heart transplant recipients conditional on survival to 1 year post-transplant, birth—17 years of age. (ISHLT Registry.)
Figure 2
Figure 2
Survival and hazard curves for death after heart transplant for patients with dilated cardiomyopathy included in the Pediatric Heart Transplant Study Registry (PHTS Registry).
Figure 3
Figure 3
Percentage of pediatric heart transplant recipients experiencing any rejection between discharge and 1-year follow-up based on era (ISHLT Registry).
Figure 4
Figure 4
Freedom from first episode of rejection [2000-2009] (PHTS Registry).
See this image and copyright information in PMC

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