Abstract | OBJECTIVE: Orthotopic heart transplantation has become an accepted therapeutic concept for adult patients with endstage heart disease. In newborns and infants this procedure is still a matter of discussion because of unknown long-term results and the lack of donor organs. METHODS: RESULTS: There were six peri-operative deaths caused by drug-resistant right- heart failure in three cases, humoral rejection (n = 1), CMV infection (n = 1) and multi organ failure (n = 1). One infant died late, due to rejection. The actuarial survival rate for the entire group is now 82%. There is a remarkable influence of increasing experience. Whereas six of 15 infants who had heart transplantation between 1988 and 1993 died early post-operatively (survival rate: 60%), only one late death occurred among 24 recipients in the period from 1994 to April 1997 (survival rate: 96%). Episodes of rejection occurred once or several times in about half of the patients in this series (48%). All surviving children are living at home in excellent condition. CONCLUSIONS:
Heart transplantation during early infancy is a rational and durable therapy for heart diseases with irreversible myocardial failure or severe structural anomalies. The intermediate-term results have been encouraging in many centers, but more data must be accumulated to determine the sequelae of chronic immunosuppression. The lack of donor organs remains one of the major problems in pediatric heart transplantation.
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Authors | F Dapper, J Bauer, J Kroll, B Zickmann, R M Bohle, K J Hagel, D Schranz |
Journal | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
(Eur J Cardiothorac Surg)
Vol. 14
Issue 1
Pg. 1-5; discussion 5-6
(Jul 1998)
ISSN: 1010-7940 [Print] Germany |
PMID | 9726607
(Publication Type: Journal Article)
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Topics |
- Body Height
- Body Weight
- Cardiomyopathy, Dilated
(surgery)
- Endocardial Fibroelastosis
(surgery)
- Graft Rejection
- Heart Diseases
(mortality, surgery)
- Heart Transplantation
(mortality)
- Humans
- Hypoplastic Left Heart Syndrome
(surgery)
- Infant
- Infant, Newborn
- Survival Analysis
- Time Factors
- Treatment Outcome
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