Heart transplantation in children and young adults: early and intermediate-term results.
The purpose of this article is to report our short- and intermediate-term follow-up of cardiac transplantation for congenital heart disease and cardiomyopathy in children (age greater than 6 months), adolescents, and young adults. Thirty patients (ages 8 months to 24 years) with end-stage heart failure have undergone cardiac transplantation in our program: 12 (40%) for postoperative end-stage heart failure, 9 (30%) as primary treatment for congenital heart disease, 5 (17%) for dilated cardiomyopathy, and 4 (13%) for restrictive/hypertrophic cardiomyopathy. Nineteen patients (63%) had undergone prior operations; 4 patients received transplants for failed Fontan procedures. Induction therapy with antithymocyte therapy was used routinely, and long-term immunosuppression was by cyclosporine and azathioprine alone. Rejection surveillance/diagnosis was based on echocardiographic criteria. Posttransplantation follow-up ranges from 3 to 78 months. Operative mortality was 3.3% (1/30). No patients have been diagnosed with either accelerated allograft atherosclerosis or posttransplantation lymphoproliferative disease. We conclude that cardiac transplantation may be performed with excellent early and intermediate-term results.
Fullerton
D A
DA
Department of Surgery, University of Colorado, Denver.
Campbell
D N
DN
Jones
S D
SD
Jaggers
J
J
Brown
J M
JM
Wollmering
M M
MM
Grover
F L
FL
Mashburn
C
C
Luna
M
M
Sondheimer
H M
HM
D000293:Adolescent; D000328:Adult; D001807:Blood Vessel Prosthesis; D002311:Cardiomyopathy, Dilated / Q000601:surgery*; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery*; D002313:Cardiomyopathy, Restrictive / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000628:therapy; D006330:Heart Defects, Congenital / Q000601:surgery*; D016027:Heart Transplantation / Q000379:methods / Q000401:mortality; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery; D012086:Reoperation