title: First two decades of paediatric heart transplantation in Sweden - outcome of listing and post-transplant results.
abstract: OBJECTIVE
  To evaluate outcome in the first generation of children with end-stage heart disease to whom heart transplantation was available.
  
  
  METHODS
  Retrospective review of all 135 Swedish children <18 years old listed for heart transplantation 1989-2009, followed to December 31, 2009, including 74 (55%) with cardiomyopathy and 61 (45%) with congenital heart disease; 34 (25%) were infants (<1 year). Cumulative risk of requiring heart transplantation was 1:17,300 (11 patients who improved were omitted from outcome analysis).
  
  
  RESULTS
  Waiting-list mortality was 31% (44% in infants). Median waiting time in 82 transplanted patients was 57 days (0-585 days). Post-transplant follow-up time was median 5.9 years (0.03-20.1 years), and actuarial survival was 92% at 1 year, 82% at 5 years, 76% at 10 years and 58% at 15 years. Survival after listing was 64% at 1 year, 58% at 5 years, 52% at 10 years and 40% at 15 years. Post-transplant complications included rejections (34%), malignancies (12%), renal failure (8%), coronary artery vasculopathy (6%) and re-transplantation (5%). Among 64 survivors, 84% were free of complications affecting prognosis.
  
  
  CONCLUSIONS
  High waiting-list mortality and post-transplant attrition precluded 60% of this pioneer population from reaching adulthood. Functional status in survivors is generally good.
authors.affiliation: Pediatric Cardiology, Queen Silvia Children's Hospital, Sahlgrenska Academy, Gothenburg University, Sweden. thomas@gilljam.com
authors.forename: Thomas
authors.initials: T
authors.lastname: Gilljam
authors.forename: Thomas
authors.initials: T
authors.lastname: Higgins
authors.forename: Rolf
authors.initials: R
authors.lastname: Bennhagen
authors.forename: Håkan
authors.initials: H
authors.lastname: Wåhlander
mesh_terms: D000293:Adolescent; D009202:Cardiomyopathies / Q000401:mortality / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D014850:Waiting Lists / Q000401:mortality