title: Good long-term survival after paediatric heart transplantation.
abstract: BACKGROUND
  The brain-death criterion was introduced in Denmark in 1990. The first Danish paediatric heart transplantation (HTx) was performed at Copenhagen University Hospital, Rigshospitalet, in Copenhagen in 1991. We describe our experiences during the first 20 years with paediatric HTx.
  
  
  METHODS
  This was a retrospective study of 37 paediatric patients (<18 years) who were listed for HTx from 1991 to 2011.
  
  
  RESULTS
  A total of 26 of the 37 children listed underwent HTx, nine due to congenital heart disease (CHD) and 17 due to cardiomyopathy (CM). Ten patients died while being on the waiting list. One patient was withdrawn from the list due to spontaneous improvement. A total of 21 patients remain alive. Survival was 92% after five years and 82% after ten years. We had two early (CHD) and three late (CM) deaths. Complications were few, but significant. Early acute rejection occurred in seven patients, whereas one patient with repeated late episodes of acute rejection died from graft failure 5.5 years after HTx. We found a time-related progressive deterioration in renal function. Two patients underwent renal Tx, two others died while being on dialysis. Cardiac allograft vasculopathy occurred in three patients, two of whom died. The third remains alive today, 19 years after HTx.
  
  
  CONCLUSIONS
  Our paediatric HTx results are comparable with those of larger international centres and consistent with true long-term survival.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Department of Paediatrics, Hvidovre Hospital, Denmark.
authors.forename: Charlotte Duhn
authors.initials: CD
authors.lastname: Kruse
authors.forename: Morten
authors.initials: M
authors.lastname: Helvind
authors.forename: Tim
authors.initials: T
authors.lastname: Jensen
authors.forename: Finn
authors.initials: F
authors.lastname: Gustafsson
authors.forename: Svend Aage
authors.initials: SA
authors.lastname: Mortensen
authors.forename: Henrik Orbaek
authors.initials: HO
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D001161:Arteriosclerosis / Q000209:etiology / Q000473:pathology; D009202:Cardiomyopathies / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006085:Graft Survival; D006330:Heart Defects, Congenital / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects / Q000941:ethics / Q000276:immunology / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D007223:Infant; D008297:Male; D018579:Patient Selection / Q000941:ethics; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000209:etiology / Q000628:therapy; D017741:Survivors / Q000706:statistics & numerical data; D013995:Time; D020858:Tissue and Organ Harvesting / Q000379:methods; D014850:Waiting Lists / Q000401:mortality