title: Adults with congenital heart disease and heart transplantation: optimizing outcomes.
abstract: The growing population of adults with congenital heart disease (ACHD) present a distinct set of challenges in the evaluation, listing, and safe performance of heart transplantation. We review existing literature to (1) describe the complex anatomic and physiologic features that characterize this group of patients, (2) discuss factors contributing to high waiting list times and waiting list morbidity and mortality experienced by this population, and finally, (3) identify risk factors for the elevated post-transplant morbidity and mortality reported in ACHD patients. We conclude with a discussion of critical areas in need of further investigation as well as ways to amend the current listing criteria to better accommodate ACHD patients in need of heart transplantation.
authors.affiliation: Division of Pediatric Cardiology, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Sara W
authors.initials: SW
authors.lastname: Goldberg
authors.affiliation: Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: sfisher@medicine.umaryland.edu.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Fisher
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Brody
authors.initials: B
authors.lastname: Wehman
authors.affiliation: Division of Cardiology, Harvard Medical School, Center for Advanced Heart Disease, Boston, Massachusetts.
authors.forename: Mandeep R
authors.initials: MR
authors.lastname: Mehra
mesh_terms: D000328:Adult; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D015996:Survival Rate; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: adults; congenital heart disease; heart transplantation; morbidity and mortality; outcomes