title: A contemporary review of paediatric heart transplantation and mechanical circulatory support.
abstract: Improvements in the care of children with cardiomyopathy, CHDs, and acquired heart disease have led to an increased number of children surviving with advanced heart failure. In addition, the advent of more durable mechanical circulatory support options in children has changed the outcome for many patients who otherwise would have succumbed while waiting for heart transplantation. As a result, more children with end-stage heart failure are being referred for heart transplantation, and there is increased demand for a limited donor organ supply. A review of important publications in the recent years related to paediatric heart failure, transplantation, and mechanical circulatory support show a trend towards pushing the limits of the current therapies to address the needs of this growing population. There have been a number of publications focussing on previously published risk factors perceived as barriers to successful heart transplantation, including elevated pulmonary vascular resistance, medication non-adherence, re-transplantation, transplantation of the failed Fontan patient, and transplantation in an infant or child bridged with mechanical circulatory support. This review will highlight some of these key articles from the last 3 years and describe recent advances in the understanding, diagnosis, and management of children with end-stage heart disease.
authors.affiliation: 1Department of Pediatric Cardiology,Children's Hospital of Wisconsin,Medical College of Wisconsin,Milwaukee,Wisconsin,United States of America.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Kindel
authors.affiliation: 2Heart Institute,Children's Hospital Colorado,University of Colorado,Aurora,Colorado,United States of America.
authors.forename: Melanie D
authors.initials: MD
authors.lastname: Everitt
mesh_terms: D009202:Cardiomyopathies / Q000601:surgery / Q000628:therapy*; D002648:Child; D015199:Extracorporeal Membrane Oxygenation; D006333:Heart Failure / Q000601:surgery / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D055118:Medication Adherence; D010372:Pediatrics; D012307:Risk Factors; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: Heart transplant; cardiomyopathy; heart failure; mechanical circulatory support; paediatrics