title: Cardiac transplantation in a neonate-First case in Switzerland and European overview.
abstract: Twenty-four percent of pediatric heart transplantations (pHTx) are carried out in infants. Neonatal heart transplantation is both rarely performed and challenging. We report on a newborn baby girl suffering from cardiac failure due to a huge tumor (24×52 mm) within the free wall of the left ventricle (LV) and subtotal obstruction of the main left bronchus. Following a surgical tumor resection, a Berlin Heart EXCOR left ventricular assist device was implanted as the bridge to the transplantation. In spite of an organ donor/recipient mismatch of >200%, both heart transplantation and the postoperative course were successful. In addition to this case report, the authors also present data from a survey on performed infant and neonatal transplantations in Western Europe. As neonatal heart transplantation is a rare event in Europe, the authors think it is of crucial importance to share this limited experience. We discuss an alternative strategy-namely, palliative surgical correction using the Fontan pathway. The challenges of donor/recipient weight mismatch and the possibilities of overcoming infant donor organ shortage as a postoperative immunosuppressive regimen are discussed as well.
authors.affiliation: Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland.|Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Martin
authors.identifier: 0000-0001-7793-7051
authors.initials: M
authors.lastname: Schweiger
authors.affiliation: Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.|Division of Pediatric Cardiology, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Brian
authors.initials: B
authors.lastname: Stiasny
authors.affiliation: Swisstransplant, Bern, Switzerland.
authors.forename: Franz
authors.initials: F
authors.lastname: Immer
authors.affiliation: Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.|Department of Anesthesiology, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Bürki
authors.affiliation: Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland.|Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Schmiady
authors.affiliation: Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland.|Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Hitendu
authors.initials: H
authors.lastname: Dave
authors.affiliation: Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.|Division of Pediatric Cardiology, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Anna
authors.initials: A
authors.lastname: Cavigelli-Brunner
authors.affiliation: Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.|Division of Pediatric Cardiology, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Kretschmar
authors.affiliation: Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.|Department of Intensive Care Medicine and Neonatology, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cannizzaro
authors.affiliation: Division of Congenital Cardiovascular Surgery, University Children's Hospital Zurich, Zurich, Switzerland.|Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Hübler
mesh_terms: D005260:Female; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D007231:Infant, Newborn; D013557:Switzerland; D016896:Treatment Outcome
keywords: infant heart transplantation; neonatal donor; neonate; ventricular assist device