Pediatric heart transplantation in infants and small children under 3 years of age: Single center experience - "Early and long-term results".

Autor: Rosenthal LL; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany; Department of Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany. Electronic address: L.Rosenthal@med.uni-muenchen.de., Ulrich SM; Division of Pediatric Cardiology and Intesive Care, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany. Electronic address: sarah.ulrich@med.uni-muenchen.de., Zimmerling L; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany; Department of Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany., Brenner P; Department of Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany. Electronic address: paolo.brenner@med.uni-muenchen.de., Müller C; Department of Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany. Electronic address: christoph.mueller@med.uni-muenchen.de., Michel S; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany; Department of Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany. Electronic address: sebasian.michel@med.uni-muenchen.de., Hörer J; Division for Pediatric and Congenital Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany. Electronic address: juergen.hoerer@med.uni-muenchen.de., Netz H; Division of Pediatric Cardiology and Intesive Care, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany. Electronic address: heinrich.netz@med.uni-muenchen.de., Haas NA; Division of Pediatric Cardiology and Intesive Care, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany. Electronic address: nikolaus.haas@med.uni-muenchen.de., Hagl C; Department of Heart Surgery, Ludwig Maximilians University Munich, Campus Grosshadern, Marchionini Street 15, D-81377 Munich, Germany; Munich Heart Alliance (MHA) - DZHK, Ludwig Maximilians University Munich, Department for Epidemiology and Prevention of Cardiovascular Diseases, Pettenkoferstr. 8a & 9, D- 80336 Munich, Germany. Electronic address: christian.hagl@med.uni-muenchen.de.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2022 Jun 01; Vol. 356, pp. 45-50. Date of Electronic Publication: 2022 Apr 05.
DOI: 10.1016/j.ijcard.2022.04.002
Abstrakt: Objectives: We analyzed the early and long-term survival after ABO-compatible heart transplantation in children under 3 years of age from 1991 to 2021 at our center. This retrospective and descriptive study aimed to identify serious adverse events associated with mortality after pediatric heart transplantation.
Patients and Methods: 46 patients with congenital heart failure (37%) in end-stage heart failure have undergone a pediatric heart transplantation. Primary outcome of interest was survival at follow-up time.
Results: Median (IQR) follow-up time (y), age (y), body-weight (kg) and BMI (kg/cm 2 ) were 13.2 (5.7-19.5), 0.9 (0.2-2.0), 6.8 (4.3-10.0) and 14.2 (12.3-15.7). Twenty-four (52%) patients were male. 15 patients (33%) had a single ventricle physiology. At 30- days survival rate was 94 ± 4%. Survival rate at 1, 5, 10 and 15 years post HTx was 87 ± 5%, 84 ± 6%, 79 ± 6% and 63 ± 8%. One child underwent re-transplantation after 4 years, and another one after 11 years - in both cases due to graft failure. Higher early mortality in patients under 3 months of age and in patients with single ventricle physiology. Transplant free survival at 15 years was in children with cardiomyopathy better (71 ± 10%) than in those with congenital heart disease (50 ± 13%). One or more previous heart surgeries prior to HTx (n = 21) were associated to more mortality.
Conclusion: Pediatric heart transplantation has acceptable long-term results and is still the best therapeutic option in children with end-stage cardiac failure. Underlying anomalies and single ventricle physiology, age below 3 months had a significant impact on survival.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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