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Long term results of pediatric heart transplantations — single center experiences
Affiliations- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Disease, Medical University of Silesia in Katowice, Zabrze, Poland
- Department of Cardiac Surgery, Transplantology and Mechanical Circulatory Support in Children, Silesian Center for Heart Diseases, Zabrze, Poland
- Department of Cardiac Transplantation and Mechanical Circulatory Support, Wroclaw Medical University, Wrocław, Poland
- Department of Cardiac Anesthesiology and Intensive Care, Silesian Center for Heart Diseases, Zabrze, Poland
- Transplant coordinator in Silesian Center for Heart Disease, Zabrze, Poland
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Abstract
BACKGROUND: Heart failure (HF) is characterized by significant mortality in both adults and children. Characteristic of paediatric HF are feeding problems, poor weight gain, exercise intolerance or dyspnoea. These changes are often accompanied by endocrine disorders. The main causes of HF are congenital heart defects (CHD) cardiomyopathies, arrhythmias, myocarditis or heart failure secondary to oncological treatment. Heart transplantation (HTx) is the method of choice for treatment of end-stage HF in paediatric patients.
AIMS: The aim is to summarize single center experience in heart transplantation in children.
METHODS: Between 1988 and 2021 in the Silesian Center for Heart Diseases in Zabrze 122 pediatric cardiac transplantations were performed. In the group of recipients with falling Fontan circulation HTx was performed in 5 children. The study group was evaluated for postoperative course: rejection episodes depending on the medical treatment scheme, coinfections and mortality.
RESULTS: 1-, 5- and 10-year survival rate between 1988 and 2001 were 53%, 53% and 50%, respectively. 1-, 5- and 10-year survival rate between 2002 and 2011 was 97%, 90% and 87%; between 2012 and 2021 1-year observation with survival rate 92%. The main cause of mortality both in early and in late period after transplantation was graft failure.
CONCLUSIONS: Cardiac transplantation in children remains the main method of treatment of end-stage heart failure. Our results at both early and long-term posttransplant period, are comparable to those obtained in the most experienced foreign centers.
Abstract
BACKGROUND: Heart failure (HF) is characterized by significant mortality in both adults and children. Characteristic of paediatric HF are feeding problems, poor weight gain, exercise intolerance or dyspnoea. These changes are often accompanied by endocrine disorders. The main causes of HF are congenital heart defects (CHD) cardiomyopathies, arrhythmias, myocarditis or heart failure secondary to oncological treatment. Heart transplantation (HTx) is the method of choice for treatment of end-stage HF in paediatric patients.
AIMS: The aim is to summarize single center experience in heart transplantation in children.
METHODS: Between 1988 and 2021 in the Silesian Center for Heart Diseases in Zabrze 122 pediatric cardiac transplantations were performed. In the group of recipients with falling Fontan circulation HTx was performed in 5 children. The study group was evaluated for postoperative course: rejection episodes depending on the medical treatment scheme, coinfections and mortality.
RESULTS: 1-, 5- and 10-year survival rate between 1988 and 2001 were 53%, 53% and 50%, respectively. 1-, 5- and 10-year survival rate between 2002 and 2011 was 97%, 90% and 87%; between 2012 and 2021 1-year observation with survival rate 92%. The main cause of mortality both in early and in late period after transplantation was graft failure.
CONCLUSIONS: Cardiac transplantation in children remains the main method of treatment of end-stage heart failure. Our results at both early and long-term posttransplant period, are comparable to those obtained in the most experienced foreign centers.
Keywords
cardiomyopathy, congenital heart defect, heart failure, paediatric heart transplantation
About this articleTitle
Long term results of pediatric heart transplantations — single center experiences
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Article type
Original article
Published online
2023-03-16
Page views
3
Article views/downloads
7
DOI
10.33963/KP.a2023.0068
Pubmed
Keywords
cardiomyopathy
congenital heart defect
heart failure
paediatric heart transplantation
Authors
Szymon Pawlak
Joanna Śliwka
Arkadiusz Wierzyk
Roman Przybylski
Jerzy Czapla
Bogusława Król
Piotr Przybyłowski
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