Skip to main content
NCBI home page
The Texas Heart Institute Journal logoLink to The Texas Heart Institute Journal
. 1998;25(1):57–63.

Cardiac transplantation for pediatric patients. With inoperable congenital heart disease.

K M Shaffer 1, S W Denfield 1, K O Schowengerdt 1, J A Towbin 1, B Radovancević 1, O H Frazier 1, J K Price 1, R J Gajarski 1
PMCID: PMC325503  PMID: 9566065

Abstract

Recent studies have reported the expanding use of transplantation as the definitive option for pediatric patients with inoperable congenital heart disease. This study compares perioperative risk factors and outcomes in pediatric patients who received heart transplants for congenital heart disease with those in pediatric patients who received heart transplants for cardiomyopathy. Retrospective data collected on 40 consecutive pediatric patients undergoing cardiac transplantation from 1 January 1990 through 31 January 1995 provided the following results: 26 patients with cardiomyopathy (mean age, 7.6 years) and 14 patients with congenital heart disease (mean age, 7.2 years) underwent heart transplantation. Between groups, no significant difference was detected in waiting time for a donor heart (cardiomyopathy = 85 days, range = 2 to 409; congenital heart disease = 126 days, range = 9 to 396; P = NS); in donor/recipient weight ratio (1.27 +/- 0.34 vs 1.27 +/- 0.28, P = NS); or in ischemic times (209 +/- 92 minutes vs 248 +/- 70 minutes, P = NS). Cardiopulmonary bypass times accounted for the only significant difference (73 +/- 21 minutes vs 102 +/- 29 minutes, P = 0.003). No significant difference was found in the number of infection episodes, total days hospitalized, rejection episodes, or incidence of transplant coronary artery disease. Forty-month actuarial survival was 88% +/- 6% and 92% +/- 7% for cardiomyopathy and congenital heart disease transplant recipients, respectively (P = NS). We conclude that post-transplantation morbidity and mortality in patients with previous congenital heart disease are not significantly different from morbidity and mortality in patients with cardiomyopathy. Transplantation should be considered an acceptable therapeutic option for patients with congenital heart disease when surgical repair of the native heart is not possible.

Full text

PDF
57

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bailey L. L. Pediatric heart transplantation. Ann Thorac Surg. 1989 Nov;48(5):612–612. doi: 10.1016/0003-4975(89)90771-6. [DOI] [PubMed] [Google Scholar]
  2. Baum D., Bernstein D., Starnes V. A., Oyer P., Pitlick P., Stinson E., Shumway N. Pediatric heart transplantation at Stanford: results of a 15-year experience. Pediatrics. 1991 Aug;88(2):203–214. [PubMed] [Google Scholar]
  3. Bhargava H., Donner R. M., Sanchez G., Dunn J. M., Zaeri N., Brickley S., Cavarocchi N. Endomyocardial biopsy after heart transplantation in children. J Heart Transplant. 1987 Sep-Oct;6(5):298–302. [PubMed] [Google Scholar]
  4. Carrel T., Neth J., Pasic M., Laske A., Jenni R., Maggiorini M., Turina M. Should cardiac transplantation for congenital heart disease be delayed until adult age? Eur J Cardiothorac Surg. 1994;8(9):462–469. doi: 10.1016/1010-7940(94)90015-9. [DOI] [PubMed] [Google Scholar]
  5. Gajarski R. J., Towbin J. A., Bricker J. T., Radovancevic B., Frazier O. H., Price J. K., Schowengerdt K. O., Denfield S. W. Intermediate follow-up of pediatric heart transplant recipients with elevated pulmonary vascular resistance index. J Am Coll Cardiol. 1994 Jun;23(7):1682–1687. doi: 10.1016/0735-1097(94)90675-0. [DOI] [PubMed] [Google Scholar]
  6. Hasan A., Au J., Hamilton J. R., Hunter S., Hilton C. J., Dark J. H. Orthotopic heart transplantation for congenital heart disease. Technical considerations. Eur J Cardiothorac Surg. 1993;7(2):65–70. doi: 10.1016/1010-7940(93)90182-b. [DOI] [PubMed] [Google Scholar]
  7. Hosenpud J. D., Novick R. J., Breen T. J., Daily O. P. The Registry of the International Society for Heart and Lung Transplantation: eleventh official report--1994. J Heart Lung Transplant. 1994 Jul-Aug;13(4):561–570. [PubMed] [Google Scholar]
  8. Hsu D. T., Quaegebeur J. M., Michler R. E., Smith C. R., Rose E. A., Kichuk M. R., Gersony W. M., Douglas J. F., Addonizio L. J. Heart transplantation in children with congenital heart disease. J Am Coll Cardiol. 1995 Sep;26(3):743–749. doi: 10.1016/0735-1097(95)00253-Z. [DOI] [PubMed] [Google Scholar]
  9. Kriett J. M., Kaye M. P. The Registry of the International Society for Heart Transplantation: seventh official report--1990. J Heart Transplant. 1990 Jul-Aug;9(4):323–330. [PubMed] [Google Scholar]
  10. Mayer J. E., Jr, Perry S., O'Brien P., Perez-Atayde A., Jonas R. A., Castaneda A. R., Parness I. A. Orthotopic heart transplantation for complex congenital heart disease. J Thorac Cardiovasc Surg. 1990 Mar;99(3):484–492. [PubMed] [Google Scholar]
  11. Menkis A. H., McKenzie F. N., Novick R. J., Kostuk W. J., Pflugfelder P. W., Goldbach M., Rosenberg H. Expanding applicability of transplantation after multiple prior palliative procedures. The Paediatric Heart Transplant Group. Ann Thorac Surg. 1991 Sep;52(3):722–726. doi: 10.1016/0003-4975(91)90987-2. [DOI] [PubMed] [Google Scholar]
  12. Miller L. W., Naftel D. C., Bourge R. C., Kirklin J. K., Brozena S. C., Jarcho J., Hobbs R. E., Mills R. M. Infection after heart transplantation: a multiinstitutional study. Cardiac Transplant Research Database Group. J Heart Lung Transplant. 1994 May-Jun;13(3):381–393. [PubMed] [Google Scholar]
  13. Reitz B. A., Jamieson S. W., Gaudiani V. A., Oyer P. E., Stinson E. B. Method for cardiac transplantation in corrected transposition of the great arteries. J Cardiovasc Surg (Torino) 1982 Jul-Aug;23(4):293–296. [PubMed] [Google Scholar]
  14. Sarris G. E., Smith J. A., Bernstein D., Griffin M. L., Pitlick P. T., Baum D., Billingham M. E., Oyer P. E., Stinson E. B., Starnes V. A. Pediatric cardiac transplantation. The Stanford experience. Circulation. 1994 Nov;90(5 Pt 2):II51–II55. [PubMed] [Google Scholar]
  15. Slaughter M. S., Braunlin E., Bolman R. M., 3rd, Molina J. E., Shumway S. J. Pediatric heart transplantation: results of 2- and 5-year follow-up. J Heart Lung Transplant. 1994 Jul-Aug;13(4):624–630. [PubMed] [Google Scholar]
  16. Trento A., Griffith B. P., Fricker F. J., Kormos R. L., Armitage J., Hardesty R. L. Lessons learned in pediatric heart transplantation. Ann Thorac Surg. 1989 Nov;48(5):617–623. doi: 10.1016/0003-4975(89)90774-1. [DOI] [PubMed] [Google Scholar]
  17. Turrentine M. W., Kesler K. A., Caldwell R., Darragh R., Means L., Mahomed Y., Brown J. W. Cardiac transplantation in infants and children. Ann Thorac Surg. 1994 Mar;57(3):546–554. doi: 10.1016/0003-4975(94)90543-6. [DOI] [PubMed] [Google Scholar]
  18. Vouhé P. R., Tamisier D., Le Bidois J., Sidi D., Mauriat P., Pouard P., Lefebvre D., Albanese S. B., Khoury W., Kachaner J. Pediatric cardiac transplantation for congenital heart defects: surgical considerations and results. Ann Thorac Surg. 1993 Dec;56(6):1239–1247. doi: 10.1016/0003-4975(93)90660-a. [DOI] [PubMed] [Google Scholar]
  19. Webber S. A., Fricker F. J., Michaels M., Pickering R. M., del Nido P. J., Griffith B. P., Armitage J. M. Orthotopic heart transplantation in children with congenital heart disease. Ann Thorac Surg. 1994 Dec;58(6):1664–1669. doi: 10.1016/0003-4975(94)91655-1. [DOI] [PubMed] [Google Scholar]
  20. Zales V. R., Crawford S., Backer C. L., Pahl E., Webb C. L., Lynch P., Mavroudis C., Benson D. W., Jr Role of endomyocardial biopsy in rejection surveillance after heart transplantation in neonates and children. J Am Coll Cardiol. 1994 Mar 1;23(3):766–771. doi: 10.1016/0735-1097(94)90766-8. [DOI] [PubMed] [Google Scholar]

Articles from Texas Heart Institute Journal are provided here courtesy of Texas Heart Institute

RESOURCES