Experience of 23 cases of pediatric heart transplantation
10.3760/cma.j.issn.0254-1785.2016.01.006
- VernacularTitle:儿童心脏移植23例的经验
- Author:
Si CHEN
;
Nianguo DONG
;
Bo WANG
;
Jinping LIU
;
Wei SU
;
Jie CAI
;
Jing ZHANG
- Publication Type:Journal Article
- Keywords:
Heart Transplantation;
Child;
Indications;
Complications;
Survival
- From:
Chinese Journal of Organ Transplantation
2016;37(1):23-28
- CountryChina
- Language:Chinese
-
Abstract:
Objective Although heart transplantation (HTx) has become a standard therapy for end-stage heart diseases,experience with pediatric HTx is limited in China.In this article,we will try to provide the experience with indications,complications,perioperative management,immunosuppressive therapy,and survival for pediatric HTx based on our clinical work.Method This is a retrospective chart review of the pediatric patients undergoing HTx at Department of Cardiovascular Surgery of Union Hospital from September 2008 to December 2015.We summarized the indications,surgical variables,postoperative complications,and survival for these patients.Result Twenty-three pediatric patients presented for HTx at Union Hospital of Tongji Medical College,of whom 12 were male.The age at the time of transplantation ranged from 3 months to 18years (median 14 years).Patient weight ranged from 5.2 kg to 57.0 kg (median 36.0 kg).Pretransplant diagnosis included cardiomyopathy (16 cases),complex congenital heart disease (5cases) and tumors (2 cases).All recipients received ABO compatible donor hearts.Postoperative complications occurred in 14 patients,including cardiac dysfunction,arrhythmia,pulmonary infection,renal dysfunction,and rejection.Two of them experienced cardiac failure and required extracorporeal membrane oxygenation.The immunosuppression regimen was comprised of prednisone,a calcineurin inhibitor,and mycophenolate.All patients recovered with New York Heart Association (NYHA) Class Ⅰ Ⅱ cardiac function and were discharged.Only one patient suffered sudden death 19 months after transplantation.Conclusion Orthotopic HTx is a promising therapeutic option with satisfactory survival for the pediatric population in China with end-stage heart disease.
