Volume 3, 1998, No 3/4
Backgroud: Pediatric heart transplantation has recently become an accepted method of treatment for end-stage pediatric heart disease. However the long-term outlook for children after heart transplantation remains uncertain.
Methods: Between March, 1989 and May, 1997, 67 children underwent heart transplantation at the Heart Center of North Rhine-Westfalia in Bad Oeynhausen. Indications for heart transplantation included congenital heart disease (CHD ;24 patients), dilated cardiomyopathy (DCM ;40 patients), and others (3 patients). Patients ranged in age from 2 days to 16 years (mean : 5.96 years). Donor age ranged from 1 day to 28 years (mean : 6.31 years). The donor organ ischemic time ranged from 95 minutes to 332 minutes (mean : 216 minutes). Follow-up ranged from 1 to 96 months.
Results: Early deaths (within 30 days) were 11 (16.4%), and late deaths were 5 (7.5%). Seven of 11 early deaths were seen in the patients under the age of 1 year. The 1-year, 3-year, and 5-year actuarial survivals were 82%, 79%, and 75%, respectively. The actuarial survival in patients with DCM was better than in patients with CHD. Early mortality in undersize-mismatching was greater than in oversize-mismatching in CHD cases.
Conclusions: The resuls of pediatric heart transplantations were well comparable to heart transplantations in adults. However the mortality of the patients under 1 year of age still remains high. Strict size-matching might be preferable especially in CHD cases.
Key words: pediatric
heart transplantation, weight-mismatching, height-mismatching,
heart disease, dilated cardiomyopathy
Address for Correspondence:
Kazutomo Minami, MD, Ph.D
Herzzentrum NRW, Klinik für Thorax- und Kardiovaskularchirurgie
D-32545 Bad Oeynhausen
CVE. 1998; 3 (3/4): 144-148
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