Pediatric heart transplantation in the current era

D'Addese, L.; Joong, Anna; Burch, Michael; Pahl, Elfriede

doi:10.1097/mop.0000000000000805

Cited by 15 publications

(12 citation statements)

References 61 publications

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“…The ultimate therapy for ESHF is heart transplantation (HT) (3,4). However, this is not readily available in infants and children (5)(6)(7). Therefore, novel therapeutic strategies are needed.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Artery Banding for Ventricular Rehabilitation in Infants With Dilated Cardiomyopathy: Early Results in a Single-Center Experience

et al. 2020

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Background: Pulmonary artery banding (PAB) is reported as an innovative strategy for children with end-stage heart failure (ESHF) to bridge to transplantation or recovery. We report our early experience with PAB to evaluate outcomes, indications, and limitations. Materials and Methods: This is a single-center prospective clinical study, including infants and children admitted for ESHF owing to dilated cardiomyopathy (DCM) with preserved right ventricular function after failure of maximal conventional therapy. All patients underwent perioperative anticongestive medical therapy with ACE inhibitor, beta blocker, and spironolactone. Post-operatively, all patients underwent echocardiographic follow-up to assess myocardial recovery. Results: We selected five patients (four males) who underwent PAB at a median age of 8.6 months (range 3.9-42.2 months), with preoperative ejection fraction (EF) < 30%. Sternal closure was delayed in all. One patient did not improve after PAB and underwent Berlin Heart implantation after 33 days, followed by heart transplant after 13 months. Four patients were discharged home on full anticongestive therapy. However, 2 months after discharge, one patient experienced severe acute heart failure secondary to pneumonia, which required mechanical circulatory support, and the patient underwent a successful heart transplant after 21 days. The remaining three patients are doing well at home, 22.4, 16.9, and 15.4 months after PAB. They all underwent elective percutaneous de-banding, 18.5, 4.8, and 10.7 months after PAB. EF increased from 17.7 ± 8.5% to 63.3 ± 7.6% (p = 0.03), and they have all been delisted. Conclusion: Use of PAB may be an effective alternative to mechanical support in selected infants for bridging to transplant or recovery. Better results seem to occur in patients aged < 12 months. Further experience and research are required to identify responders and non-responders to this approach.

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Section: Introductionmentioning

confidence: 99%

Pulmonary Artery Banding for Ventricular Rehabilitation in Infants With Dilated Cardiomyopathy: Early Results in a Single-Center Experience

et al. 2020

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“…Their frequency varies according to the time elapsed after transplant. Infections (non-CMV) and acute graft rejection rank second and third among the leading causes of death between 31 days and one year following heart transplantation [ 23 ] .…”

Section: Discussionmentioning

confidence: 99%

Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil

Cajueiro¹,

Croti²,

Barufi³

et al. 2022

Braz J Cardiovasc Surg

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“…Internationally, pediatric waitlist duration and mortality vary by country. By comparison, in the United States, the median waitlist duration for the most urgent patients is 2–3 months; in Brazil, it is 6 months; and in Japan, it is >1000 days 50 . The majority of countries from 5 continents who responded to a recent survey replied that there was a priority designation for children leading to expedited transplantation 51 .…”

Section: Heart Transplantmentioning

confidence: 99%

Deceased donor organ allocation in pediatric transplantation: A historical narrative

Ettenger

Venick

Gritsch

et al. 2022

Pediatric Transplantation

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Background Since the earliest clinical successes in solid organ transplantation, the proper method of organ allocation for children has been a contentious subject. Over the past 30–35 years, the medical and social establishments of various countries have favored some degree of preference for children on the respective waiting lists. However, the specific policies to accomplish this have varied widely and changed frequently between organ type and country. Methods Organ allocation policies over time were examined. This review traces the reasons behind and the measures/principles put in place to promote early deceased donor transplantation in children. Results Preferred allocation in children has been approached in a variety of ways and with varying degrees of commitment in different solid organ transplant disciplines and national medical systems. Conclusion The success of policies to advantage children has varied significantly by both organ and medical system. Further work is needed to optimize allocation strategies for pediatric candidates.

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Pediatric heart transplantation in the current era

Cited by 15 publications

References 61 publications

Pulmonary Artery Banding for Ventricular Rehabilitation in Infants With Dilated Cardiomyopathy: Early Results in a Single-Center Experience

Pulmonary Artery Banding for Ventricular Rehabilitation in Infants With Dilated Cardiomyopathy: Early Results in a Single-Center Experience

Pediatric Heart Transplant: Initial Experience in a Tertiary Center in Brazil

Deceased donor organ allocation in pediatric transplantation: A historical narrative

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