Abstract
Introduction: Heart transplantation has become an acceptable treatment in pediatric patients with end-stage heart disease and complex congenital heart disease. The liberalization of recipient eligibility criteria, mainly age, along with the expansion of the donor pool has resulted in the acceptable transplantation of older recipients.
Methods: Between July 1994 and June 1998, 39 pediatric patients aged 16 days to 17.6 years (median 6.68 years) and 123 elderly patients aged 60 to 74.8 years (median 64.1 years) were transplanted at our institution. In the pediatric group, 19 had idiopathic dilated cardiomyopathy (DCM) (46 %), 14 had congenital heart disease (34 %), 4 had other etiologies of cardiomyopathy (10 %), 2 had transplant coronary artery disease (TCAD) (5 %), and 1 each had acute rejection and graft failure. In the elderly group, 71 had ischemic cardiomyopathy (58 %), 38 had DCM (31 %), 9 had other forms of cardiomyopathy (7 %), and 5 had TCAD (4 %).
Results: Thirty-day, 1-year, and 4-year survival_was 97.4 %, 87.2 %, and 70.9 % for the pediatric group and 92.7 %, 81.3 %, and 79.3 % for the elderly_group. One and 4-year freedom from TCAD was_100.0 % and 85.3 % for the pediatric group and 91.9 % and 83.3 % for the elderly group.
Conclusions:[emsp3 ]Orthotopic heart transplantation is effective for the treatment of irreparable congenital and end-stage heart disease. It provides excellent long-term results in both the very young and elderly.
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References
Kesten S. Is survival that important? J Heart Lung Transplant 1998;17:651–653.
Stein DG, Drinkwater DC, Laks H, et al. Cardiac preservation in patients undergoing transplantation. J Thorac Cardiovasc Surg 1991;102:657–665.
Ihnken K, Morita K, Buckberg GD. New approaches to blood cardioplegic delivery to reduce hemodilution and cardioplegic overdose. J Card Surg 1994;9:26–36.
Pearl JM, Drinkwater DC, Laks H, et al. Leukocyte-depleted reperfusion of transplanted human hearts: a randomized, double-blind clinical trial. J Heart Lung Transplant 1992;11(6):1082–1092.
Boucek MM, Novick RJ, Bennett LE, Fiol B, Keck BM, Hosenpud JD. The registry of the international society of heart and lung transplantation: first official pediatric report-1997. J Heart Lung Transplant 1997;16:1189–1206.
Boucek MM, Novick RJ, Bennett LE, Fiol B, Keck BM, Hosenpud JD. The registry of the international society of heart and lung transplantation: second official pediatric report-1998. J Heart Lung Transplant 1998;17:1141–1160.
Radley-Smith R, Khaghani A, Yacoub M. Medium term results of children with two hearts. J Heart Lung Transplant 1998;18:84.
Kobashigawa JA, Laks H, Marelli D, Moriguchi JD, Hamilton M, Fonarow G, Hage A, Kawata N. The University of California at Los Angeles experience in heart transplantation. In: Cecka Terasaki, ed. Clinical Transplants, 1998.
Fullerton DA, Campbell DN, Jones SD, Jaggers J, Brown JM, Wollmering MW, Grover FL, Mashburn C, Luna M, Sondheimer HM, Boucek MM. Heart transplantation in children and young adults: early and intermediate-term results. Ann Thorac Surg 1995;59:804–812.
Pennington DG, Noedel N, McBride LR, Naunheim KS, Ring S. Heart transplantation in children: an international survey. Ann Thorac Surg 1995;52:710–715.
Mitchell MB, Campbell DN, Clarke DR, Fullerton DA, Grover FL, Boucek MM, Pietra B, Luna M, Shroyer AL, Coll JR, Rosky JW. Infant heart transplantation: improved intermediate results. J Thorac Cardiovasc Surg 1998;116:242–252.
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Laks H, Marelli D. The alternate recipient list for heart transplantation: a model for expansion of the donor pool. Advances in Cardiac Surgery 1999;11:233–244.
Borkon AM, Muehlebach GF, Jones PG, Bresnahan DR, Genton RE, Gorton ME, Long ND, Magalski A, Porter CB, Reed WA, Rowe SK. An analysis of the effect of age on survival after heart transplant. J Heart Lung Transplant 1999;18:668–674.
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Laks, H., Marelli, D., Odim, J. et al. Heart Transplantation in the Young and Elderly. Heart Fail Rev 6, 221–226 (2001). https://doi.org/10.1023/A:1011406022657
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DOI: https://doi.org/10.1023/A:1011406022657