Heart transplantation in children with congenital heart disease

Daphne T. Hsu, Jan M. Quaegebeur, Robert E. Michler, Craig R. Smith, Eric A. Rose, Maryanne R. Kichuk, Welton M. Gersony, Judith F. Douglas, Linda J. Addonizio

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Objectives: The aim of this study was to describe heart transplantation in children with congenital heart disease and to compare the results with those in children undergoing transplantation for other cardiac diseases. Background: Reports describe decreased survival after heart transplantation in children with congenital heart disease compared with those with cardiomyopathy. However, transplantation is increasingly being considered in the surgical management of children with complex congenital heart disease. Present-day results from this group require reassessment. Methods: The diagnoses, previous operations and indications for transplantation were characterized in children with congenital heart disease. Pretransplant course, graft ischemia time, posttransplant survival and outcome (rejection frequency, infection rate, length of hospital stay) were compared with those in children undergoing transplantation for other reasons (n = 47). Results: Thirty-seven children (mean [±SD] age 9 ± 6 years) with congenital heart disease underwent transplantation; 86% had undergone one or more previous operations. Repair of extracardiac defects at transplantation was necessary in 23 patients. Causes of death after transplantation were donor failure in two patients, surgical bleeding in two, pulmonary hemorrhage in one, infection in four, rejection in three and graft atherosclerosis in one. No difference in 1- and 5-year survival rates (70% vs. 77% and 64% vs. 65%, respectively), rejection frequency or length of hospital stay was seen between children with and without congenital heart disease. Cardiopulmonary bypass and donor ischemia time were significantly longer in patients with congenital heart disease. Serious infections were more common in children with than without congenital heart disease (13 of 37 vs. 6 of 47, respectively, p = 0.01). Conclusions: Despite the more complex cardiac surgery required at implantation and longer donor ischemic time, heart transplantation can be performed in children with complex congenital heart disease with success similar to that in patients with other cardiac diseases.

Original languageEnglish (US)
Pages (from-to)743-749
Number of pages7
JournalJournal of the American College of Cardiology
Volume26
Issue number3
DOIs
StatePublished - 1995
Externally publishedYes

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Heart Transplantation
Heart Diseases
Transplantation
Length of Stay
Tissue Donors
Ischemia
Infection
Hemorrhage
Transplants
Survival
Cardiopulmonary Bypass
Cardiomyopathies
Thoracic Surgery
Cause of Death
Atherosclerosis
Survival Rate
Lung

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Nursing(all)

Cite this

Heart transplantation in children with congenital heart disease. / Hsu, Daphne T.; Quaegebeur, Jan M.; Michler, Robert E.; Smith, Craig R.; Rose, Eric A.; Kichuk, Maryanne R.; Gersony, Welton M.; Douglas, Judith F.; Addonizio, Linda J.

In: Journal of the American College of Cardiology, Vol. 26, No. 3, 1995, p. 743-749.

Research output: Contribution to journalArticle

Hsu, DT, Quaegebeur, JM, Michler, RE, Smith, CR, Rose, EA, Kichuk, MR, Gersony, WM, Douglas, JF & Addonizio, LJ 1995, 'Heart transplantation in children with congenital heart disease', Journal of the American College of Cardiology, vol. 26, no. 3, pp. 743-749. https://doi.org/10.1016/0735-1097(95)00253-Z
Hsu, Daphne T. ; Quaegebeur, Jan M. ; Michler, Robert E. ; Smith, Craig R. ; Rose, Eric A. ; Kichuk, Maryanne R. ; Gersony, Welton M. ; Douglas, Judith F. ; Addonizio, Linda J. / Heart transplantation in children with congenital heart disease. In: Journal of the American College of Cardiology. 1995 ; Vol. 26, No. 3. pp. 743-749.
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abstract = "Objectives: The aim of this study was to describe heart transplantation in children with congenital heart disease and to compare the results with those in children undergoing transplantation for other cardiac diseases. Background: Reports describe decreased survival after heart transplantation in children with congenital heart disease compared with those with cardiomyopathy. However, transplantation is increasingly being considered in the surgical management of children with complex congenital heart disease. Present-day results from this group require reassessment. Methods: The diagnoses, previous operations and indications for transplantation were characterized in children with congenital heart disease. Pretransplant course, graft ischemia time, posttransplant survival and outcome (rejection frequency, infection rate, length of hospital stay) were compared with those in children undergoing transplantation for other reasons (n = 47). Results: Thirty-seven children (mean [±SD] age 9 ± 6 years) with congenital heart disease underwent transplantation; 86{\%} had undergone one or more previous operations. Repair of extracardiac defects at transplantation was necessary in 23 patients. Causes of death after transplantation were donor failure in two patients, surgical bleeding in two, pulmonary hemorrhage in one, infection in four, rejection in three and graft atherosclerosis in one. No difference in 1- and 5-year survival rates (70{\%} vs. 77{\%} and 64{\%} vs. 65{\%}, respectively), rejection frequency or length of hospital stay was seen between children with and without congenital heart disease. Cardiopulmonary bypass and donor ischemia time were significantly longer in patients with congenital heart disease. Serious infections were more common in children with than without congenital heart disease (13 of 37 vs. 6 of 47, respectively, p = 0.01). Conclusions: Despite the more complex cardiac surgery required at implantation and longer donor ischemic time, heart transplantation can be performed in children with complex congenital heart disease with success similar to that in patients with other cardiac diseases.",
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T1 - Heart transplantation in children with congenital heart disease

AU - Hsu, Daphne T.

AU - Quaegebeur, Jan M.

AU - Michler, Robert E.

AU - Smith, Craig R.

AU - Rose, Eric A.

AU - Kichuk, Maryanne R.

AU - Gersony, Welton M.

AU - Douglas, Judith F.

AU - Addonizio, Linda J.

PY - 1995

Y1 - 1995

N2 - Objectives: The aim of this study was to describe heart transplantation in children with congenital heart disease and to compare the results with those in children undergoing transplantation for other cardiac diseases. Background: Reports describe decreased survival after heart transplantation in children with congenital heart disease compared with those with cardiomyopathy. However, transplantation is increasingly being considered in the surgical management of children with complex congenital heart disease. Present-day results from this group require reassessment. Methods: The diagnoses, previous operations and indications for transplantation were characterized in children with congenital heart disease. Pretransplant course, graft ischemia time, posttransplant survival and outcome (rejection frequency, infection rate, length of hospital stay) were compared with those in children undergoing transplantation for other reasons (n = 47). Results: Thirty-seven children (mean [±SD] age 9 ± 6 years) with congenital heart disease underwent transplantation; 86% had undergone one or more previous operations. Repair of extracardiac defects at transplantation was necessary in 23 patients. Causes of death after transplantation were donor failure in two patients, surgical bleeding in two, pulmonary hemorrhage in one, infection in four, rejection in three and graft atherosclerosis in one. No difference in 1- and 5-year survival rates (70% vs. 77% and 64% vs. 65%, respectively), rejection frequency or length of hospital stay was seen between children with and without congenital heart disease. Cardiopulmonary bypass and donor ischemia time were significantly longer in patients with congenital heart disease. Serious infections were more common in children with than without congenital heart disease (13 of 37 vs. 6 of 47, respectively, p = 0.01). Conclusions: Despite the more complex cardiac surgery required at implantation and longer donor ischemic time, heart transplantation can be performed in children with complex congenital heart disease with success similar to that in patients with other cardiac diseases.

AB - Objectives: The aim of this study was to describe heart transplantation in children with congenital heart disease and to compare the results with those in children undergoing transplantation for other cardiac diseases. Background: Reports describe decreased survival after heart transplantation in children with congenital heart disease compared with those with cardiomyopathy. However, transplantation is increasingly being considered in the surgical management of children with complex congenital heart disease. Present-day results from this group require reassessment. Methods: The diagnoses, previous operations and indications for transplantation were characterized in children with congenital heart disease. Pretransplant course, graft ischemia time, posttransplant survival and outcome (rejection frequency, infection rate, length of hospital stay) were compared with those in children undergoing transplantation for other reasons (n = 47). Results: Thirty-seven children (mean [±SD] age 9 ± 6 years) with congenital heart disease underwent transplantation; 86% had undergone one or more previous operations. Repair of extracardiac defects at transplantation was necessary in 23 patients. Causes of death after transplantation were donor failure in two patients, surgical bleeding in two, pulmonary hemorrhage in one, infection in four, rejection in three and graft atherosclerosis in one. No difference in 1- and 5-year survival rates (70% vs. 77% and 64% vs. 65%, respectively), rejection frequency or length of hospital stay was seen between children with and without congenital heart disease. Cardiopulmonary bypass and donor ischemia time were significantly longer in patients with congenital heart disease. Serious infections were more common in children with than without congenital heart disease (13 of 37 vs. 6 of 47, respectively, p = 0.01). Conclusions: Despite the more complex cardiac surgery required at implantation and longer donor ischemic time, heart transplantation can be performed in children with complex congenital heart disease with success similar to that in patients with other cardiac diseases.

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