J Korean Med Sci.  2011 May;26(5):593-598. 10.3346/jkms.2011.26.5.593.

Heart Transplantation in Pediatric Patients: Twelve-Year Experience of the Asan Medical Center

Affiliations
  • 1Division of Pediatric Cardiac Surgery, Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. dmseo@amc.seoul.kr
  • 2Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, School of Medicine, Konkuk University, Seoul, Korea.

Abstract

Heart transplantation is a standard treatment for end-stage heart disease. Pediatric heart transplantation, however, is not frequently performed due to the shortage of pediatric heart donors. This is the first report of pediatric heart transplantation in Korea. Our retrospective study included 37 patients younger than 18 yr of age who underwent heart transplantation at Asan Medical Center between August 1997 and April 2009. Preoperative diagnosis was either cardiomyopathy (n = 29, 78.3%) or congenital heart disease (n = 8, 22.7%). Mean follow up period was 56.9 +/- 44.6 months. There were no early death, but 7 late deaths (7/37, 18.9%) due to rejection after 11, 15, 41 months (n = 3), infection after 5, 8, 10 months (n = 3), suspicious ventricular arrhythmia after 50 months (n = 1). There was no significant risk factor for survival. There were 25 rejections (25/37, 67.6%); less than grade II occurred in 17 patients (17/25, 68%) and more than grade II occurred in 8 patients (8/25, 32%). Actuarial 1, 5, and 10 yr survival was 88.6%, 76.8%, and 76.8%. Our midterm survival of pediatric heart transplantation showed excellent results. We hope this result could be an encouraging message to do more pediatric heart transplantation in Korean society.

Keyword

Pediatric Heart Transplantation

MeSH Terms

Adolescent
Arrhythmias, Cardiac/mortality
Cardiomyopathies/surgery
Child
Child, Preschool
Female
Graft Rejection/mortality
Heart Defects, Congenital/surgery
*Heart Transplantation
Humans
Immunosuppression/methods
Infant
Infection/mortality
Male
Postoperative Complications
Republic of Korea
Retrospective Studies
Tissue Donors
Treatment Outcome

Figure

  • Fig. 1 Recipient age distribution.

  • Fig. 2 Donor age distribution.

  • Fig. 3 Kaplan-Meier cumulative survival of patients.


Reference

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