Long term results of pediatric heart transplantations - single center experiences.

BACKGROUND: Heart failure (HF) is characterized by significant mortality in both adults and children. Characteristic of paediatric HF are feeding problems, poor weight gain, exercise intolerance or dyspnoea. These changes are often accompanied by endocrine disorders. The main causes of HF are congenital heart defects (CHD) cardiomyopathies, arrhythmias, myocarditis or heart failure secondary to oncological treatment. Heart transplantation (HTx) is the method of choice for treatment of end-stage HF in paediatric patients.

AIMS: The aim is to summarize single center experience in heart transplantation in children.

METHODS: Between 1988 and 2021 in the Silesian Center for Heart Diseases in Zabrze 122 pediatric cardiac transplantations were performed. In the group of recipients with falling Fontan circulation HTx was performed in 5 children. The study group was evaluated for postoperative course: rejection episodes depending on the medical treatment scheme, coinfections and mortality.

RESULTS: 1-, 5- and 10-year survival rate between 1988 and 2001 were 53%, 53% and 50%, respectively. 1-, 5- and 10-year survival rate between 2002 and 2011 was 97%, 90% and 87%; between 2012 and 2021 1-year observation with survival rate 92%. The main cause of mortality both in early and in late period after transplantation was graft failure.

CONCLUSIONS: Cardiac transplantation in children remains the main method of treatment of end-stage heart failure. Our results at both early and long-term posttransplant period, are comparable to those obtained in the most experienced foreign centers.