Cardiology Letters 2023, 32(3):175-184

25 years of heart transplantation in children in Slovakia - retrospective analysis of group

Lajmon M^{1, 2}, Záhorec M¹

¹ Detské kardiocentrum, NÚSCH, a. s., Bratislava

² Klinika detskej kardiológie LF UK a DKC, Bratislava, Slovenská republika

Aim: To evaluate the results of pediatric orthotopic heart transplantations (HTx), performed in the Pediatric Cardiac Center, National Institute of Cardiovascular Diseases (PCC NICD).

Methods: Retrospective analysis of patients who underwent HTx at PCC NICD from 1998 to 2022; the nature of the study was descriptive. Recipient peri-transplantation characteristics, long-term and early morbidity and mortality were analyzed.

Results: In almost 25 years, 19 HTx were performed at PCC NICD, with a patient's median age of 4.25 years (0,2-19.5) at the time of HTx. The preoperative diagnoses were cardiomyopathy (CMP) (n = 13) and congenital heart disease (CHD) (n = 6). Six patients were on mechanical circulatory support as a bridge to HTx: a fully implantable left ventricular assist device was used in one patient. Blood group AB0 compatible transplantations were performed in all patients; neither retransplantation nor HTx in a patient with univentricular circulation was performed. Overall survival at 5 years was 74%, median follow-up was 1226 days (19-8248). A trend towards higher survival in patients with CMP compared to patients with CHD was observed. Early in-hospital mortality was recorded in 2 patients, late mortality was recorded in 5 patients. Causes of late mortality were acute graft rejection (n = 2), sudden cardiac death (n = 1), chronic renal failure (n = 1), and post-transplant lymphoproliferative disease (n = 1).

Conclusions: HTx is an integral part of the complex care of a pediatric patient in the terminal stage of heart failure. Patients after HTx require advanced medical care. For CMP patients transplanted at PCC NICD, survival is comparable to previously published studies. With the development of modern treatment approaches, long-term outcomes for these patients are improving.

Keywords: heart transplantation; pediatrics; congenital heart defects; cardiomyopathy

Published: March 1, 2023  Show citation