Pediatric heart transplant survival in single ventricle disease

TL;DR

This paper discusses the challenges and outcomes of pediatric heart transplants, especially in children with single ventricle disease.

Contribution

The paper highlights the ongoing challenges in improving survival and outcomes for pediatric heart transplant recipients with single ventricle disease.

Findings

Patients with single ventricle disease face higher risks of rejection and severe hemodynamic compromise after heart transplants.

There has been little improvement in cardiac allograft vasculopathy and post-transplant lymphoproliferative disease outcomes over decades.

Survival rates remain poor for pediatric heart transplant recipients despite advances in medical care.

Abstract

Outcomes in pediatric heart transplantation have steadily improved since the first pediatric heart transplant was performed by Dr. Kantrowitz and his team in 1967; however, there is still progress to be made. Patients with congenital heart diseases (CHD) consistently have worse waitlist mortality, post-transplant survival, infection rates, and post-transplant lymphoproliferative disease (PTLD) risk, with single ventricle disease (SVD) patients being at particularly high risk for rejection and rejection with severe hemodynamic compromise (RSHC). Furthermore, there has been little improvement in the development of cardiac allograft vasculopathy (CAV) and PTLD over the decades, and survival following diagnosis continues to remain poor for all patients regardless of diagnosis. Hopefully, as new advances in immunosuppression, mechanical support, and surgical techniques emerge, we will continue to develop a deeper understanding of the co-morbidities associated with pediatric heart transplant to further improve the survival and quality of life of pediatric heart transplant recipients.