NEWBORN AND INFANT HEART-TRANSPLANTATION

Over a decade has passed since the first successful neonatal heart tra nsplant was performed for palliation of hypoplastic left heart syndrom e. Although neonates and infants represent a growing group of pediatri c heart transplant recipients, survival remains inferior to that in ol der children. Decisions regarding transplantation in infancy pose uniq ue problems for the pediatric cardiologist, including limited donor av ailability, pre-and posttransplant management, and improving results o f alternative palliative surgery for hypoplastic left heart syndrome. A number of recent articles provide important information about donor availability, waiting times to transplantation, and outcome after list ing and transplantation. Other studies focus on the treatment of infan ts awaiting transplantation. Important laboratory investigations repor ted this year focus on strategies for inducing immunologic tolerance ( the ''Holy Grail'' of the transplant physician) as well as ongoing res earch in the controversial area of xenotransplantation.