HEART-TRANSPLANTATION IN CHILDREN AND YOUNG-ADULTS - EARLY AND INTERMEDIATE-TERM RESULTS

The purpose of this article is to report our short- and intermediate-t erm follow-up of cardiac transplantation for congenital heart disease and cardiomyopathy in children (age greater than 6 months), adolescent s, and young adults. Thirty patients (ages 8 months to 24 years) with end-stage heart failure have undergone cardiac transplantation in our program: 12 (40%) for postoperative end-stage heart failure, 9 (30%) a s primary treatment for congenital heart disease, 5 (17%) for dilated cardiomyopathy, and 4 (13%) for restrictive/hypertrophic cardiomyopath y. Nineteen patients (63%) had undergone prior operations; 4 patients received transplants for failed Fontan procedures. Induction therapy w ith antithymocyte therapy was used routinely, and long-term immunosupp ression was by cyclosporine and azathioprine alone. Rejection surveill ance/diagnosis was based on echocardiographic criteria. Posttransplant ation follow-up ranges from 3 to 78 months. Operative mortality was 3. 3% (1/30). No patients have been diagnosed with either accelerated all ograft atherosclerosis or posttransplantation lymphoproliferative dise ase. We conclude that cardiac transplantation may be performed with ex cellent early and intermediate-term results.