GROWTH AND NEURODEVELOPMENTAL OUTCOME OF INFANTS UNDERGOING HEART-TRANSPLANTATION

The purpose of this study was to examine the long-term growth and deve lopmental outcome of infants undergoing heart transplantation. We stud ied weight, length, and head circumference from birth to 12 months aft er surgery in 110 infant recipients less than 6 months of age. Forty-e ight early transplant recipients (0 to 30 days) were compared with 62 late transplant recipients (31 to 180 days). Late transplant recipient s showed less growth in all parameters at the time of transplant. Howe ver, by 6 months after transplantation, there were no differences betw een the two groups. Growth in 20 infants, now 3 to 7 years old, appear s normal. Neurodevelopmental outcome was evaluated prospectively in 57 infants. Four months after transplantation, 11 infants (19%) had abno rmal neurologic examinations, with generalized hypotonia (64%) being t he most common finding. The Bayley Scale of Infant Development was adm inistered to 48 of 57 infants. The Mental Developmental Index averaged 87 (+/- 21) and the Psychomotor Developmental Index averaged 90 (+/- 21). Of 140 infants who have undergone heart transplantation, transien t postoperative seizures occurred in 23 survivors (21%) and 10 nonsurv ivors (33%). Our findings suggest that growth, neurologic outcome, and development are normal in the majority of infants who undergo transpl antation before 6 months of age.